Atty Alcohol Misuse: What's Worked, What Hasn't, What's Next

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In the eight years since the American Bar Association published a comprehensive report revealing pervasive alcohol misuse among lawyers, the legal industry has made numerous efforts to address the problem.

However, according to researchers who focus on attorney mental health, the issue has only intensified, complicated by the COVID-19 pandemic, which brought increased alcohol misuse across society, coupled with a resistance among legal employers to tackle some of the root causes of disproportionately high levels of mental health issues among lawyers.

According to Patrick Krill, the author of the 2016 ABA study that kicked off many of the industry's efforts around mental health, a subsequent study he conducted in the early stages of the pandemic showed that more than half of lawyers in California and Washington, D.C., were engaging in risky drinking, and 30% were engaging in hazardous drinking consistent with an alcohol use disorder.

In the study, Krill and his co-authors warned that the findings "may signal the early manifestation of what will ultimately prove to be a long-term problem for some lawyers."

"Three years after the study's publication, my observation is that our fears were well founded, and that far more law firms are experiencing problems with alcohol use among their lawyers than they were a few short years ago," Krill told Law360 Pulse.

Still, a great deal of action and effort have been made within the industry since 2016. Krill said he believes that the impacts of the pandemic could have been even worse had legal employers and bar associations not taken the steps they have in recent years.

One major, industrywide effort is the ABA's well-being pledge, which invites legal employers to sign a pledge to commit to a seven-point framework for addressing substance misuse and mental health problems in the legal profession. The seven points include providing education on mental health and substance use disorders; disrupting the status quo of drinking-based events; providing confidential access to addiction and mental health experts; and developing proactive policies to support assessment and treatment of substance use disorders.

More than 225 legal employers have signed the pledge.

Eileen Travis, executive director of the New York City Bar Association's Lawyer Assistance Program, said that she saw a flood of interest from law firms in bringing her in to provide educational programming following the 2016 study and the subsequent ABA well-being pledge.

"That had a dramatic effect and really opened the door for me," Travis said. "I had rarely ever been invited to speak at a large law firm before that and all of a sudden there were numerous invitations to do programs. And I still get invitations."

The biggest change in terms of legal employers, Travis said, is that they are increasingly interested in talking openly about mental health, whereas previously it was a stigmatized topic.

"They are understanding that this is a huge problem and finally acknowledge that there are people in their firms that probably have this problem," she said. "The more the profession is willing to discuss these issues, the less the stigma."

Despite those positive strides, Travis said that "substance misuse is alive and well" in law firms and it's still the number one issue she sees as a lawyer assistance program leader, with her team regularly getting calls from people seeking help when it comes to problem drinking.

One issue, she said, is that even if firms provide education and resources, lawyers need to find the time to make use of those resources, and in an environment where many lawyers are working long hours it isn't always feasible.

"Some associates tell us: 'I'm working 15 hours a day. How could I possibly take advantage of that?'" she said. "There's still a gap between the long hours and the efforts firms are making. Everything happens in stages, and hopefully that will improve as well."

Stress at work, as well as anxiety and depression caused by poor mental health, can lead lawyers to begin misusing alcohol, and alcohol misuse itself can lead to further anxiety and depression, according to Krill, creating a cycle where stress caused by work can feed a burgeoning problem.

"Research shows that long-term or heavy drinkers experience higher levels of anxiety when faced with a stressful situation than nondrinkers or moderate drinkers, partly because regular drinking lowers levels of serotonin — the brain chemical that helps to regulate moods," Krill said. "This is one factor leading to symptoms of depression if people drink heavily and regularly. And finally, problem drinking is also directly linked to an increased risk of suicide and suicidal thoughts, two other problems that disproportionately affect lawyers and for which the profession has had few solutions."

David Mann, who runs The Other Bar, a nonprofit organization and resource for lawyers struggling with substance misuse issues in California, said he continues to see a big influx of lawyers reaching out for help with problem drinking. Mann runs a phone line that attorneys can call if they need help, and he does "triage," helping them navigate the system for seeking help with substance misuse problems as a lawyer.

He, too, believes that long hours and deeply ingrained cultural factors are driving the continued problems in the legal profession.

"Firms may offer yoga class at lunch, but nobody goes to it because they need to stay at their desk and bill another hour. They make free counseling available, but nobody does it because they don't want to be perceived as weak. They pay work-life balance lip service, but nobody takes full weekends off because they need to be seen in the office and bill," Mann said.

"My take on it is that the changes are great, but the problem is that the toxicity that's built into the profession is structural," he added. "It's going to be a long, slow process because we're trying to change a culture."

Law firms have also generally used strategies to tackle alcohol misuse that are not tailored to the industry or to their specific law firms, with many essentially throwing a bunch of ideas at the problem to see what sticks, according to Matthew Thiese, a professor of occupational health at the University of Utah and vice president of the Institute for Well-Being in Law's research and scholarship committee.

Most law firms are also not measuring the outcomes of their efforts to ensure they are effective, Thiese said.

The next step for the industry and for individual law firms is to take an evidence-based and tailored approach to addressing mental health issues, he said.

For example, a recent report out of New Jersey found that litigators reported higher levels of alcohol misuse than other types of lawyers. Law firms could tailor their mental health resources to acknowledge differences like that and offer additional support where it is more likely needed, such as trauma-informed care for those who encounter traumatic subject matter in the course of their work as lawyers.

"Many law firms want to do the right thing. Many are working on doing something. But there's not a lot of evidence for what some of the firms are doing," Thiese said. "A study just came out that found breathwork is no better than placebo at reducing depression and burnout. Some of these things may help, but is it better than placebo and is it the most efficient thing firms could be doing?"

According to Mann, a cultural shift will only be possible once law firms realize the financial impacts of the current mental health and substance use crisis.

Law firms invest a lot of money hiring and training lawyers, only to see too many slowed down by unaddressed mental health issues, he said.

"Even something as intractable as the legal culture will eventually figure out that it's better for the bottom line to treat people more humanely."

--Editing by Robert Rudinger.


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