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Fighting fear, stigma of impairment due to mental health issues

August 22, 2018
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harrell-terry-mug-lg.jpg Harrell

For the past year, well-being and mental health advocate Terry Harrell has spent countless hours trying to find a solution for the hidden hurts legal professionals face behind closed doors.

“A lawyer shouldn’t be embarrassed to say ‘I’m going to see my therapist tonight,’” Harrell said. “Getting help shouldn’t be a big deal, but it still is apparently. That’s part of what we want to change.”

Harrell, executive director of the Indiana Supreme Court’s Judges and Lawyers Assistance Program, set out on assignment as the chair of an American Bar Association working group appointed by Immediate Past President Hilarie Bass to advance well-being measures in legal communities.

Harrell’s 10-member team created and continues to tweak a drafted model policy that could serve as a future framework for addressing lawyer impairment in the workplace.

impairment-factbox.png“Impairment is a condition that materially and adversely affects a person’s judgment, memory or reactions or otherwise interferes with work performance,” Harrell said. “Getting the resources and help they need to restore them to full functioning, whether or not impaired, should always be the goal.”

Legal employers interested in helping colleagues impaired by issues such as substance abuse, depression or cognitive degeneration would be able to customize the framework for their needs. But Harrell said the model still requires lots of finessing before it can be released for use.

However, the working group recently released the Well-Being Toolkit for Lawyers and Legal Employers, which aims to break down stigmas surrounding mental health and well-being in the workplace. It serves as a tool for legal employers who don’t know where or how to start promoting positive change.

Harrell knows firsthand the silent struggles attorneys, judges and law students face. Mostly though, she sees their fear.

Lawyers are too reluctant to ask for help when they know they need it, a 2016 Hazelden Betty Ford study found. They’re fearful they’ll be greeted with judgment and labeled by negative stigmas that surround such issues.

“Huge numbers of us will be depressed or anxious at some point in our career,” Harrell said, “so someone seeking some counseling or help for that should be seen as a wise and strong thing to do. Not a negative.”

Stigma and shame

Lawyers take pride in working hard, but often the work leaves them burned out and feeling broken.

According to the 2016 Hazelden Betty Ford Foundation report, 28 percent, 19 percent and 23 percent of lawyers struggle with some level of depression, anxiety and stress, respectively. The same report found 21 to 36 percent qualify as problem drinkers.

Likewise, the report found younger lawyers in the first 10 years of practice experience the highest rates of problem drinking at 28.9 percent.

Indianapolis attorney Patricia McKinnon experienced that burnout early on in her career as a solo attorney trying to juggle a marriage and three kids at once. Although she didn’t struggle with depression or substance abuse, McKinnon did notice a lack of resources available to help her find balance.

mckinnon-patty-mug McKinnon

Now, she passionately serves as a JLAP volunteer and chair of the Indiana State Bar Association Wellness Committee, offering resources to others in need. But she’s scared that’s not enough.

“I’m concerned about the future of our profession,” McKinnon said. “I don’t think anyone is doing enough to combat this right now. I think we’re trying, but we need to try harder.”

The stigma surrounding impairment related-issues in the legal profession hasn’t wavered much, which McKinnon thinks it might be a perfectionism problem.

“It’s clear that attorneys struggle with anxiety and depression at a higher rate than other professions, but we’re uncomfortable talking about it with our peers, certainly with our supervisors or in a firm setting,” she said. “We just don’t want people to know. There’s a shame factor.”

In an adversarial profession that praises strength, McKinnon said that sadly, appearing weak isn’t an option.

“We don’t ever want to admit we have any flaws that the opposing counsel could use against us or that would make us look worse in the eyes of a judge,” she said. “Admitting you have any weakness, that you need treatment, that you see a counselor or take medication — we perceive them as flaws, even if they’re not.”

As a result, lawyers are reluctant to seek help for fear that doing so might negatively affect their licenses and lead to judgment from their peers, according to the 2017 National Task Force on Lawyer Well-Being report.

Offering resources

In 2010, family law attorney Stephen Terrell lost a close friend and colleague to suicide. When Terrell started practicing law in 1980, he said no one talked about depression or mental health, and there was no help available.

“It was a thing that you did on your own,” he said. “They either let lawyers wallow in their misery or were shown the door if they couldn’t carry their weight.”

Terrell said he thinks the well-being toolkit can only help in the fight to break down the stigma of fear and prevent unnecessary loss of life.

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“That’s one of the reasons why the substance abuse and mental health toolkit is such a welcome resource, because it has lots of information in there about what to ask, what to do, where to go, and can really be helpful,” said JLAP volunteer and Magistrate Judge Tim Baker of the U.S. District Court for the Southern District of Indiana.

Currently free and available online, the Well-Being Toolkit for Lawyers and Legal Employers was designed to help legal employers who want to assist their colleagues but have been unsure where to start. Offering tools and practical guidance for organizational initiatives, Harrell said the toolkit focuses on the bigger picture.

Specifically targeted at employers, the toolkit covers a lot of ground, addressing the factors of a healthy workplace, the dimensions of lawyer well-being and an eight-step action plan for launching a well-being program. It also offers ideas for well-being activities and events, education and development and activity worksheets.

Baker said he thinks the resource is a welcomed addition to the efforts to combat the ill effects of impairment caused by stressors in the workplace.

“Things like a task force report and a toolkit that has an arsenal of suggestions can be very helpful to combat the stigma, negativity and bad results that can sometimes result from depression and substance abuse,” he said.

Making changes

Despite deep-rooted fear and stigma, Baker said he has heard a chorus of employers interested in implementing impairment programs that could help avoid bad outcomes for lawyers who may be experiencing mental health issues.

“It’s not like flipping a light switch, and suddenly the task force report comes out and law firms implement a few changes and suddenly we don’t have JLAP-related issues anymore,” he said. “That’s not realistic. But what you’re seeing, I think, is recognition of the issue and a shift in the way many law firms are approaching it.”•

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