Mental Health Issues for Attorneys
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CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
Mental Health Issues for Attorneys
Linda Kim, MD
CMCP/ KP CLE meeting
January 16, 2019
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Agenda
• “The Arrival”
• Current Landscape
• What are common Mental Health and Substance Abuse issues and how do
I know what they are?
• What can we do?
• Comments and Questions
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California Minority Counsel Program 1
CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
“The Arrival”
http://www.abajournal.com/voice/article/4_strategies_for_building_the_habit_of_lasting_resilience_in_the_legal_prof/?icn=sidebar&ici=text
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Current Landscape of Mental Health
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California Minority Counsel Program 2
CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
5
Mental Health in USA
• Mental Illnesses are very common, among the most common health condition
• 1 in 5 will be diagnosed with a MH condition in any given year
• Over 50% will be diagnosed with a mental illness or disorder at some point
• Suicide Rates are increasing (2012 to 2016, 12.9/100,000 to 17.3/100,000)
Nearly 45,000 deaths by suicide in 2016
Nearly half the states have had increasing rates of suicide by 30%
More than 50% of all those who died by suicide were not known to have a MH illness
Males (21.4/100,000) and Women (6.0/100,000) in 2016. This represents a 50%
increase in females from 2000 to 2016
https://www.cdc.gov/nchs/products/databriefs/db309.htm
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California Minority Counsel Program 3
CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
Suicide Rates are increasing.
CA rate increased by 15%
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“The Study”
• 2016 review of nearly 13,000 currently practicing lawyers1
21-36% qualify as problem drinkers
28% struggle with depression
19% struggle with anxiety
23% struggle with elevated stress
25% work addiction
“Signal an elevated risk in the legal community for mental health and substance use disorders
tightly intertwined with an alcohol-based social culture”
• For reference, nearly 1 in 3 medical professionals are depressed
• Suicide rates in lawyers – for males, 14th highest job category (18.7/100,000) and for females, 5th
highest (9.2/100,000)
1. ABA Commission on Lawyer Assistance Programs and Hazleden Betty Ford Foundation
Peterson C, Stone DM, Marsh SM, et al. Suicide Rates by Major Occupational Group — 17 States, 2012 and 2015. MMWR Morb Mortal Wkly Rep 2018;67:1253–1260.
DOI: http://dx.doi.org/10.15585/mmwr.mm6745a1
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California Minority Counsel Program 4
CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
Brief Overview of Depression, Anxiety, and Alcohol Use Disorder
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Signs and symptoms of depression
• Persistent sad, anxious or "empty" mood
• Sleeping too much or too little, middle of the night or early morning waking
• Reduced appetite and weight loss, or increased appetite and weight gain
• Loss of pleasure and interest in activities once enjoyed, including sex
• Restlessness, irritability
• Persistent physical symptoms that do not respond to treatment (such as chronic pain or digestive
disorders)
• Difficulty concentrating, remembering or making decisions
• Fatigue or loss of energy
• Feeling guilty, hopeless or worthless
• Thoughts of suicide or death
Diagnostic and Statistical Manual 5 (DSM 5)
http://www.mentalhealthamerica.net/conditions/depression#depression
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California Minority Counsel Program 5
CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
Depression
• Prevalence: 20-25% of adults (at some point in lifetime)
• Prevalence: 8.1% aged 18 and above had depression in a given 2 week period of time
• Higher in women, 10.4% in women, 5.5% in men
• Frequently undiagnosed in older and younger populations, underreported in men
• Previous episode of depression
Diagnostic and Statistical Manual 5 (DSM 5)
http://www.webmd.com/depression/guide/major-depression#1
https://www.cdc.gov/nchs/products/databriefs/db303.htm
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Anxiety
• Most common MH Illness
• Prevalence: Aged 18 and older, 19% had anxiety disorder
• Higher in women, 23.4% in women, 14.3% in men
• Include Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Specific Phobias,
Obsessive Compulsive Disorder, and PTSD
Diagnostic and Statistical Manual 5 (DSM 5)
https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml#part_155094
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California Minority Counsel Program 6
CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
Signs and symptoms of anxiety
Generalized anxiety disorder symptoms include:
• Feeling restless, wound-up, or on-edge
• Being easily fatigued
• Having difficulty concentrating; mind going blank
• Being irritable
• Having muscle tension
• Difficulty controlling feelings of worry
• Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep
https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
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Alcohol Use Disorder
• Around 16 million people age 18 and over have Alcohol Use Disorder
• 9.8 million men and 5.3 million women, total of 6.2% of the population in 2016
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California Minority Counsel Program 7
CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
Alcohol Use Disorder – 2 or more of the below qualifies for AUD
(2-3 is Mild, 4-5 Moderate, 6+ Severe)
• Had times when you ended up drinking more, or longer than you intended?
• More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
• Spent a lot of time drinking? Or being sick or getting over the aftereffects?
• Experienced craving — a strong need, or urge, to drink?
• Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or
caused job troubles? Or school problems?
• Continued to drink even though it was causing trouble with your family or friends?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as
driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or
after having had a memory blackout?
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had
much less effect than before?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping,
shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?
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Why more common in Lawyers?
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California Minority Counsel Program 8CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
Risks specific to Lawyers
Time
Pressures
Intense
Perfectionism demands of
the job
+/- Highly Demands
Adversarial exceed
Environment resources
Long and
Stressful
Work Hours
https://lawyerist.com/94605/recognize-prevent-lawyer-burnout/
http://www.lawyerswithdepression.com/articles/a-lawyers-guide-to-dealing-with-burnout-does-burnout-mean-i-should-leave-my-job-or-the-law-altogether/
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Raise your hand if…
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California Minority Counsel Program 9CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
A Lawyer writes in…
“How do I deal with it? Not very well. While I hope my experience is an extreme case, I fear it is
not uncommon. My stress follows me home from my office. My stress has not only damaged my
relationships with friends and family, but is has put a large strain on my marriage. My stress has
turned me into a person I have trouble recognizing. My stress has put me into therapy where I talk
about feeling trapped or stuck in a situation that will never improve because I will never get a
better job. My stress makes me drink too much sometimes and has me taking anti-depression and
anti-anxiety medication.
Despite it all, I pray and rely on my faith that it will get better. My stress will not win.”
https://abovethelaw.com/2018/08/stressed-out-lawyers-in-first-10-years-of-practice-more-likely-to-have-mental-health-and-wellness-issues /
19January 14, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.
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NATIONAL TASK FORCE ON LAWYER WELL-BEING
Creating a Movement To Improve Well-Being in the Legal
Profession
ENTITIES REPRESENTED: ABA LAW PRACTICE DIVISION, ABA CPR
PROFESSIONALISM, ABA/HAZELDEN STUDY, APRL, ALPS, CoLAP, CONFERENCE OF
CHIEF JUSTICES, NCBE, NOBC
August 14, 2017
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California Minority Counsel Program 10CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
So What Can I Do?
Well-Being Tool Kit – American Bar Association
https://www.americanbar.org/content/dam/aba/administrative/lawyer_assistance/ls_colap_well-
being_toolkit_for_lawyers_legal_employers.authcheckdam.pdf://
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Lawyer Well-Being Occupational
WHO’s Healthy Workplace
A healthy workplace is one in which all Social Emotional
organizational members collaborate to
continually improve processes to protect
and promote member well-being and
organizational success. All seek
alignment of organizational and member
goals and needs so that they can grow
and thrive together.
Spiritual Physical
Intellectual
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California Minority Counsel Program 11CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
RECOMMENDATIONS FOR ALL STAKEHOLDERS
1. Acknowledge the Problems and Take Responsibility.
2. Use This Report as a Launch Pad for a Profession-Wide Action Plan.
3. Leaders Should Demonstrate a Personal Commitment to Well-Being.
4. Facilitate, Destigmatize, and Encourage Help-Seeking Behaviors.
5. Build Relationships with Lawyer Well-Being Experts.
1. Partner with Lawyer Assistance Programs.
2. Consult Lawyer Well-Being Committees and Other Types of Well-Being Experts.
6. Foster Collegiality and Respectful Engagement Throughout the Profession.
1. Promote Diversity & Inclusivity.
2. Create Meaningful Mentoring and Sponsorship Programs.
7. Enhance Lawyers’ Sense of Control.
8. Provide High-Quality Educational Programs and Materials About Lawyer Well-Being.
9. Guide and Support The Transition of Older Lawyers.
10. De-emphasize Alcohol at Social Events.
11. Use Monitoring to Support Recovery from Substance Use Disorders.
12. Begin a Dialogue About Suicide Prevention.
13. Support A Lawyer Well-Being
23January 14, 2019 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.
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Please, don’t tell me to just go out and meditate…
• 10 TED Talks for when you feel burnt out
https://www.ted.com/playlists/245/talks_for_when_you_feel_totall
• Add Humor to your day
• Take a few deep breaths
• Walking Meeting
• Meetings with “the Arrival”
• Gratitude Journal
• Take time to transition
• One minute meditation
• The basics – sleep, exercise, nutrition
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California Minority Counsel Program 12CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
Beautiful, serene garden
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Right in front of me…
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California Minority Counsel Program 13CMCP/Kaiser 8th Annual CLE Marathon Date of Activity: January 16, 2019
Mental Health Issues for Attorneys Time of Activity: 9:00 am – 10:00 am PST
Questions?
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California Minority Counsel Program 14You can also read
