It’s the Family Day long weekend!
When Alberta’s then Premier Don Getty created Canada’s first provincial February statutory holiday in 1990, he reportedly intended the holiday to assist in reducing drug addiction and to celebrate the importance of families. Thirty-three years later, I don’t think Family Day has led to victory in the war on drugs, and most of us tend to view Family Day simply as a day off.
This week, I have been thinking about newly released research about lawyer mental health out of the US, titled “Stressed, Lonely, Overcommitted: Predictions of Lawyer Suicide Risk” (the Krill Study). From the title, you may be able to guess what this study indicates.
However, I don’t think any of us would have predicted one shocking finding from this study:
Compared to lawyers with low perceived stress, those with high or intermediate stress levels were 22 times more likely and 5.5 times more likely, respectively, to endorse suicidality. (Page 8).
That isn’t a typo—it is supposed to be twenty-two. Lawyers with high stress levels were 22 times more likely to have suicidal ideation than lawyers with low perceived stress. And lawyers with intermediate stress levels were 5.5 times more like to have suicidal ideation than their less-stressed peers. Suicidal ideation appears to increase exponentially with stress levels, and since law is an inherently stressful profession, we need to think about this means both for us as individuals and as a profession.
The Krill Study surveyed a random sample of California and District of Columbia lawyers during the summer of 2020, when COVID-19 had changed our society and workplaces. The researchers cite the American lawyer suicidal ideation rate from the ground-breaking 2016 ABA lawyer mental health research in which more than 11% of participant lawyers reported having experienced suicidal ideation since beginning their legal careers. Researchers noted that this suicidal ideation rate was more than double that of the American general population.
I had found the 11% suicidal ideation figure shocking but was utterly gobsmacked when I saw the rate of suicidal ideation for Canadian lawyers since commencing practice in the National Study on the Psychological Health Determinants of Canadian Legal Professionals –more than 22%! The Canadian survey was completed during 2021, while the pandemic was still actively affecting all of us. But one in five lawyers having thoughts of suicide is a serious situation that requires a response from all players in the legal sector, and not just individual lawyers.
We know that law is a stressful career—the Krill Study authors note that “lawyers are expected to work long hours, meet tight deadlines, and handle complex legal issues, all while maintaining a high level of professionalism and client satisfaction.” They report that these factors all lead to burnout and overwhelm which have previously been linked to suicidal ideation. Other key factors linked to suicidal ideation include work-family conflict, alcohol use, and pre-existing mental health diagnoses.
Lawyers are skeptics and I can imagine that many lawyer-readers of the Krill Study will question the validity and accuracy of these findings.
First: how did they measure stress since levels of stress that were tied to suicidal ideation? The Krill Study used the ten question Perceived Stress Scale to assess “how unpredictable, uncontrollable and overloaded respondents found their lives.” You can check out the ten question Perceived Stress Scale here along with an empirical review of the ten question Perceived Stress Scale which finds the ten-question instrument to be valid: https://www.sciencedirect.com/science/article/pii/S1976131712000527.
Secondly, how accurate is the instrument used to measure suicidal ideation is considered highly accurate? Very, says a recent review of the validity of the instrument.
FULL STOP: If you have suicidal thoughts, please don’t ignore them. Please call our professional counsellors for assistance, which includes 24/7 crisis counselling: 1-877-498-6898 (after hours, press 0 to be connected to the psychologist on call.)
Finally, and this is a popular basis for discounting lawyer well-being surveys, does selection bias taint the result, i.e., did only lawyers who were feeling extremely stressed or had suicidal ideations bother to complete the survey? This is always a possibility when a large pool of candidates are invited to participate in a study, but the Krill Study addressed this risk by randomly inviting 40,000 of the 169,000 eligible lawyers from California and DC to participate. About 5300 lawyers from the random group agreed to participate in the survey with about 4000 actually completing the survey.
One American study found that lawyers were not uniquely unwell when compared with veterinarians, doctors, and dentists (perhaps not the most well groups, either) but we drink excessively at higher rates. This study used data from the National Health Interview Survey (NHIS) administered by the U.S. Centers for Disease Control. But the skeptic in me questions whether individuals gloss over mental health issues when completing a survey for a branch of government. Do people trust government agencies with this type of information? I don’t have a study about that, so it is just a question from me for those who are questioning the mainstream lawyer well-being studies.
Even if we discounted the rate of suicidal ideation of highly-stressed lawyers by 50%, we would still have more than one in ten highly-stressed lawyer experiencing suicidal ideation which would still be of great concerns. And the trends reported in large lawyer mental health studies tend to be relatively consistent across different countries which adds validity to me—these are not one-off studies that are never replicated.
Practicing law is stressful, as is life, and I vividly remember the day I decided to leave private practice when my stress level both personally and at work was over-the-top. I had a fifteen-month-old son and was pregnant. I was already working on a reduced hours basis but I did deal work so the hours could still be crazy. I was waiting for additional testing since a recent obstetric ultrasound revealed the possibility of a serious genetic disorder in my yet-to-be-born baby’s brain, and I was waiting for a more intensive ultrasound to search for a second cyst which would be an indicator of a usually fatal genetic disorder, in which case difficult decisions would be on the table. My sister, who lived with us, had a medical emergency one evening and I had to take her to the local ER along with documents I needed to revise for the next day. On the Friday of that same week, I was trying to file something with the securities commissions—probably a prospectus but I don’t really remember.
While getting dressed for work for my terribly important day, out of the corner of my eye, I saw my toddler put something in his mouth. It turned out to be a Tylenol tablet that had apparently fallen to the floor.
I was pretty sure that he hadn’t ingested a pill—Tylenol tablets are large and bitter-tasting--so I told myself that everything was probably fine and left for work.
But I felt sick about the whole situation as I drove downtown for my terribly important day, and the first thing I did when I got into my office was call the Poison Control Centre to ask how dangerous ingesting even a small amount of Tylenol would be for a toddler. They told me that I needed to take my son to the ER immediately and said that they would call the hospital closest to me to say that I was on my way. They asked what my estimated time of arrival at the hospital would be. I was too mortified to tell them that I had left my child and gone downtown. I said I would be there in half an hour, handed my terribly important file off to another lawyer, begging for help, and rushed to pick up my toddler and convey him to the ER.
The protocol at the ER was to test blood for acetaminophen but to administer activated charcoal to neutralize the potential presence of the acetaminophen without waiting for the blood test results. The procedure was awful—they pour the activated charcoal down the child’s throat while a few staff hold the child down. And when the blood test results came back, there was no indication that he had ingested any acetaminophen.
I took my son back home, dreading my return to the office. I don’t think my colleague actually made any calls or advanced my file—but all parties had become comfortable with pushing the filing date out a few days.
I swore that I would never put myself in that position again and began to develop a plan for how I would restructure my career after my second maternity leave. It involved taking some risks. I left a highly desirable (in law culture) position for a contract position as part of a job-share at much-lower rate of pay than I had hoped for, but I accepted it, and launched into my three day per week with all the vigor (over-commitment?) that I had brought to private practice. Within six months, the corporation’s General Counsel offered both my partner and me permanent part-time positions and promoted us to Senior Corporate Counsel, which included a raise—not the type of salary that I could earn in private practice, but decent money for an interesting job that offered work-life balance.
I have no regrets about exiting private practice and embarking on a journey to find work-life balance (which, incidentally, included needing to rein in my tendency towards overcommitment). I have enjoyed most of the practice roles I have had since then most of the time—it would be unrealistic to expect any more than that, and I love where I landed twenty-five plus years later.
But when my family stress was high and my work stress was high, I opted to reduce the intensity of my work stress, perhaps moving from high stress to moderate or even low stress. I don’t think I experienced suicidal ideation—I just wanted to opt out of my high-stress job and pursue a career that had a bit more room for family emergencies. My sister recovered from her injury, and the intensive ultrasound allayed the risk of a genetic disorder in my unborn baby, and my life became less chaotic, eventually.
Sometimes we have to make changes. When we work in private practice, it is primarily what we know and, even if we are unhappy, inertia sets in and we stay. All law jobs have stress. But they differ in whether the stress is relentless and terrifying or intermittent and in a manageable range. We each also find different types of stress more manageable. No law job is going to be stress-free, but they are stressful in different ways, so we should explore work opportunities that are manageable according to our own stress profile.
The powers that be in the legal profession must now digest both what the National Study and this latest American research report tell us: there is dysfunction embedded in our culture. The National Study named billable hours as a key detriment, while the American research focuses more on the results, like overcommitment and work-life conflict.
The American research notes:
Stress should be a primary target of suicide prevention and mitigation strategies…. A twofold strategy whereby stressors in lawyers’ lives are reduced, and their stress tolerance is enhanced, would seem to be the most efficacious approach for mitigating the stress-suicidality risk. To date. However, most efforts to reduce stress within the legal profession have tended to target the individual, e.g., through the provision of personal stress management tools and self-care resources. Where employers have attempted to address the more structural and systemic precipitators of stress (i.e., unrealistic time pressures, unclear expectations, workload control, lack of feedback), employees have generally rated their efforts as “highly ineffective.” Simply put, it would seem the legal profession has been better at alleviating the effects of stress than in throttling the causes.
Assist, and our colleagues across North America, are here to support law firms, regulators, legal educators, and others in the legal support sector as we take steps to improve aspects of culture that are harmful to health. We are happy to come to your workplace to talk about strategies at an organizational level.
And of course, we continue to be here for individual lawyers with professional counselling, peer support, education and community, our core programs. If you are feeling your work stress is high and that you are overcommitted—please call use. We are here to help you.
As we head into Family Day weekend, however you celebrate the day off in February, please stop to think about yourself and your well-being, and what you need. Whether the people you view as family are biologically or legally related to you or whether you have chosen them (your brothers from another mother and your sisters in spirit if not in blood), you are important to them. The best Family Day gift we can give our loved ones is to be there with them and for them.
Most of all, I hope that you can psychologically detach from your work role. Psychological detachment—turning your brain off from work, essentially—is a skill which has protective properties for lawyers, according to the National Study. And remember that skills are not innate talents. They can be learned.
Here are four tips for psychologically detaching in your downtime:
1. Educate yourself about what activities allow you to detach, usually because of your degree of engagement. I am a big barre class fan—if you aren’t truly in the moment mindfully following movement instructions, you realize that everyone else has moved on and you are the only one still doing lunges or mountain climbers!
2. Consider a transition ritual that helps you disconnect from work, perhaps listening to music or a podcast during your commute.
3. Check your focus periodically to ensure that you are not drifting back to work thoughts.
4. Disconnect from electronics when possible.
If you feel that your lawyer role—or law student role—takes you away from your family more than you would like on a recurring basis, please remember that there are many ways you can practice law. We are not all the same and we do not have to be on the same path. Assist’s professional counsellors can help you if you are considering career transition, and our peer support volunteers can share their experiences and provide personal support and encouragement.
Call us. We are here for you.