Alberta Lawyers' Assistance Society

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Lawyer Mental Health and Stigma - June 2021

LAWYER MENTAL HEALTH AND STIGMA - JUNE 2021
 
It is hard to write a light-hearted blog about stigma and mental health issues in the legal profession. I am afraid that today’s topic will be a bit on the dry side, but it is important because there are actions we can take, and we can start with completing the National Lawyers Well-Being Study.
 
Here is the context for my comments today: I have heard stories over the last few years about senior lawyers telling a more junior colleague that any lawyer who is using Assist’s services should not be practicing law. In other words, any lawyer who is participating in our programs is either unfit or incompetent. You may think that I am hearing old stories, or—being a bit on the older side—I am remembering stories I heard years ago, but unfortunately that isn’t true.
 
I think that there are many lawyers who think that Assist is basically helping down-and-out lawyers who are living on the margins. Just like an old kids’ camp song that some of you may remember that had a chorus that went “Put a nickel in the drum, save another drunken bum.” Assist is not that. While of course we want to help lawyers whose situations are dire, whether through substance use, mental health or other situations, the reality is that most lawyers we work with are practicing law without any red flags regarding fitness.
 
When Assist began as a Lawyers Helping Lawyers organization, its volunteer lawyers would reach out to colleagues who were noticeably demonstrating problematic behaviours, like being impaired during court appearances or acting irrationally in public. As you can imagine, it took a fair bit of evidence that a colleague was struggling for interventions to occur. This may explain the idea that Assist’s clientele was lawyers whose practices were impacted by substance use or serious mental illness.
 
However, Assist has had a much broader mandate for quite some time now, which includes supporting lawyer well-being proactively. Research shows that the earlier you address a mental health issue, the more easily (and cost-effectively) it is resolved. So, we want people coming to us with early signs, rather than waiting until they have full-blown disabilities.
 
Secondly, if lawyers who seek counselling through Assist (or through any other provider) are assumed to be unfit to practice law, our profession has a big problem. Since 2008, more than 21% of Alberta lawyers have accessed our counselling services program (and we know that many lawyers also have access to EAPs or choose to pay privately).
 
In 2019 alone, Assist had more than 1000 individual cases, with a usage rate of more than 10% of eligible users. If using our program means that a lawyer is not competent to work, then we would have an awfully large number of lawyers out there endangering the public. Clearly, this is not true.
 
And yet stigma remains. But I know that stigma grows best in the dark. The more that we shine a light on the mental health challenges in our profession and reveal that most lawyers continue to practice safely and effectively while being treated, the more stigma will recede. So today we are shining our light on stats (yes, because I love data but also because they are essential to data-based decision-making, a process we, as lawyers, embrace) but also to help us understand lawyer distress, stressors and solutions.”
 
Being fit to practice law is important. We are entrusted with rights and obligations by virtue of the office we hold. We need to take care of ourselves to ensure that we are able to protect other people’s interests to the best of our ability. This can involve both our physical health and our mental health.
 
However, the mere fact of having a physical or mental health issue does not mean that you are unable to practice law. Like just about everything in our world, our health exists on a continuum. Just as there are many stops along the way from perfect cardiac health and cardiac arrest, there are many stops along the way between perfect mental health and incapacity. However, we express sympathy for the lawyer who has a heart attack in the middle of a huge file, yet we blame the lawyer who has a mental health breakdown in a similar situation.
 
And just as we may make lifestyle changes when our physician identifies concerns about our hearts or other vital organs—warning signs—we may want to make changes when we realize that we are experiencing mental health warning signs. Assist is here for people who realize that their mental health isn’t quite what it used to be. There are checkups that our counsellors, or your family doctor, can perform, and there are therapies and practices that lead to improved mental health.
 
Unfortunately, stigma about mental health issues creates barriers to help-seeking. If you work at a firm where lawyers seeking mental health supports are assumed to be incompetent, you are going to be reluctant to seek help. And if you do seek help, you are going to do your utmost to ensure that no one knows. You may know that you are still capable of practicing law effectively, but what will happen if your co-workers start to suspect that there is something wrong with you?
 
One of the best ways that we can battle stigma in our profession is through education, and education is based on empirical data. This is why I want to urge everyone to participate in the National Lawyer Well-Being study.
 
The Alberta legal community hasn’t participated in a well-being study since the CBA Ipsos Reid survey in 2013. This was a ground-breaking study, but it is getting a bit dated. The Federation of Law Societies and the CBA are partnering in a new national study (which, no doubt, will break out data by province so we can learn more about mental health among Alberta lawyers.) To learn more about the study, and to participate, please read your e-bulletin from the Law Society on June 10th.
 
How helpful is the data being gathered in this study? Very. This study is based on a study of Quebec lawyers conducted from 2014 to 2019. Here is a sample of data from the Quebec study:
  • 43% of study participants scored high for psychological distress
  • Younger lawyers, with less than 10 years in practice, had higher distress levels (49.9%) than lawyers with more than 10 years in practice (36.7%)
  • The proportion of distress is higher among women (44%) than men (39%)
  • Practice areas with the highest rates of distress were
    • Litigation: 51.5%
    • Corporate/Commercial/Business: 49.4%
    • Family law: 49.1%
  • Lawyers in private practice had higher rates of distress (49.7%) than in the public sector and in-house (both 37.4%)
 
The trends in this data are consistent with Assist’s usage rates—more women use our services than men, and the practice areas that account for the most cases are litigation (21%), general practice (19%) and family (15%) in 2020. Corporate/Commercial lawyer usage has been in the top three practice areas in other years.
 
These trends are also consistent with a recent American study of lawyers—see my blog “Stress, Drink, Leave”. The consistency of data across many studies and in different jurisdictions confirms the reality of mental health challenges in law.
 
The Quebec study also measures burnout, using a widely-accepted inventory.
  • 19% of lawyers scored high for burnout
  • Young lawyers (22.4%) are more affected by burnout than older lawyers (16.5%)
  • Private practice lawyers (22.8%) have higher rates of burnout than public sector (17.1%) and in-house (15.2%)
  • By practice area, family law has the highest burnout rate (29.7%), followed by criminal lawyers (28.2%) and litigation (23.1%)
 
When distress and burnout are looked at together, Quebec lawyers in private practice have lower well-being averages than public sector and in-house lawyers, and litigation and family lawyers have the lowest well-being averages while labour lawyers have the highest well-being averages.
 
In addition to practice area, years of experience and practice type (private practice versus public sector or inhouse), the Quebec study identified additional risk factors at the social, organizational, family, and individual levels. Social factors impacting distress and burnout include being a member of a regulated profession and demands created by technology. Organizational risk factors include job insecurity, emotional demands, and high billable hour requirements (where applicable). At the family level, work-family conflicts are associated with distress and burnout, and at the individual level, having an external locus of control is linked with distress, burnout, and lower levels of well-being. Women have higher risks of burnout.
 
It is important to recognize that just as we each have risk factors that increase likelihood of negative outcomes, we also have protective factors. People with enhanced social images appear to have lower levels of distress, and having harmonious and collegial relationships with peers is also a positive factor. Having social supports outside of the workplace and having dependent children are associated with well-being (lower psychological distress and burnout). At the individual level, having self-esteem and having values that align with workplace values also reduces distress and burnout.
 
Unfortunately, being a young lawyer often means that your self-esteem is regularly called into question and some of your work relationships are harsh. You work long hours, which is hard on both your social and your family relationships. You can see how these factors all interact. 

When I was a young lawyer, we used to refer to the process that students and young lawyers go through to learn to think and act like lawyers as Stockholm Syndrome. It often felt like senior lawyers were tearing you down to your core and that then, in order to adapt and rebuild, you became what they wanted you to be.

And we shouldn’t underestimate the value of relationships with dependent children. It was the birth of my oldest son that freed me to be who I really was, and not what my firm wanted me to be. The data from this study certainly rings true to me.
 
This is why I am excited about having comparable Alberta data that shows well-being trends across practice types and areas correlated to well-being—we need accurate snapshots of how much distress and burnout is being experienced by Alberta lawyers, which may help normalize these issues and seeking help within our profession.
 
Once we have this data, individuals who are in a practice type associated with higher levels of distress and burnout can then recognize their increased risk and then look at mitigating factors, like ensuing family and social support and are working in a workplace that aligns with their values. And knowing the link between certain practice types and areas with distress and burnout may equip a lawyer to adapt their work situation to something that works is healthier for them.
 
With data, organizations can recognize that internal tweaks might mitigate some of the ravages associated with high-risk practice areas—does having a high billable hour quota for lawyers conducting high stakes litigation make the most sense from a long-term point of view? And can the organization enable greater senses of job security and internal loci of control to compensate?
 
As a profession, we can be informed about the levels of distress and burnout common among us and understand that lawyers who are experiencing distress or burnout are not morally culpable or “lesser than.” They are simply lawyers whose work and lives have worn them down because of factors known to have these effects.
 
So, please take the time to complete the National Well-Being Survey. The survey takes 30 to 45 minutes to complete, and it is designed to allow you to leave and resume where you left off as necessary.
 
We can make better decisions, both personally and collectively, when we have accurate data, and we can use good quality data to fight stigma.  Please help make this survey the most meaningful it can be by including your data an encouraging your friends and colleagues to complete it as well.
 
Loraine