Report: Only a cultural shift can improve substance use problems in legal profession

Substance use and mental health problems among attorneys so consistently outpace these problems in other professions that the situation demands a transformation of the legal profession's culture. This is a conclusion of a report from a coalition of groups that believes the issue cannot be resolved through actions at the individual attorney level alone.

“We decided that this would not be a report to individual lawyers to tell them to eat better and exercise,” Bree Buchanan, who chairs the American Bar Association (ABA) Commission on Lawyer Assistance Programs, tells Addiction Professional. “We've [already] been doing that sort of thing. The system needs to change.”

Following last year's release of a comprehensive survey finding that 21% of employed attorneys meet criteria for problem drinking and 28% have some level of depression, several associations representing sectors of the legal profession convened to discuss strategies. Suddenly armed with reliable data to confirm long-held suspicions, “We could not in good conscience ignore this,” says Buchanan, director of the Texas Lawyers Assistance Program. “We felt passionately that now is the time to change the culture of the legal profession.”

The report, The Path to Lawyer Well-Being: Practical Recommendations for Positive Change, makes the point that all sectors, from judges to law schools to the highest-powered law firms, have turned a blind eye to the dangerous byproducts of stress in the legal profession.

“An overworked profession is profitable in the short term, but not in the long term,” Buchanan says.

Far from a standard

Professional groups such as physicians and pilots are governed by standard procedures that are activated when a member of the profession falls into problematic substance use. Behavioral health issues in the legal profession, however, have been largely ignored for so long that Buchanan believes the profession is far away from arriving at such a standard. “There is so much work to do before we can approach a standard,” she says.

The report makes a strong case for each sector of the legal profession to take direct action to reduce stigma around behavioral health issues and to promote lawyer well-being. The recent research has shown that “the two most common barriers to seeking treatment for a substance use disorder that lawyers reported were not wanting others to find out they needed help and concerns regarding privacy or confidentiality,” the report states.

The report suggests that efforts to educate lawyers about stress in the profession should enlist the help of recovering lawyers who are successful in the field. The report also advocates the work of lawyer assistance programs, stating that research has shown better alcohol use outcomes for attorneys who attend a treatment program that is tailored to their specific needs.

Adversarial profession

Buchanan says that unlike the medical profession, where doctors work in a generally cooperative environment rooted in care for the patient, “Our work is inherently combative.” People need to understand “the stress that this imposes when a lawyer is asked to go into battle every day,” she says.

The report recommends that all stakeholders develop and enforce standards of collegiality in the profession. A lack of civility appears to be a growing concern: One survey of Illinois lawyers found that 72% considered incivility to be at least a moderately serious problem in the field.

The report's writers also did not hesitate to recommend dramatic changes in how lawyers and the profession in general are evaluated. The report recommends that the ABA and its state affiliates create a “well-being index” that would measure progress on standards other than attorneys' economic success. “For law firms, it also may help counterbalance the 'profits per partner metric' that has been published by The American Lawyer since the late 1980s, and which some argue has driven the profession away from its core values,” the report states.