The legal field has high rates of substance use, mental illness
More than a third of Americans show signs of clinical anxiety and depression, according to Census Bureau data released in late May.
While these numbers represent an increase over pre-pandemic results, for lawyers across the country, the risk of depression, anxiety and substance abuse was already at dangerous levels according to a 2016 study in the Journal of Addiction Medicine.
This study found that 20.6% of avocados had a score corresponding to problematic alcohol use. The levels of depression, anxiety, and stress were also significant, with 28%, 19%, and 23% showing symptoms of depression, anxiety, and stress, respectively.
The study highlighted the need for more resources for lawyer assistance programs across the country as well as the expansion of prevention and treatment interventions specific to lawyers.
The New Hampshire Attorney Assistance Program, which began in 2007, assists New Hampshire attorneys, judges and law students with mental health and addiction issues.
Jill O’Neill, who took over as executive director of NH-LAP on July 6, said she is committed to working with New Hampshire attorneys to overcome the obstacles they face in securing l help with addiction and mental health issues. O’Neill has spent the past 19 years with Greater Nashua Mental Health, where she has held various roles providing services to individuals and families seeking care.
“My lifelong passion is helping people. I grew up with a parent struggling with mental health and addiction issues and when I got to college I wanted to understand the biology behind it. Once I could start helping others, it became a passion, ”says O’Neill.
One of the programs she became familiar with during her tenure at Greater Nashua Mental Health was a diversion program in which she first witnessed the many stressors affecting lawyers.
“I was in court every day and started to make personal connections with various legal professionals. This is where I really began to understand the dynamics of legal culture and the stressors that go with it.
O’Neill recalled waiting for court hearings and being approached numerous times by lawyers who were disclosing their issues.
“Sometimes you could see the relief in their faces just by validating their concerns,” she said. “When I heard about this job I thought, ‘this is really important’ and felt like I could make a dent in the job in terms of education and elimination of mental health barriers. ”
Some of the obstacles O’Neill talks about were described in the Journal of Addiction Medicine in 2016 as well as a 2020 study on stress and resilience in the judiciary. Some of the stressors for judges in the report included: the importance and impact of decisions; a heavy business case; unprepared avocados; and public ignorance of the courts.
Cecie Hartigan, acting director of NH-LAP since February 2021, and the organization’s first executive director, serving from 2007 to 2017, says some of these obstacles for lawyers include issues with perfectionism and fear of making mistakes. errors. She teaches a course at UNH Franklin Pierce Law School that deals with this topic, which she says is always well attended.
“And when you add ethics to perfectionism, failure and mistakes are not an option,” says Hartigan. “There is a lot of anxiety around the courts and people feel the need to appear invincible. ”
While Hartigan says breakthroughs have been made in terms of speaking openly about mental health and substance abuse, the battle continues.
“When you add the training, rationalization, and great intelligence that many lawyers have to something like drug addiction, you can really create a battle for people to get help. But it’s a beautiful thing when people get help.
Lisa Houle, Concord’s licensed mental health and substance abuse counselor, specializing in concurrent disorders, has been with the NH Lawyer Assistance Program for over 10 years.
A concurrent disorder occurs when a person suffers from two or more mental health disorders or medical illnesses. Typically, says Houle, those who abuse substances have an underlying mental health problem such as anxiety and / or depression.
“I have dealt with many, many lawyers and I have spoken to law school in the area of law having inherently higher stress incidents as well as a higher incidence of anxiety disorders, substance use disorders and depression. ,” she says.
Houle says lawyers are her favorite population to work with because of their personality dynamics.
“As a rule, lawyers have very driven Type A personalities and are very perfectionists,” she says. “They tend to overwork, but because of that motivation, they also have a high rate of success and recovery from substance use disorders or any of the mental health issues that can accompany this type of. personality.”
Therapy, Houle says, typically lasts between one and two years, but she sometimes receives phone calls from lawyers needing help after being out of therapy for long periods of time.
“Lawyers have contacted me after their initial therapy to ask for help again and I am always happy when they contact me. ”
Tackling the roots of mental health and addiction issues is Houle’s goal in his work. But, she says, this cannot be achieved with “quick interventions” such as cognitive behavioral therapy.
“These approaches are band-aids and I do this job every day and it’s great. But it will not be a curative preventive work that will last, ”she said. “People have to be prepared to accept that this is a longer term process if you are to get to the root of the pain and trauma.”
Getting to the root of the trauma requires asking tough questions, says O’Neill. One of these questions is “are you planning to kill yourself?” ”
Suicide is the third leading cause of death after cancer and heart disease, and research indicates lawyers are the “most depressed” of the 105 professions surveyed, according to the American Bar Association.
Hartigan drew attention to a recent video produced by the Texas LAP program on suicide as a sign of progress but also as a warning.
According to the National Institute of Mental Health, compared to 14 suicide deaths per 100,000 deaths (in 2019) in the general population, the national average rate for lawyers is 66 suicides per 100,000 deaths. This means that lawyers are almost five times more likely than the general population to kill themselves.
As the director of NH-LAP, Hartigan received a certificate for a QPR or “Question, Persuade, Refer” program that seeks to identify suicidal behavior and says that without this training she would not have known how to approach the problem. suicide problem with individuals.
The first step is to ask the question “are you planning to kill yourself?” ”
“If they think about suicide, they’ll tell you,” says Hartigan. “This is one of the most important things I learned and repeated over and over again with lawyers. It’s so confrontational, but for the person having the problem, sometimes, as the video shows, they often wait for someone to ask them.
Sara Giddings, a Texas tax lawyer, says the first time she tried to kill herself was when she was 16. uselessness.
“I think people fear that if you ask someone about suicide, you’re going to put the idea in their mind. No one ever thought I should try to kill myself. The idea was already there. The worst part is when you notice that something is wrong and you never say anything.
O’Neil cited an interview in the movie with Chris Ritter, director of the Texas Lawyers’ Assistance Program, as a good example of how people can’t find out what’s going on with someone until they ask for it.
Ritter describes having the best year of his life professionally in 2007 while feeling miserable emotionally.
“From the outside, I felt like everything was fine. Inside, I didn’t want to exist, ”he said.
The New Hampshire Bar Association recently adopted the American Bar Association’s Lawyer Well-Being Pledge, which is designed to address disturbing rates of alcohol and other substance use disorders, as well as mental health problems.
Hartigan says the pledge initiative is timely as there is greater overall awareness of the welfare of lawyers.
“The choice of the Bar Association to make the pledge is a good step in the right direction, especially with the effects of Covid on mental health and addiction issues,” she said. “I don’t know the full extent of the pandemic, but we have every reason to believe it has been difficult for lawyers and one of the things these initiatives do is educate people and remind them that ‘they don’t need to be afraid to ask for help. ”
The New Hampshire Bar Association is one of many legal organizations in the state that have made a commitment to the Promise of Wellness. Hartigan says she hopes the New Hampshire Supreme Court will also adopt the “seven points” of the pledge at a future meeting later this year.
Hartigan also says she hopes the momentum toward mental health and substance abuse awareness continues at Concord Law School. She teaches there about perfectionism – how not to let it take precedence over her life – and the character and fitness process that lawyers go through before being excluded.
“The character and fitness process is a great place to reach people. Sometimes people come over there with red marks on their resumes that we’ve never had, like alcohol offenses, ”she says. “I explain to them that in the 1970s, when I was driving drunk, the police brought me home. They need to hear that they can be honest.
While the pandemic has led to an increase in mental health problems, Hartigan says there are positives, too.
“People have opened up to the idea of arranging virtual office hours for one-person attorney assistance. They didn’t like the idea of me being in there, but we’ve come a long way.
And O’Neill highlighted the reshaping of values and lifestyle reflected by the record number of people working from home.
“Being able to take a break from the hamster wheel to do it all is important and things change in the professional workplace,” she says. “This is why I think wellness initiatives are really important around issues like ‘how not to come back entirely to what was not working’ and ‘how can we learn from them and create flexibility. to create balance and take care of yourself “.”
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