Mental Health Resources with Joe Ankus

Episode Notes

Transcript

Molly Ranns:

Hello, and welcome to another edition of the State Bar of Michigan’s On Balance Podcast on Legal Talk Network. I’m Molly Ranns.

JoAnn Hathaway:

And I’m JoAnn Hathaway. We are very pleased to have Joe Ankus join us today. Joe is an experienced attorney and certified national mental health first aid instructor who since 2017 has been actively involved in educating attorneys, law students, judges and legal professionals about mental health and wellness. And he is joining us today from sunny Florida. So Joe, could you share some more information about yourself with our listeners please?

Joe Ankus:

It’d be my pleasure, and thank you, Joanne. Thank you, Molly. Thank you for having me. Thanks. State Bar Michigan for including me in a very important discussion. So my name is Joe Ankus and I appreciate being here today. For me, after having practiced with two large law firms, I was a corporate lawyer and a creditor’s rights bankruptcy lawyer due to a lived experience with stress and anxiety, I actually left the practice of law, which really underscored my interest all the way back into 1991 of addressing the topics of mental health with attorneys and legal professionals. And ultimately in 2017, I became involved with the Florida Bars Special Committee on Mental Health and Wellness, which led me to where we are today to talk about the topics of anxiety, depression, substance use, and other resources that we can use to help our colleagues.

Molly Ranns:

Joe, we’re so grateful that you’re here with us today and to get started, I’m hoping that you can help our listeners understand what really inspired you to become involved in mental health education in the legal profession.

Joe Ankus:

I mean, I appreciate the question, Molly. And I would say the pivotal point or the focal point for me was really kind of a watershed moment in the South Florida legal community. And tragically and unfortunately we lost a number of our colleagues to suicide. The common denominator among all of the losses was that there was no common denominator. I think there was a point in time when I just finally said, enough is enough. Something needs to be done and I want to be part of the solution. And I was fortunate enough to be selected to be one of six people on the Florida Bar Special Committee for Mental Health and Wellness. And my mandate on that committee was to come up with an educational vehicle that I as a lay person could teach other lay people very similar to a First Aid class or a CPR class and a gentleman on the committee with me, a fellow by the name of Rahul Mera, who is a psychiatrist, suggested Mental Health First Aid. And so then I became certified to teach Mental Health First Aid, and I have since 2018 have literally gone around the country virtually and in person to teach people the basics of what we can do as laypeople to support our colleagues and give them credible information and referrals and really be the bridge between somebody that might be experiencing a mental health challenge and getting the help that they need and they deserve.

JoAnn Hathaway:

Joe, I’m curious to hear even more about your journey. It’s clear you have a passion for mental health. Did you have any personal or professional experiences that influenced you to teach mental health First aid to the legal community?

Joe Ankus:

Yes, Joanne, definitely. And again, thank you for the question. So in a nutshell, because as you know, stories can be as shorter as long as the author wants ’em to be, and I will keep mine fairly brief. So when I graduated law school, I was on a trajectory that in theory would’ve led me to be a partner at a major law firm. I had done well in law school. I had again gotten hired by two of the largest firms in the country. And what happened, interestingly, was when I first graduated, I joined a large firm in Philadelphia and I was a corporate associate, and my responsibility as a corporate associate was fairly discreet because for those of you that are familiar with kind of larger firm practice, my responsibility was really limited to writing these really unexciting legal research memos on topics like the Blue Sky Act for a publicly traded company in a jurisdiction that hasn’t been reported yet.

I mean these esoteric things that nobody would ever willingly choose to do. I didn’t mind that kind of work because it was discreet, it was prepackaged. I knew what my project was, I cranked out my memo, I gave it to the partner, and I moved on and everything was fine. Things changed for me dramatically. When I returned home to Florida where I’m from and I rejoined, I was a summer associate with another large firm, I rejoined a large firm. And on the first day of my job, my then boss, who I always say parenthetically, is still a dear friend and somebody I care deeply about. We’ve maintained a friendship for over 30 years. Came into my office and he had about 14 files, and I remember the color of the files. They were this avocado green with a brown binder, and he dropped them on my desk and I still remember the thud of those files.

And he had a big grin and he says, Joe, these are yours. And most lawyers might have felt like, oh my gosh, this is what I’ve been training for. I’ve got 14 clients that I’m responsible. For me, it was like getting hit in the head with a bat. That’s the only way I can describe the feeling. I was paralyzed. And so I literally struggled for the next nine months, just long enough to have a baby. I struggled with anxiety, doubt, fear, terror, you name it. And I literally had to make a decision for me at that point, which was, it’s going to be the law, it’s going to be my health. And I made the decision to leave. And at that time, in 1991, unfortunately nobody talked about these things. There was no clearinghouse of resources. People talked about it in very hush tones. There was no sort of support network.

There was really just, it was almost regressive in the fact that nobody was willing to acknowledge it. It was very binary. You either could cut it in a law firm or you couldn’t cut it. And so I had to make the decision between my health and my profession, and I chose my health and I left. So that personal journey affected me profoundly because I still felt deeply that something needed to be done. And I only regret that it took until 2017 for me to become actively involved in the eternal mental health space. But I’m grateful that I have been and will continue to be involved. But that Joanne gives you kind of a background of when it occurred, what it caused it to occur and brings you up to present day.

Molly Ranns:

Joe, thank you so much for sharing that story with us. As the director of the Lawyers and Judges Assistance Program in Michigan, I hear such a similar story from so many every day and your willingness to come on here and share that story, I think it just validates that what people are experiencing and helping them understand that they’re not alone. I’m wondering if you would be willing to share maybe a couple of concepts that you could help our listeners understand about Attorney mental health in general.

Joe Ankus:

Absolutely, Molly, and before I answer the question, and I’m happy to share a couple key concepts. The other thing is in sharing my story or for anybody that shares their story, I certainly speak for myself when I say I don’t share it in any way, shape or form for sympathy, pity, anything like that. I share it because I find that talking about it openly is part of solving the challenges of stigma and shame. And there is just nothing to be ashamed about. And we’re going to talk more about that later in the podcast. But I always reiterate that sometimes I’ll share the story and when I’m training and people are like, oh, I’m so sorry. I said, no, I said, I appreciate that. But this is not about sympathy or pity. This is about education, acknowledgement, resources, and support. And for me, that’s really what keeps me marching forward with this.

So segwaying back into your question. So there are two key concepts I think that the audience would benefit from knowing. Number one is, is that the evidence around mental health and wellness is clear, and it’s not Joe’s opinion. This is what the evidence is that most people with professional help can and do get better. And I think that is just so important for any listener that is personally struggling right now, or any listener that is perhaps has somebody very close to them, whether it be a friend, colleague, family member that is struggling, please know that most people with proper help can and do get better. That is something we have to keep repeating, okay? Most people can and do get better. The other thing is that many times, and I’m speaking from the perspective of a layperson, many of us as laypeople feel paralyzed or powerless because we simply don’t know what to say or do.

If we suspect somebody is struggling, or if somebody opens up to us about a struggle, we don’t know what to say or do. And sometimes we can feel helpless, we can feel powerless, we can feel scared. These are all expected feelings somebody could have now. But the one thing we can do that every one of us can do on this podcast is we all have the capacity to listen. We all have the capacity to listen. And especially those of us in the legal profession, which this is the audience is targeted to, is being able to listen in many respects is as valuable or even more valuable than the ability to speak. So if somebody is willing to open up and talk to you, just by you listening attentively, nonjudgmentally, and giving them the space to share what’s going on can be very, very helpful. So just remember two concepts.

Most people can and do, get better. And no matter what your training or lack thereof is, you all, you, I, Molly, Joanne, we all have the ability to listen. We all have the ability to listen. And by the way, listening does not require that you give your opinion or advice. Listening means what it says, it means listening, trying to understand, reflecting and supporting somebody, giving advice, giving opinions. Generally, I prefer when the mental health world, I prefer to leave that to the professionals that are qualified and trained to give their opinion and advice, but never underestimate the power and capacity you have to simply give somebody a safe space to talk.

Molly Ranns:

Thank you so much, Joe. I could not agree more with those two key concepts. I really appreciate you sharing. We are now going to take a short break from our conversation with Joe Ankus to thank our sponsors.

JoAnn Hathaway:

Welcome back. We are thrilled to be here today with Joe Ankus, attorney and certified National Mental Health First Aid instructor. As we discuss mental health in the legal profession. Joe, I can see how the key concepts you just referenced would be crucial points. And considering these, what are some resources you would recommend our audience know about?

Joe Ankus:

So I think that when it comes to resources, Joanne, there’s a few things I would say. There’s a lot. There’s really an innumerable amount of resources that are available, and I’m going to use the web as our focal point just because it’s just the easiest and most user friendly. Before I give you some resources that I find particularly helpful, I want to caution people about over-relying on things just because they’re on the internet. And I know all of us approach the internet with a bit of healthy skepticism because the credibility of a site, we might not have the ability to determine what’s truly credible, what’s not. But the important thing to remember is that Google research comes to mental health only one slice of the pie. And we’ve all heard about playing Dr. Google and attorney Google and using Google to substitute for competent professional advice.

So against that backdrop, I am a big fan of people doing research on the internet. I’m a big fan of people self-educating, reading resources. But at the same time, I just want to gently remind everybody that not everything you read is credible or for example, timely or necessarily germane to the person who might be experiencing a struggle. So with that caveat, let me share some resources that I think are credible and really essential that we add to our toolbox. The first one that I’m going to say is 9 8 8 and nine eight. Eight is the number to reach the National Suicide Lifeline, national Suicide Helpline Prevention, however you want to phrase it. Everybody needs to know this number almost as readily or actually as readily as you might know. The number for 9 1 1, and the reason why it is so important is because it is a first line of defense for anybody that may be suicidal themselves.

It may be the first line of defense for a family member, friend or colleague who is concerned that somebody is suicidal. It could be the first line of defense for you sitting with somebody who could be suicidal. So we always encourage people to research a little bit about 9, 8, 8, learn about 9, 8, 8, 8, and don’t hesitate to call 9 8 8 if you need to. You can call for general information without a crisis being evident, or you can call if you suspect a crisis or if there is a crisis. So we share that as a first line resource, 9, 8, 8. You can also text them as well, and you can find other resources about 9, 8, 8 that are credible online. So I encourage everybody, if you listen to this podcast, I would ask take a look at 9 8 8 online. A couple other things about 9, 8 8 that I will share with you.

Number one is this. This is going to sound ironic. So I’ve had people tell me that they’ve actually called 9 8 8 when they were in crisis and they were put on hold and people, when this was shared with me, the person said to me, Joe, can you believe I called the prevention lifeline and I was put on hold. And I said, notwithstanding kind of the initial irony of that statement, I said, what does that really tell you? And they kind of paused and they said to me, I guess other people need help too. And I said, exactly, nobody puts you on hold because they didn’t care. You were put on hold because there were other people that were needing help. And I reframed that for that person. So just remember that they’re not alone. And so when you call 9 8 8, it’s possible you could be put on hold, and I just want people to understand that, but it’s not a reflection on you.

Another resource that I really advocate for is the National Alliance on Mental Illness, which is nami, NAMI. Their website, they have credible information, tremendous amounts of robust resources. NAMI chapters are almost every major city, and if they’re not in your city, they’re in your state. I have done some volunteer work in my local NAMI chapter. My personal experience with NAMI has been nothing short of phenomenal. I think these are people that not only walk the walk and talk the talk, but they genuinely care. And so I’m grateful for my interfacing with them, but their website is good, and I encourage anybody that has any question about anxiety, depression, bipolarity, substance use, NAMI should be one of your first stops for credible information. Another resource, because we are in the legal profession, is the A. A. The American Bar Association to its credit has done a masterful job and has a fairly robust website talking about mental health and resources that are available.

The Institute for Wellness and Law, I will another phenomenal organization that has credible resources and people that care. So those are just a handful. You obviously have the National Institutes of Health. They have credible information. SAMHSA has credible information. I often reference the anonymous programs and the family related programs. So for example, you have Alcoholics Anonymous and Al-Anon for family members. I don’t take a position personally on the efficacy of the 12 step programs. What I tell people is, is it’s a resource. And for some people it can be very, very helpful. Other people find it less helpful. But at the end of the day, it is a recognized resource and there is an anonymous program for almost any sort of challenge, whether it be gambling, whether it be alcohol, drugs, eating. And oftentimes there are ancillary family support groups such as Al-Anon to support family members, somebody that might be struggling.

Another resource to consider that most people don’t really think about is your primary care physician. Your primary care physician is often a leading entry point for people to get the mental health help that they might need. Many primary care physicians now are very fluent in basic mental health education. They’re fluent in managing minor less complicated mental health challenges. Or they can be the gateway to refer to a psychiatrist or another professional. But people tend to think, well, my primary care physician, they really just do my height, weight, blood, stuff like that, check my heart lungs, but they actually can do much more. So don’t neglect that as a possible entry point. Another thing that I encourage people, if you have access to your employee assistance program, and I know that not everybody does, but if you have access to an EAP or employee assistance program, by all means use it.

They’re confidential and they may be able to connect you with credible resources or a therapist or other professional to get you the help that you might need. And then finally, I will share a little bit about 9 1 1. So the reason why I referenced 9 1 1 is while it’s unlikely, it’s possible that you may have a true exigent crisis where immediate help is needed, we are talking about a life-threatening situation that involves safety and health to the person that might be considering taking their life or somebody that is having a psychotic break. And this is simply going to require immediate intervention. But here’s what I share about 9 1 1, and I am not ignorant nor unsympathetic to the concerns that some people have about calling 9 1 1, and I can understand why they have those concerns. What I would say is this, if you determine that you need to call 9 1 1 for a life-threatening emergency, please remember the following guidelines.

Number one is let the dispatcher know it is a mental health emergency. That’s number one. Let them know it is a mental health emergency. If it’s suicide, let them know that this person is actively suicidal. If it involves a suicide, let them know whether or not the person is under the influence of alcohol or drugs, whether they have a weapon and whether this is a repeated attempt, if they have a history of suicidal attempts, you’re giving the dispatcher important information that can be relayed to the professionals in the field. Another thing to add to that is to tell, or I should say, ask the dispatcher, do you have a crisis intervention officer or a mental health crisis response team that can respond? Again, many jurisdictions have this, I can’t speak for every jurisdiction around the country. I know in South Florida we have crisis intervention officers, but ask the dispatcher, do you have a mental health crisis team or do you have a crisis intervention officer?

And these are specially trained professionals that can help to deescalate and ensure the safety of people that are involved. So just remember, if you call 9 1 1, let ’em know it’s a mental health crisis emergency. Let ’em know whether the person is under the influence of alcohol or drugs. Let ’em know whether the person has a weapon. Let ’em know if the person has multiple prior attempts of suicide and ask for a crisis intervention officer or mobile mental health response team. By doing that, you greatly improve the likelihood of a better outcome, a more favorable outcome, just because you’ve got more professional power brought to bear. So that really kind of summarizes some of my primary go-to resources, but please know that that is literally the tip of the iceberg. There are many, many, many more, but I know time just doesn’t allow us to go into that. So I hope that kind of answers your question on resources.

Molly Ranns:

It certainly does. Joe, thank you so much for providing those. I can agree with them all. I have utilized them or provided them all to someone at some point in time. And I just want to add one more really important resource that we need to address, and it does fit with your recommendation for utilization of the A BA, the A BA has the Commission on Lawyer Assistance Programs. Just for the listeners on this call, don’t forget that most every state in the country does have a LAP or a lawyer’s assistance program. Here in Michigan we’re called the Lawyers and Judges Assistance Program, but these laps are confidential programs and they are uniquely positioned to provide services to law students, lawyers, judges, and other legal professionals from an array of issues. And we don’t just help those folks with mental health and substance use issues, but also we help legal professionals thrive both personally and professionally. So please use your Lawyer’s assistance program if you’re struggling. Again, they’re confidential programs and most every state has one, and that helps us to keep up on our self-care and make sure that we’re taking care of our mental and our emotional health and fitting with that idea of self-care. Joe, can you talk to the importance of self-care and the essential need for self-care in the legal community today?

Joe Ankus:

Absolutely, Molly. Self-care is something that I probably really didn’t pay as much attention to as I should have for too many years. Self-care number one is not selfish. Self-care is exactly what it sounds like, which is taking care of ourselves is important for two reasons. One, it’s important for our own health and wellbeing. And number two, it’s important for the health and wellbeing of those around us. And it’s very simple. And the analogy that’s often used and one that makes the most sense is the analogy of the oxygen mask on the airplane, which is fortunately, I’ve never had one drop down from the overhead compartment, but if it did, I think everybody knows from having flown that. They say, please take care of your mask first before you help somebody else. And in a roundabout sort of way, it’s the exact same thing, which is if we are not taking care of ourselves, we are in a hugely disadvantaged position to be of assistance to our friends, colleagues, families, friends that may be struggling.

So yes, self-care is not meant to be kind of a buzz phrase. It’s not meant to be a throwaway phrase. It’s not meant to be a feel good phrase. Self-care requires concentrated effort. And self-care can really span the gamut from things as simple as taking five good focused deep breaths when you’re feeling stressed to up through and including taking a sabbatical for a week or two or a month if you’re really, really struggling. And every permutation in between. The more common referenced topics around self-care generally are involve mindfulness, meditation, yoga, exercise, proper nutrition, reducing negative coping strategies, which would mean using alcohol, tobacco, or anything that is what we call negative coping strategy, which would be harmful to your health. And we use to kind of mute or blunt any sort of pain that we might be feeling psychologically, but don’t diminish its importance. I have found that for me, if I need a break, I make the time to take the break and you really will reap its dividends, but never feel guilty about taking care of yourself.

Too many people who especially are struggling or have somebody close to them that is struggling, they tend to forego their needs in lieu of everybody else around them. And I would submit to you, you’re doing both yourself and the person or persons that you might be trying to help a huge disservice. And that’s why it’s just so important not to just say, yeah, I’ll get around to it. If you need a break, take the break. Your clients will appreciate it, your colleagues will appreciate it, and most importantly, you will appreciate it. So yes, I’m a big proponent of self-care.

JoAnn Hathaway:

Thank you for that. Joe. It seems that emphasis on self-care has, and thankfully so come to the forefront more so since the pandemic, and we know it can sometimes be hindered by feelings of shame, stigma, and embarrassment. How do you think we can address these issues surrounding mental health?

Joe Ankus:

Joanne, let me tell you again, the questions you ask are all timely and relevant. I think underlying this entire discussion, even though we haven’t talked about it until now, is the role of shame, stigma, and embarrassment. One of the things that really motivates me, and what I hope I’m imparting today is that for anybody that’s struggling or anybody that knows anybody that’s struggling, one of the biggest hurdles to people getting help or opening up is shame, stigma and embarrassment. And I can tell you, as somebody who has a lived experience with severe anxiety, there is just nothing to be ashamed about. And the easiest way to frame this is to say, would you be embarrassed if you had a broken arm and sought treatment? I don’t think so. In fact, I think it would be frowned upon if you had a broken arm and did not get it seen by an orthopedist death.

Do we shame or stigmatize somebody because they have high blood pressure? No. In fact, we might shame them if they didn’t get help and get on high blood pressure medication. Do we shame somebody because they a cavity? No, we in fact encourage them to get to the dentist and get it failed. So I think that the shame and the stigma and embarrassment is we’ve come a long way, a long way towards reducing it. I will say that there still unfortunately is a fair swath of our population and our colleagues that feel that in law it’s about being mentally tough. It’s about being fight till the end. There’s no room for weakness. I just say that largely, that’s nonsense. When I teach, a lot of times a question I ask is, why do you think people won’t get help? Or why do you think people suffer in silence?

And they all say, because it’s just embarrassing. And I say, well, just because you can’t see it on an X-ray or just because you can’t see it in a blood test result, doesn’t mean that the struggle isn’t real. And everybody intuitively knows, especially if they have an experience, a lived experience, or they know somebody, they know it’s real. But there is just still this inherent bias towards viewing anything mentally health related as a weakness. And it’s just simply not. And the only way that we are going to attack this challenge is by having these upfront open discussions. And what you find is more and more lawyers and doctors and other professionals, doesn’t matter which industry or whether even if it’s not even a professional, is the willingness to just talk about being human. Okay, we are complicated and that’s a good thing. But as far as the steam and the stigma and the embarrassment, I think the way that I like to present it is first we have to identify it.

We have to identify it, we have to call it for what it is. The other thing is after we’ve identified it, we’ve acknowledged it. And most importantly, we have to confront it. And part of confronting it is if somebody tells you they’re struggling, or even if they don’t tell you they’re struggling, but you see it because of outward signs, believe them. Is there a minority of people that might use mental health as an excuse to avoid certain things and really aren’t struggling and they just use it as a convenient excuse? I’m sure that there probably are. We’re not really going to be concerned about that very minor segment of the population, but we have to start believing people when they tell you they’re struggling, and people say, well, Joe, I think it’s a lot of fluff. It’s a lot of soft around the edges. You got to be tougher.

And I would say, well, if you don’t believe that there’s some challenges out there, why don’t you go see how easy it is to get an appointment with a therapist or a psychiatrist? And they go, what do you mean? And I go, well, why don’t you go try? And they will say, what do you mean? I said, well, it could take months to get an appointment with a therapist or psychiatrist. And I go, and that’s because the demand is so great. There might be shame, stigma, and embarrassment, which again, I think is misplaced. But we know the demand is there, and we know that as human beings, we are thinking, feeling creatures, and so there’s just nothing to be ashamed about. But only through robust conversations like this and willingness to talk openly about it, will we continue to chip away and erode the shame and the stigma.

But I can only speak for myself. I have spoken to hundreds and hundreds of people both publicly and privately, and every time I reassure them and tell them, number one, you’re not alone, and number two, you have nothing to be ashamed about. I will continue the struggle to de-stigmatize anything relating to mental health because I think to do otherwise really undermines what all of us are trying to do on this podcast with State Bar of Michigan is trying to do what Legal Talk Network is trying to do. What everybody is trying to do is we’re trying to move towards a healthier embrace of the human condition by viewing mental health as just one component of our overall humanity. And it’s a mission that is just so worthy for me and all of us to fight.

JoAnn Hathaway:

This has been great information, but it does look like we’ve come to the end of our show today. We would like to thank our guests, Joe Ankus, for this important discussion on mental health and wellness.

Molly Ranns:

Joe, if folks would like to follow up with you personally, what is the best way to reach you?

Joe Ankus:

I would say the easiest way to reach me is you could certainly go to my website, www.ankusankusconsulting.com, or you can, my email address is info I nfo at ankus A-N-K-U-S consulting.com. That’s probably the easiest way. If anybody had any questions, again, thank you Molly and JoAnn and the State Bar of Michigan for really allowing an open, frank and productive conversation about something that is just so important to all of us. And I can’t express my gratitude any more profoundly than to say thank you for allowing me to speak.

Molly Ranns:

Thank you so much for being here with us, Joe. We are grateful as well. This has been another edition of The State Bar of Michigan On Balance Podcast.

JoAnn Hathaway:

I’m JoAnn Hathaway.

Molly Ranns:

And I’m Molly Ranns. Until next time, thank you for listening.

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