Mental Health in the Legal Profession: A Crisis, a Case Study and a Call to Action - Articles

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Posted by: Kent Halkett on Jan 1, 2021

Journal Issue Date: Jan-Feb 2021

Journal Name: Vol 57 No 1

Mental health issues challenge the legal profession’s most valuable asset — the individual attorney.

 I have been a practicing attorney for nearly 40 years. I attempted suicide six years ago. Thankfully, I did not succeed.

A recent survey1 asked thousands of practicing attorneys in the United States: “In your professional legal career, have you contemplated suicide?” Almost 17.9 percent of the respondents answered “Yes.”2 It is hard to contemplate, much less completely “wrap your head around,” that reality.

A terrible secret is hiding in plain sight, but too often it is swept under the rug: lawyers, statistically, suffer from some form of mental illness at a rate much higher than society as a whole.3 

That is a crisis.

The law is an inherently stressful way to earn a living. The profession is now a business. Poor mental health is a medical condition. It is perpetuated in the law through a combination of shame, stress, status and stigma. Attorneys — who are excellent problem solvers by nature, education and training — have not solved the mental health problem in their ranks. Why? 

The good news: attorneys with mental health challenges can thrive in the profession.

The legal profession needs to refocus its attention and resources on this crisis. Colleagues are suffering on a daily basis. The COVID-19 virus pandemic has disrupted the practice of law and increased stress levels. The time is now.

A Crisis

Numerous studies have been performed on the prevalence of alcohol, drugs and mental health problems among attorneys.4 Two of the most respected studies are the American Bar Association’s study, “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys,” released in 2016 (ABA Study)5 and the “ALM Survey on Mental Health and Substance Abuse: Big Law’s Pervasive Problem,” released in 2018 (ALM Survey).6

The ABA Study found that 19 percent of legal professionals in the United States reported symptoms of anxiety and 28 percent of practicing attorneys suffered from depression.7 

The ALM Survey found that 64 percent of legal professionals feel anxiety,8 a huge increase from the results in the ABA Study just two years earlier. It found that 31 percent of attorneys feel depressed.9 In addition, generally, when asked, “Do you think the profession has had a negative effect on your mental health over time? — nearly three-quarters of the respondents in the ALM Survey (more than 74 percent) answered “Yes.”10 Also, more than one out of six of the attorneys surveyed admitted to considering suicide.11 

A Case Study

Historical Context. Mental illness has long and persistent roots in the legal profession. By most current accounts, Abraham Lincoln, a lawyer by trade and the 16th president of the United States, suffered severe bouts of “melancholy” most of his adult life.12 He had a “mood disorder” in current parlance.

Modern Context. This case study is based on Gabriel “Gabe” MacConaill’s tragic death. He was a young, well-respected partner in Sidley Austin’s Los Angeles office. Gabe committed suicide in 2018.

This case study is not an indictment of the Sidley Austin firm, “Big Law”13 or any other individual, firm or segment of the legal profession. It should not be interpreted in that manner. Indeed, the same basic issues and themes exist across the full spectrum of the legal landscape. Instead, this case study is offered as a teaching moment since it deals with recent events and a great deal of the underlying facts are readily available online. In addition, I believe that I have some relevant experience to add to the ongoing public discussion arising from Gabe’s situation and premature passing.

Gabe’s Story. In November 2018, Sidley Austin was thrust into the public debate on mental health in the legal profession when The American Lawyer published an op-ed, written by Gabe’s wife Joanna Litt, titled “Big Law Killed My Husband: An Open Letter from a Sidley Partner’s Widow.”14 He was a 42-year-old partner in the Bankruptcy Department in Sidley Austin’s downtown Los Angeles office, who fatally shot himself in the parking garage under the high-rise office building, on Sunday, Oct. 14, 2018.

The piece, published less than a month after Gabe’s suicide, is a raw, powerful, first-hand account of the events leading up to that tragedy. It must be read, reread and digested in its entirety to fully capture all of the warning signs that Gabe exuded and the wisdom imparted by Joanna, a courageous and insightful person on the front lines of the problem. Nonetheless, the following snippet from her open letter vividly highlights the conditions culminating in Gabe’s untimely death.

Joanna, left adrift in the wake of Gabe’s sudden passing, tried to make sense of it:15    

Though it’s only the beginning stages of trying to figure out why this happened, I came across a concept, maladaptive perfectionism, that combines unrealistic standards of achievement with hypercriticism of failing to meet them. [Italics added.]

Gabe displayed most if not all of the characteristics. Simply put, he would rather die than live with the consequences of people thinking he was a failure....

The constant striving to be perfect at work, to be the perfect husband, son, uncle, brother and friend. And then living with this deep unbearable shame that he wasn’t performing to the impossibly high standards he set for himself. He said a few times how he couldn’t turn off his head, but again, I didn’t understand the severity of that statement.

Maladaptive perfectionists lack self-compassion

Gabe’s story, including all of the thoughts and comments offered by Joanna, his Sidley Austin colleagues, and his managing partner in charge of the firm’s Los Angeles office, initially struck me like a bolt of lightning and stayed with me, resonating like a tuning fork perfectly calibrated to me and my personal journey of coping with mental health issues in the legal profession for nearly 25 years.

Ernest Hemingway famously instructed aspiring writers to “[w]rite about what you know and write truly ... whatever success I have had has been through writing what I know about.” That is sound advice from a master. I am not a professional author, but I know the truth about mental health in the legal profession. Briefly, I have practiced law for nearly 40 years as a litigator and trial attorney, including 13 years at Sidley Austin’s Los Angeles office (10 years as a partner) from 1987–2000. I was diagnosed with “clinical depression” in 1996. I attempted suicide in 2015. I have to manage my mood disorder daily.

Gabe’s suicide, as broadly shared in Joanna’s op-ed, focused a bright spotlight on the special challenges of mental health in the legal profession and helped fuel a broader discussion of such problems in the modern workplace. In July 2019, Financial Times Magazine published a thought-provoking article,16 in which the authors interviewed Dan Clivner, the managing partner of Sidley Austin’s Los Angeles office, to gain an understanding of the firm’s impressions and response to the on-site suicide of one of its partners. They also contacted “[m]any former colleagues who spoke to the FT [but] requested anonymity to protect their job prospects.”

Clivner told the FT that Sidley Austin was still grieving the loss of Gabe. The authors reported his explanation of the firm’s public positions:

...MacConaill did not go to any of his senior partners about his mental health or workload, and that for Sidley to be able to provide support, an employee would need to be willing to ask for help. To illustrate his point, Clivner references his own personal struggle at the time: his husband had terminal cancer, and the firm was supportive of his needs.

“When you call in with something like cancer or stress, in a discreet and professional way the firm will respond,” he says. “On the first day of every orientation that I’ve done for decades, I say ‘You have to raise your hand.’ In a place like this, you have to be able to say, ‘I haven’t done deals, I’d like to do deals,’ or ‘I’d be interested in travel’ or ‘I’m overworked.’ You have to trust somebody.”

The authors of the FT article probed Sidley Austin’s position:

Asked if the firm has taken longer-term mental health measures in response to MacConaill’s death, Clivner says no. He points to initiatives the firm already had in place, from generous insurance coverage for mental health to anonymous hotlines and wellness programming, which includes serving fresh fruit and encouraging fitness.

One of Gabe’s former colleagues at Sidley Austin, an attorney in the trenches, offered a different perspective:

“There are resources available, of course” says a former colleague. “But there is not a culture or feeling of safety right now in that set of offices. You can have resources in place, but unless you have the right culture, people aren’t going to feel safe using them or approaching someone to ask for help.”

In July 2019, just days after the FT article, Above The Law published an article, “Sidley Still Thinks They Handled Partner’s Suicide Correctly. His Widow Disagrees.”17 This article draws a significant distinction:

[Joanna Litt] titled her op-ed “Big Law Killed My Husband,” not the firm killed my husband, and that rings true because whatever the particulars of what led to MacConaill’s death, the attitudes are industry wide. Too often the demands of the profession mask real mental health issues, and the overachievers drawn to the law don’t feel able to avail themselves of these necessary services. The stigma is something we see throughout the legal industry, and is what needs to be dismantled to prevent more of these tragedies.

Conjecture, Comparison and Comment

It is not clear if Gabe ever received a professional psychological diagnosis and, if so, his exact medical condition. Joanna discusses “maladaptive perfectionism,” a term that she learned during her research, but it is not a medically recognized condition. However, no doubt, her description of that ailment resonates with a large number of law students, attorneys and judges. It resonates with me.

It is impossible to know precisely what Gabe was experiencing and thinking in his final moments. He had been under tremendous, sustained pressure from a massive bankruptcy filing prior to his death. Gabe had soldiered on with his professional obligations and pushed the matter through to a successful conclusion despite his obvious personal struggles. Joanna recounts that, during that stressful period, Gabe told her, “You know, if we go [for professional help], this is the end of my career.”18 

Similarly, in 1995, I was a young litigation partner at Sidley Austin under severe pressure from being tasked by the firm’s management with taking control of the “case from hell” and fixing it. I readily tackled the assignment. I worked around the clock, nose to the grindstone, until the immediate threat had been successfully resolved. However, internally, something was terribly “wrong” with me. A couple of months later, I first saw a psychiatrist for my ongoing mental anguish and was diagnosed as suffering from “clinical depression.” 

The diagnosis was a relief and a nightmare. There was a medical reason for my misery, but I was absolutely convinced that my career at Sidley Austin and in “Big Law” was over. 

I viscerally understand how Gabe’s profound sense of professional duty put the interests of the client and the firm over his own personal well-being. Both of us held the same gut-wrenching conviction that our mental suffering, arising in the work environment, jeopardized our legal careers and our family’s way of life.

Depression, a common mood disorder, clouds the mind and makes “clear thinking” extremely difficult, if not impossible. Moreover, as one of Gabe’s Sidley Austin colleagues astutely observed, absent the “right culture,” attorneys do not “feel safe” to come forward to take advantage of available resources.19

Clivner noted that Gabe never disclosed his pain to Sidley Austin, nor did he take advantage of the firm’s anonymous hotline or any of its other mental health resources. I did not disclose my suffering, condition or diagnosis with any of my colleagues or Sidley Austin, except in desperation to the managing partner of the firm’s Los Angeles office. I was ashamed and scared. I assume that Gabe experienced similar feelings. 

I was most afraid that I would be labeled “damaged goods” if my condition was known by the firm’s management. My worst fears were confirmed. I took six weeks of paid leave from the firm. When I resumed my practice, I went right back to having my nose to the grindstone, despite my painful experience, ongoing recovery and better instincts. I did high-quality legal work and consistently obtained good results for the firm and its clients. My colleagues did not know about my mood disorder, and they did not detect anything “wrong” with my legal abilities. Nonetheless, my career at Sidley Austin hit a plateau that I could not move beyond. The firm no longer directed choice cases and assignments to me. It curtailed my administrative contributions. My compensation was stagnant. It was clear that my time in “Big Law” was prematurely over. I resigned, and joined a small firm that provided an opportunity to continue to practice high-quality legal work, and offered the possibility of a brighter future in the legal profession.

After a few years, I moved again laterally as a litigation partner in an old-line, well-respected California firm with more than 100 attorneys and multiple offices. I thought that my struggle with depression was behind me forever. However, after successfully resurrecting my career and practicing without any further mental health incidents for more than 15 years, my depression resurfaced with much more severity. Again, I quickly became “damaged goods” for my new firm. I left and tried to reinvent myself at another firm, but I was fighting a losing battle. I attempted suicide less than six months later.

A Call to Action 

Attorneys with firsthand experience dealing with mental health issues have invaluable experience to contribute to the discussion. A good starting place is to address attorneys’ fundamental concerns regarding shame, stress, status and stigma. 

Shame is the most powerful and destructive emotion for people with a mood disorder. Most people suffering from a mood disorder are acutely ashamed that they are not “normal” and afraid of being treated as inferior by society. Those concerns are real and understandable, but misplaced. Substitute a diagnosis of diabetes in place of mental illness. Diabetes is treatable through proper medical intervention and vigilance. A diabetic can live a perfectly “normal” and productive life. 

Mental illness is not a personal or moral failing. It is a treatable medical condition. Attorneys with mood disorders can be productive professionals at the highest levels. They do not have to be considered or treated as “damaged goods.” There is no shame in having diabetes. There should be no shame in having a mood disorder.

Stress comes with the territory in the legal profession. There is no easy remedy, but attorneys can and must learn that their quality of life requires a healthy balance of work, family and outside interests.

Status can be a false idol for overly driven attorneys. Society often affords attorneys an elevated status in their communities based on intelligence, education, income and power. Many attorneys covet the perqs of such esteemed professional status and fear that a mental illness diagnosis will put a dent in their real or perceived qualifications for holding positions of status. Others fear the loss of a lucrative earning capacity and their family’s standard of living. However, with proper treatment, attorneys with mood disorders can function “normally” in their professions and communities. Indeed, Abraham Lincoln proved that such attorneys can become statesmen at the pinnacle of achievement.

Stigma has long been associated with individuals with mental illnesses. That is changing throughout society. Well-known celebrity icons in entertainment and sports are openly disclosing and discussing their personal battles with the whole range of mood disorders without permanent professional repercussions.

There is no “one size fits all” approach or solution for mental illness in the legal profession. Each individual law student, attorney and judge faces a unique set of circumstances and challenges. 

Medical advances are on the horizon. Traditional and proven therapies are being augmented with new and promising approaches.

Existing legal communities, including national, state and county entities, are ready, willing and able to lend a helping hand to attorneys who need it by providing excellent tools and materials that have been developed over decades of research and experience. Fears over “confidentiality” and “prohibitive costs” are not insurmountable.

Help is Readily Available

Organizations such as the Depression Bipolar Support Alliance (DBSA),20 with local chapters and meetings across the country, offer free peer-guided support for individuals with mood disorders.

The American Bar Association formed a Working Group to Advance Well-Being in the Legal Profession in 2017.21 The ABA’s Commission on Lawyer Assistance Programs22 provides online resources and a directory of state and local lawyer assistance programs throughout the country. The bar associations in every state have similar lawyer assistance programs. The Tennessee Lawyer Assistance Program (TLAP)23 is an excellent example.

Family and friends can be invaluable to an attorney with a mood disorder. There are resources available to them even if the attorney cannot or will not seek help on their own. Organizations such as the National Alliance on Mental Illness (NAMI),24 with local chapters and meetings across the country, offer free peer-guided assistance for families and friends. 

New approaches are being tried. Indeed, some firms have hired a “well-being director” to tackle the problem and protect their most valuable assets their attorneys.

The foregoing ideas are merely a starting point, not an end point, for discussion, hope and help.

Closing Argument 

I am not a medical doctor. I am not an expert in mental health. I do not pretend to know all of the answers to the problem of mental illness in the legal profession.

What I do know is that the legal profession cannot allow Gabe’s story, and similar tragedies within its ranks, to be swept under the rug.

Further, I know that the ongoing discussion regarding the problem should include voices and advice from the medical professionals who specialize in the mental health field as well as practical insights and wisdom from attorneys, like me, who have walked the walk with mental illness in our careers.

The law must be dedicated to, and energized to, create a culture where all attorneys “feel safe” to reach out to their family, friends or professional colleagues another attorney or, as appropriate, their firm or local bar association. 

All attorneys need to know that help is available, confidentially and affordably, instantly by a telephone call or only moments away on their computer. |||

 

KENT HALKETT graduated from Vanderbilt Law School in 1981. He was a trial attorney in Los Angeles for more than 35 years, primarily with large firms. He returned to Nashville in 2017. At the Tennessee Alliance for Legal Services, he advises callers to the HELP4TN helpline on substantive and procedural issues under Tennessee law.

 


NOTES

1. “ALM Survey on Mental Health and Substance Abuse: Big Law’s Pervasive Problem, by Patrick Krill,” Sept.14, 2018, http://www.law.com/2018/09/14/alm-survey-on-mental-health-and-substance-abuse-big-laws-pervasive-problem. This survey was the ALM Intelligence’s inaugural study on mental health and substance abuse in law firms.
2. “Has the Legal Profession had a Negative Effect on Your Mental Health?,” by Stacy Zaretsky, Feb. 20, 2020, referencing the ALM Survey, http://abovethelaw.com/2020/02/has-the-legal-profession-had-a-negative-effect-on-your-mental-health/amp.
3. “The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys,” by Patrick Krill, Ryan Johnson and Linda Albert, Journal of Addiction Medicine, Jan/Feb 2016, Vol. 10, Issue 1, 46-52, http://journals.lww.com/journaladdictionmedicine/Fulltext/2016/02000/The_Prevalence_of_Substance_Use_and_Other_Mental.8.aspx. The ABA Study was funded by the Hazelden Betty Ford Foundation and the ABA Commission on Lawyer Assistance Programs.
4. It is well-established that attorneys with mood disorders often self-medicate with alcohol, drugs or both. The distinct problems arising from alcohol and drug abuse in the legal profession are covered extensively elsewhere and beyond the scope of this discussion.
5. See ABA Study (note 3 above).
6. See ALM Survey (note 1 above).
7. See ABA Study (note 3 above)
8. “Lawyers Reveal True Depth of Mental Health Struggles,” by Lizzy McLellan, Feb. 19, 2020, referencing ALM Survey, http://www.law.com/2020/02/19/lawyers-reveal-true-depth-of-the-mental-health-struggles/?slreturn+20200726223458.
9. Id.
10. See Zaretsky (note 2 above).
11. Id.
12. Abraham Lincoln’s mental health struggles are explored in depth in an article titled “Lincoln’s Great Depression,” by Joshua Wolf Shenk, The Atlantic, October 2005, http://www.theatlantic.com/magazine/archive/2005/10/lincolns-great-depression/304247/?.
13. The term “Big Law” is in vogue in the legal profession. It is commonly used to describe large, high-revenue law firms, usually located in major U.S. cities, including New York City, Los Angeles and Chicago. Firms that have grown, prospered and achieved the distinction of “Big Law” status often have satellite offices in multiple domestic markets as well as an international presence. The starting salaries for first-year attorneys, fresh out of law school, exceed $175,000 per year.
14. “Big Law Killed My Husband: An Open Letter from a Sidley Partner’s Widow,” by Joanna Litt, The American Lawyer, Nov. 12, 2018, http://www.law.com/americanlawyer/2018/11/12/big-law-killed-my-husband-an-open-letter-from-a-sidley-partner’s-widow.
15. Id.
16. “The trillion-dollar taboo: why it’s time to stop ignoring mental health at work (Stress is costing businesses and claiming lives, so why do employees feel unsafe asking for help?),” by Lilah Raptopoulos and James Fontanella-Khan, Financial Times Magazine Life & Arts, July 10, 2019, http://amp.ft.com/content/1e8293f4-q1db-11e9-974c-ad1c6ab5efd1.
17. “Sidley Still Thinks They Handled Partner’s Suicide Correctly. His Widow Disagrees,” by Kathryn Rubino, Above The Law, July 12, 2020, https://generalcounselnews.com/sidley-still-thinks-they-handled-partners-suicide-correctly-his-widow-disagrees.
18. See Litt (note 14 above).
19. See FT article (note 16 above).
20. Depression Bipolar Support Alliance (DBSA), https://www.dbsalliance.org
21. American Bar Association Working Group to Advance Well-Being in the Legal Profession, https://www.americanbar.org/groups/lawyer assistance/working-group to advance well-being in legal profession.
22. American Bar Association Commission on Lawyer Assistance Programs (CoLAP), https://www.americanbar.org/groups/lawyer assistance.
23. Tennessee Lawyers Assistance Program (TLAP), http://www.tlap.org.
24. National Alliance on Mental Illness (NAMI), https://www.nami.org/Home.