Publications on the mental health issues facing law students and legal professionals are legion. At this point, it is safe to assume most, if notall, of us have heard some of the staggering statistics on depression, anxiety, substance abuse, and suicidal ideation. Approximately one year ago, research out of Harvard summarizing data provided by nearly 900 law student participants, indicated the following:
- 25% reported suffering from depression (compared to only 7% of the general population) with only 33% of those reporting depression receiving treatment.
- 2% reported suffering from anxiety.
- 5% were at a heightened risk of suicide.
- 66% indicated they experienced new mental health challenges during law school.
- 1% said they experienced frequent or intense instances of imposter syndrome.
- 2% stated they had zero people with whom they could fully disclose their most private feelings without holding back.
- Only 8% indicated feeling comfortable approaching faculty with a mental health concern.
More recently, research conducted collaboratively by the Hazelden Betty Ford Foundation and the ABA Commission on Lawyer Assistance Programs revealed similar statistics among licensed, employed attorneys, based on a sample of nearly 13,000:
- 6% screened positive for hazardous, harmful, or alcohol dependent drinking.
- 7% reported suffering from depression at some point in their legal career.
- 1% reported suffering from anxiety at some point in their legal career.
- 5% reported suicidal thoughts and 2.9% reported self-harm behaviors.
What is equally distressing is that barriers to treatment, actual and perceived, are just as prevalent and effectively prevent individuals from seeking the help they need. Among the most common are not recognizing the need for treatment (feeling that levels of stress or anxiety are “normal”), perceived ineffectiveness of treatment, problems with accessing services, lack of time or money needed to engage in treatment services, and social stigma related both to admitting a mental health problem and to seeking treatment.
For students and practitioners in law, it is this social stigma that is perhaps the most powerful force acting against treatment-seeking. Not only are individuals concerned about impacts upon their interpersonal relationships, but also about the consequences that may arise when mental health problems or treatments are disclosed, voluntarily or involuntarily, to their state bar.
In the Harvard study, 19 percent of respondents indicated a reluctance to seek assistance for mental health struggles due to concerns about bar eligibility. Such concerns are not without merit—certain character and fitness questions regarding law student mental health have been found to be discriminatoryor in violation of the Americans with Disabilities Act (“ADA”).
Likewise, in the Betty Ford/ABA study of lawyer impairment, the most common barrier to treatment cited by practicing attorneys with mental health problems—“not wanting others to find out that they needed help.”
In the face of such challenges to alleviating the psychoemotional hardships that plague our profession, and given the unabating severity and prevalence of the symptoms and conditions students and lawyers are currently enduring, progress has been limited. Resilience-based interventions appear to be among the most popular approaches to stem the tide, but are they enough?
The contemporary emphasis on resilience is applicable and helpful in addressing the hardships of law school and legal practice; however, it tends to be a reactive approach to managing psychoemotional distress.
The American Psychological Association defines resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress.” Being resilient is embodied by mental fortitude, strong leadership skills, high levels of professional or academic performance, and unwavering tenacity. The key to developing these traits is perception, particularly with regard to stressors, challenges, or adversity. The reactive nature of resilience is apparent in the emphasis upon how individuals will respond after a negative occurrence.
Scholarly consensus indicates that resilience can be taught, practiced, and continually improved. Unfortunately, what becomes increasingly apparent in the legal profession, is that law students and lawyers are taught to be skeptical, pessimistic, and even a little paranoid in their thinking in order to identify and anticipate worst-case scenarios. This approach is great for getting out in front of clients’ problems, but is less so for a lawyer’s own mental health.
Research by Dr. Larry Richard, an expert in lawyer personality and resilience, among related subjects, indicated that approximately 90 percent of lawyers scored below the 50th percentile on assessments of resilience, with the average among lawyers falling near the 30th percentile—substantially and alarmingly lower than the general population.
According to Paula Davis-Laack, a notable leader in the promotion of resilience among lawyers, one possible reason for generally low levels of resilience within the legal profession is the combination of lawyers’ high levels of skepticism and low levels of sociability, which undermines the development of both flexibility in thinking about challenges and adversity, and which hinders the cultivation of high-quality interpersonal connections.
In an effort to surmount these inherent difficulties to building resilience in a population frequently characterized as cynical, skeptical, critical, pessimistic, or negative, numerous workshops and training programs have been developed specifically for lawyers, such as the Lawyer Strong® Resilience & Burnout Prevention Programs.
If naturally more inclined or if successfully trained, a most resilient lawyer tends to exhibit an array of positive outcomes:
- Higher stress tolerance and healthier coping strategies
- Increased confidence about the future
- Greater persistence in the face of adversity
- Higher levels of achievement motivation
- Increased flexibility and adaptability
- More easily developed and maintained interpersonal relationships
In consideration of the unique challenges to building the skills associated with psychological resilience within our field, the ABA Career Development Series and the ABA Law Student Division both provide information specifically tailored to the development of such skills among lawyers; however, while a cursory search of the ABA website revealed thousands of search results for “resilience” or “resiliency,” a search for the word “prevention” returned markedly fewer resources.
None of this is to say that resilience is ineffective; in many cases, it is. Nor is it to say that resilience does not have a protective capacity against negative outcomes, because it does. Yet the data does not suggest that the psychoemotional wellbeing of law students and lawyers is improving. The statistics above make this dismal reality quite clear.
Given that the intrinsic qualities of legal study and practice are not cohesively aligned with a resilient mindset, perhaps it is time to look beyond the promotion of resilience to what else that may be done to potentially prevent the need to be so resilient in the first instance. Could we, as a profession, collectively cultivate a social environment that is holistically more supportive of mental health so the burden doesn’t fall to each individual to steel themselves against negative influences?
Prioritizing the identification and promotion of mental health protective factors has a greater capacity to positively influence the social environment and to potentially prevent negative outcomes.
Resilience is a necessary tool in withstanding the inevitable hardships of life; however, it is not the only tool upon which individuals can rely. Resilience can help law students and lawyers endure the monumental pressures we have chosen to bear in our studies and in our work; but mere survival tools should not be at the forefront. When so many of us are floundering, failing, giving up, and contemplating ending it all, a more proactive approach is called for to potentially facilitate a thriving existence within our profession.
In providing resilience-based mental health prevention and intervention programs, the legal profession is consistently supportive of assisting students and practitioners with their struggles; however, to comprehensively address the present epidemic of mental health problems in our field, an equally exhaustive approach is necessary. This would include psychoeducation to increase awareness, sociopolitical advocacy, and collaboration with mental health professionals to effectively determine when and how to introduce therapeutic services for the greatest impact.
Recent psychological research indicates that resilience may be weakened by inadequacies in social support and feelings of isolation, leading to a cycle of increased stress and increasing needs for support. In turn, that pattern could lead to a student’s attrition from their program of study and, conceivably, a professional’s exit from their practice. Preservation of lawyers’ and law students’ vital interpersonal relationships with peers, significant others, family, and colleagues could potentially interrupt the damaging influences of being “self-sufficient” and “independent” to the alienation of those who could be our greatest source of psychological protection.
Other potential mental health protective factors identified in the scholarly literature examining the symptoms and conditions of a plethora of populations include a strong, stable self-esteem, higher levels of emotional intelligence, exercise, religion(for some), work-life or school-life balance, participation in mental health support groups, financial stability, and positive mental health programming interwoven into a students’ studies.
This list of likely protective factors is far from exhaustive, and, as with social support, interactions with sustained resilience are present with these considerations as well. Intrapersonal, interpersonal, environmental, and situational factors must be taken into account if we are to gain any ground against the increasing prevalence and severity of mental health concerns that are damaging ourselves, and by extension, our clients. Avenues for action are nearly limitless, but action is necessary. Where to begin?
The first step, naturally, is admitting we have a problem.
Both the stigma associated with mental health problems and the stigma of seeking treatment may be alleviated by collectively refusing to normalize pathology.
Two very brief anecdotes will be most informative here.
First, as an undergraduate contemplating where I would continue in my graduate studies, I was personally told by a friend who happened to be a faculty member at a nearby university that “graduate school will drive you to drink.”
Second, earlier this semester, in a conversation with several young professionals and graduate students on this very topic, it became apparent that very few were aware that binge drinking is defined as four drinks in a single occasion (for women; five drinks for men). The shock on many faces indicated that four or five drinks was not perceived as excessive, let alone pathological.
These two stories, approximately ten years apart, suggest that, even in light of the startling figures outlined previously, psychopathology and maladaptive behavior has become so normalized in high-stress, high-intensity environments (i.e., law) that there is, in all likelihood, a substantial number of people who don’t even realize they have a problem. Nor do they recognize the damaging influences that problem has on their professional or academic performance, their interpersonal relationships, and their own welfare.
What we, as law students and lawyers, inflict upon ourselves is not “normal.” The human body and mind is not intended to be subjected to these intense levels of physiological and psychological stress for such an extended period of time. It is not healthy. Nor are the coping behaviors many choose to employ. The current mental health status of the legal field is not okay.
It is time to redefine “normal.” If we have made it socially, even professionally, acceptable to go out drinking for hours every weekend, we can just as easily and openly embrace a 50-minute therapy session that keeps us balanced and grounded without the aid of substances. For example, professional networking events do not have to be accompanied by an open bar when we know that so many among us are vulnerable to alcoholism.
If we can say that panic attacks during exams are “just the usual stress, no big deal” then we can just as casually destigmatize the choice to seek help for someone who is not eager to experience the fear, chest pain, nausea, and depersonalization that are symptomatic of a panic attack. Getting treatment does not have to be a “big deal” either.
These are not occurrences we should merely brace ourselves to be resilient against. This does not have to be the inevitable reality that consumes us all, one by one.
First, we can choose to be proactive, rather than reactive, in addressing mental health risk factors in our professional environment. Second, we can enhance the efficacy of resilience-based interventions with deliberately applied preventative, protective measures. Third, we can destigmatize the conversation surrounding mental illness in the legal field. Finally, we can refuse to continue normalizing pathological, maladaptive behaviors to better support ourselves and our peers.
We can change. We can do better. We can get ahead of the struggle.