Mental Health in the Legal Profession

Episode Notes

Transcript

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Intro: Welcome to the official ABA Law Student Podcast where we talk about issues that affect law students in recent grads from finals and graduation to the bar exam and finding a job. This show is your trusted resource for the next big step. You’re listening to the Legal Talk Network. 

Megan Steenburgh: Hello and welcome to another edition of the ABA Law Student Podcast. I’m Meg Steenburgh at 2L at Syracuse University College of Law at JDI Program. This episode is sponsored by NBI taught by experienced practitioners. NBI provides practical skill-based CLE courses attorneys have trusted more than 35 years. Discover what NBI has to offer at nbi-sems.com. 

Today we are honored to have with us Patrick Krill. Patrick is an attorney as well as licensed and board certified alcohol and drug counselor, author, researcher and advocate who has spearheaded numerous groundbreaking efforts to improve mental health in the legal profession and he’s a leading authority in the field. Patrick is the founder of Krill Strategies, a behavioral health consulting firm exclusively for the legal profession. He serves as a trusted advisor to law firms and corporate legal departments throughout North America and Europe. In that role he works to help protect and improve the health and well-being of attorneys and staff. Patrick is the author of more than 70 articles relating to mental health and addiction and contributes regularly to print in news media across the nation. He frequently lectures around the world to law firms, professional and bar associations, law schools and corporations about addiction and its intersection with the law. Patrick has received awards for his service including the ABA’s Commission on Lawyer Assistance Programs. Among other degrees, Patrick holds a JD from Loyola Law School. Thank you Patrick for joining us today. 

Patrick Krill: Thank you Megan. Thank you for the kind introduction and also for the invitation to be here today, it’s a pleasure. 

Megan Steenburgh: Oh we’re honored. Well let me begin with a broad question here what inspired you to connect the dots and dedicate your life to mental health in the legal profession? 

Patrick Krill: To give you a concise answer I would say that it was really a combination of observations, personal experience and really a sense that there was a need. So I’m someone who went to law school and I you know, I got my JD I went on for an LLM, I began practicing and I practiced for several years and during that time I had my own personal challenges that I overcame and then continued on in the profession and that gave me a slightly different perspective on myself as well as some other you know, fields that were out there right, the helping professions and during that time I was also observing a lot of challenges frankly among my peers and the profession more broadly and it sort of dawned on me that I my heart wasn’t in practicing law right? And if I look back on my decision to go to law school it was frankly based on a misunderstanding of what was ahead and you know, I made the decision that I was ultimately just simply looking for something else in my career path and so I went back to school to become a licensed alcohol and drug counselor having had my own experience in that realm, having learned that there was a very meaningful and rewarding career to be had there based on my interactions with mental health professionals but also the need that was really clear as I say that I was observing and that I was beginning to research at that point. We’re talking about 15 years ago at this point and it was clear to me that there was a need in the legal profession and there wasn’t enough being done to meet that need. 

Megan Steenburgh: What is surprising to me that the company as your bio states and as I read like you focus exclusively on behavioral health for the legal profession. What is it about the legal profession? What are the roots of the issues? 

Patrick Krill: We have significant challenges in the profession and those challenges include higher than normal levels of mental health distress, higher than the general population rates of addiction you know, everything from depression to anxiety to burnout to suicidality, substance use disorders, we tend to be sort of at the front of the pack and in some cases the levels of mental health problems are simply much higher than you would find in other populations and I think it’s really a combination of things that is responsible for those challenges. A piece of it is who we are as lawyers right, and what we bring to the table our, predispositions, our habits, our values frankly, we often don’t prioritize taking care of ourselves we prioritize a lot of other things in life including professional achievement. 

00:05:05

But then there’s also a significant component that is really the profession itself, right? Beginning in law school, the way we’re trained, the competitive nature of the profession, a lot of the implicit and explicit messages that surround mental health like maybe if you’re struggling, keep that to yourself, the chronic stress that exists in some areas of the profession, right? I may be breaking news here but being a lawyer is very stressful and I’m sure anyone listening to this podcast who’s a law student is already familiar with the long hours, the hard work, the rigor and the stress, it really is part of becoming a lawyer. That continues frequently unabated once you enter the profession and in many instances depending on the context it may actually become worse. So stress is a well-known, well-documented risk factor for the onset of mental health problems also for addiction and so all of these things sort of swirling around culminate in a higher than average level of risk. So part of it is who we are, part of it is frankly what the profession does to us that results in these challenges and the good news is that the culture has begun to shift over the last five years. There’s so much more recognition of the scope of the problems but also there’s a much greater willingness to talk about it and you know, you’ve got to name it to tame it as the expression goes as the saying goes and I think we’re making some headway in that regard. 

Megan Steenburgh: So one thing you mentioned there was that law students are a little bit different than other professional degree students, how are law students similar or different from other professional degree students like a medical school student? 

Patrick Krill: Well so in terms of how the profile of a lawsuit may differ from someone in medical school, I don’t have a lot of precise examples to share with you there. I mean I wouldn’t want to say something, I wouldn’t want to over generalize, right? But a piece of what makes lawyers sort of different from other populations is the highly competitive sort of adversarial nature and environment that accompanies going to law school and then you know, if you think about it and I assume that it’s largely still like this, I graduated from law school 20 years ago, so but my assumption and my understanding is that it remains a highly competitive environment where people are essentially trying to get ahead of the person next to them and there are a lot of behaviors that go along with that that can be antithetical to you know, being open, being vulnerable, talking about challenges that you’re facing and really prioritizing your own health and well-being, there’s a level of maladaptive perfectionism that tends to be quite high and it tends to be a maybe an overused strength of for some law students and some lawyers, right, where we just take things to a level that they don’t need to be taken to and I’m not sure that that exists in other populations such as you know, medicine, medical, clearly medical students have a lot of work, very long hours and stressful, but there really is something unique about the type of people that choose to be lawyers. 

Megan Steenburgh: So what have you seen? How have mental health struggles changed over time and I guess we should first start and consider the question pre-pandemic. 

Patrick Krill: Pre-pandemic, I would say that the legal profession tended to have levels of depression and anxiety and substance use disorders that were anywhere from two to three times higher than the general population and depending on what sub population you were comparing to you know, higher there as well. And those challenges were exacerbated as your question sort of suggests greatly by the pandemic right? And so there have been a handful of really I would say useful studies on this subject among law students specifically there was a 2016 study published, the survey of law student well-being that captured data from around the country but since then individual schools right? Some schools have begun to survey their own student populations to get a handle on the level of distress that exists, sometimes those surveys are published, sometimes they’re not, but among law students specifically I would say it is well understood at this point that stress is quite high and that depression and anxiety tend to be quite high and both of those things or I should say all three of those things open the door to dysfunctional coping mechanisms, maladaptive coping mechanisms which can include excessive substance use. 

00:10:00

Megan Steenburgh: Well you recently published groundbreaking research in fact just this past May, May 2021 that released the results of your research on attorney mental health and well-being including if I’m not mistaken examination of gender specific risk factors. What did you learn from this study? 

Patrick Krill: The study was actually fascinating and I think it’s my own work so that maybe it sounds a little bit. My new study is fascinating Megan. It was a study of lawyers in California and DC and I partnered with a researcher, a colleague at the University of Minnesota Medical School to survey lawyers in that population, we wanted sort of a bi-coastal large sample of currently practicing lawyers. We were trying to accomplish a couple of things, one to get a handle on the current sort of during the pandemic prevalence of mental health distress and to really sort of get a snapshot of how practicing lawyers were doing but I’ve conducted research in the past on prevalence and I wanted to go beyond that and to begin to examine risk factors. So what are some of the predictors of depression and anxiety and substance use disorders etcetera, and what we found was there are going to be several papers that emerge from this research project but the finding that we started with that we reported first was that female attorneys are experiencing meaningfully worse mental health and they are more likely to leave the profession due specifically to mental health burnout or stress. And I should note we did not set out to study gender differences. It would you know, we were taking a broad view right, like just sort of stepping back what’s this data going to show us and that was the clear through line, the clear headline that came out of this as we were beginning to analyze the data. It was that in every single category women were faring worse than their male counterparts. Some of the predictors of that distress as you might anticipate were work family conflict, right? And we know that’s true in the general population and I think is potentially worse in the legal profession that women experience significant role conflict between being a lawyer and you know, familial obligations and that is highly predictive of depression and anxiety and general sort of mental health distress. So that’s kind of a quick summary report we found. I should note that men are not experiencing good mental health either, right? And across the board we identified and articulated in the paper a lot of challenges that are widespread and suggestive of really redoubling our efforts as a profession because I started by saying five minutes ago you know, we’ve made some progress and we’ve made some headway and we’re talking about the issues and you’ve got to name it to tame it, yeah that’s true and I stand by that statement but you’ve got to go beyond that and our research makes that clear that you know, the awareness has been raised but there continue to be significant challenges ahead and they are disproportionately affecting female attorneys and that’s clearly not something we want. 

Megan Steenburgh: So you assist law firms of every size as part of your practice and corporate legal departments, large public sector, legal employers, what’s the primary request when someone contacts you? Is it proactive or is it reactive? 

Patrick Krill: I would say it’s heartening that it is primarily proactive although I do get a lot of calls and this has been increasing during the course of the pandemic from firms sometimes their clients sometimes they’re not, who have people who are struggling. And the firm, the organization is looking for some general sort of strategic guidance. How do we resolve this issue? How do we get this person help? How do we make sure that you know, the clients are protected and the firm is protected? Basically how do we approach this behavioral health problem that we believe exists with one of our attorneys sometimes it’s a staff member but it’s typically an attorney. You know, how do we how do we make this right and get this person hopefully well. When those calls come very late in the process, sometimes there’s a lot of damage that has occurred and the person could be quite unwell and maybe there won’t be a favorable outcome in terms of them actually being able to stay at the firm, right? I mean maybe there’s just there are too many things have gone wrong for example as a result of an untreated addiction or something like that. And I make that point simply to underscore the value of being proactive, right? And so that’s why I characterize it as heartening that most firms are calling on a proactive basis, right? Can you provide some education? Can you give us — give a talk to our lawyers or staff? 

00:15:00

Or you know, what do you offer in the way of programming or educational content to help our people understand the risk to give them some tools to better take care of themselves and to generally just you know, help people comprehend that this is really important and this should be part of your overall approach to your practice in some level of self-care? 

Megan Steenburgh: It’s difficult to put into words this next question because what I’m trying to figure out is sort of is there — are there one or two things that were missing as law students and lawyers that would help in terms of coping? 

Patrick Krill: Yeah I think this is actually the most important thing that we’ve discussed and I’m glad you asked the question because law schools have a long way to go and I don’t mean this in you know, I’m not just trying to spotlight deficiencies in your legal education but we have a long way to go in terms of better preparing lawyers and we specifically make this point in that paper by the way which is called stress-drink-leave, a gender specific examination of risk factors for mental health problems, it was published in the journal PLOS ONE, one stands for Public Library of Science ONE. I would encourage anyone to read the paper, it was published open access so it’s not behind a paywall. So read it, share it, post it on social media, do whatever you want because I think the findings were highly instructive. We make that point in the paper that some law schools have emerged as sort of trailblazers in this arena. Most have a lot of work to do, and they need to make it a bigger piece of the conversation they need to, in my view make it mandatory requirement. Mandatory sort of compulsory and educational requirement that law students learn about mental health that they have some instruction around self-care and the basic principles of personal well-being. 

So I’m glad you asked this question I would say to anyone listening to this, the most important thing that I could tell you right now is really just to sort of step back, pause, take a deep breath and take a long view of what’s ahead of you, right? We tend to and I’m recalling my own experience in law school both getting my JD and my LLM in international law which I did you know, immediately after my JD so it’s sort of this continuous educational process. I recall, you’re just sort of focused on the next goal, the next achievement, you want to get hired at that firm, you want to sort of do all these things that are going to set you up for short-term success continuing to climb the ladder. And it’s hard to step back and see the forest for the trees when you’re in your 20s, right? And I mean it’s just — it’s almost impossible sometimes. But to try and do that, to try and step back and say I’m talking about a career here and you know, God willing everything works out this is something that I’m going to be doing for decades, right? I have a long way to go presumably until I retire and so making choices now that are going to set you up for long-term success and for a sustainable legal career because we tend to as I say just kind of do the short-term thing, right? Focus on powering through this, getting through that, I got to take care of this or make it through this next. You know, rough patch and then I’ll take better care of myself that is a short-term mentality. We’re sort of day trading with our health and well-being and I would encourage people to really try and take — to play the long game, take the long view. That’s a very long answer to your question but that is where I would start. It really has to do with mindset and perspective and realizing that you know, you want to set yourself up to be durable. 

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Megan Steenburgh: We are speaking with Patrick Krill. We’ll be right back. 

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Megan Steenburgh: And we are back now with Patrick Krill, founder of Krill Strategies, a behavioral health consulting firm exclusively for the legal profession. A personal question here, what motivates you to get out of bed every morning? Is it helping those from the past? Is it looking to the future? 

Patrick Krill: Oh that is such a great question and I think it’s one that we don’t that most of us don’t spend enough time reflecting on. 

00:20:00

I would say what motivates me to get out of bed in the morning is frequently Bonnie my dog but I think that there is — I find a lot of meaning in my work and I do feel that I am making somewhat of a difference and that helps, right? It does certainly give you energy to continue on. I also just tend to be — and so I’m not practicing law anymore but I still continue to kind of be that quintessential hard-working lawyer at heart, right? I mean I just work, I’m a worker I’ve always been kind of a worker and so you know, and I’m busy, my work is very busy. So frequently I get up because I’ve just got a lot to do and I like it enough and it gives me enough meaning that that’s doing it. To circle back to what we were talking about earlier though what I was saying about take the long view, that is something that I try to remind myself of and that is where I’m able to say okay there is, maybe you are making at least a little bit of a difference here, right, when I step back and try to acquaint myself with the forest for the trees which I think is just an important exercise for all of us to do at least a handful of times a year, right? To clarify our perspective and maybe that’s something that would ultimately lead people listening to this to make different choices or pursue different paths or similar to my experience it could actually give them that shot in the arm of this is pretty good what I’m doing right, there’s some meaning here and I need to keep that in mind even when I’m pretty tired. 

Megan Steenburgh: So how do you recognize if you have a behavioral health problem? Not even to the substance abuse side of things, just addressing the pressure what do you do? How do you know you have one? 

Patrick Krill: Yeah it’s a little bit person’s specific because part of it is really based on knowing yourself and when you’re running a million miles a minute all the time, right, and you’re just kind of working, working, working, your head down and you’re not spending a lot of time in self-reflection or introspection, pausing, you know, taking a mindful approach to your life, you could go pretty far down a track and you haven’t even really sort of stopped to check in with yourself and you’re missing kind of those warning signs and eventually they’re blaring and it gets to a point where you can’t ignore it anymore but if you had been maybe a little bit more attentive to your own needs and just sort of a little bit more in touch with yourself, you would have picked up on those warning signs sooner before they were sort of blaring loudly. It’s a change really, are you — do you not feel like yourself right? Do you feel uncharacteristically angry, anxious, agitated, moody? Are you engaging in behaviors perhaps that you didn’t used to and they’re not necessarily healthy behaviors? Are you feeling more overwhelmed by things than you used to, right? Again it’s sort of a change. Are you isolating or feeling withdrawn more than you used to, right? I mean some people are very introverted by nature and that’s kind of who they’ve always been. But if you’re changing and some of these things are on a gut level not feeling like good healthy positive changes that are putting you in a better place, pay attention to that, acknowledge it, right, honor those feelings in yourself you know, that’s really the first step. Beyond that you would at some point benefit from talking to someone to get some professional sort of feedback to get some objective feedback on what specifically you might be struggling with. But in order to do that you have to be willing and comfortable seeking help which we know based on available research on the law student population, can be a challenge, it can be a challenge. Same goes for lawyers, this is a piece of why we have such high levels of mental health problems is because early on in the process when the issues were not really acute or severe, people ignore them and they feel uncomfortable reaching out for help, and then those problems progress to a point where they really take more of a toll on the individual. So to recap I guess I would say pay attention to changes within yourself, be introspective, be honest with yourself and then when you notice those changes, get some feedback and try to just be willing to reach out and talk to someone. 

Megan Steenburgh: I think personally if part of the problem too is that in law school you feel as though that knowledge is infinite and it’s probably part of the problem as lawyers too that you just — you can always learn more. I’ve never been as unhealthy as I have been in law school because I feel as though if I get up and go for a run or something I will now lose 30 minutes of reading or whatever it might be. 

00:25:11

Patrick Krill: Yes, yeah exactly, and that’s true because there is so much to learn but again try to take that long view, right? There is. 

Megan Steenburgh: Yeah. 

Patrick Krill: Learning should be a lifelong process, journey but also a lifelong source of enjoyment when you view it the right way, or we don’t have to learn everything and you won’t learn everything right now. You know, my sort of book knowledge, my academic knowledge you know, is one thing but you gain perspective over years and you’re able to sort of integrate and synthesize that with your sort of intellectual knowledge and that is actually what gets you to the most, allows you to derive the most value from your knowledge and experience. Those things take time, so maybe don’t be so hard on yourself right? Don’t view everything in these sort of binary terms, I’m either going to study right now and set myself up to get a better grade and get that better job or take care of myself. That’s life. I don’t know but I just don’t think that’s a good setup for as I say durability in your life or your career. 

Megan Steenburgh: Yeah well as you mentioned if you wait too long you’ve got different issues but I think many people fear about opening up about mental health issues because they don’t want to be treated differently, they don’t want to — if it’s later they don’t want to lose their jobs, they don’t want to lose their licenses, is that fear rational? Have you seen repercussions for those seeking help? 

Patrick Krill: So I want to answer the question honestly but also in a way that does not — I want to be clear and I wouldn’t — you know, because you can say something and someone can hear it a different way. I think in some cases there can be — and there have been consequences right, for someone’s challenges almost always though and certainly in any environment you would want to be in right, and you have some choice and you get to make choices about your life and where you work and who you work with. In any environment you would want to be in you would not experience sort of penalties for simply having a mental health challenge, or a problem, or a substance use disorder, it’s the behavior that can manifest when those problems go untreated. And there’s not always a lot we can do about that because for example if someone engages in highly unethical behavior, they steal from a client trust fund or something to feed their addiction, at the end of the day that is a behavior that is really inconsistent with our ethical obligations with the oath we take you know, there have to be some limits and some boundaries but that’s really not about the fact that that person had an addiction, it’s really about the behavior that they engaged in where they were operating well outside of their own sort of ethical guidelines and bounds in service of an illness. And so I think that’s why we, it’s so important for us to all be proactive about our own health and well-being because simply struggling with depression or anxiety or PTSD or bipolar disorder or addiction, that in and of itself is not at all a bar to being a very effective, highly competent, fully ethical attorney. It’s when these problems go unaddressed and they lead to other challenges that you can sometimes find yourself in a you know, in a very difficult place. Again going back to what I’m saying I want to be really clear about that. I wouldn’t want anyone to hear my answer to that question as suggestive of or supportive of the idea that you should ever conceal a problem, right? Getting help is always in your best interest. 

Megan Steenburgh: Absolutely. Armed with the knowledge that you have now, what would you have done differently in law school? 

Patrick Krill: Yeah probably a lot of things. Frankly, I probably would have taken better care of myself. I would have probably — it’s something that’s really an ongoing challenge for me is to just not be so hard on myself, right, and to watch out for perfectionism and negative self-talk, I mean these things can really sort of stick with you throughout the course of a lifetime if that’s kind of your innate orientation and so you have to really work on that but that’s one thing you know, I would have done some of the things that I’m talking about today, to just take the long view which did not feel available to me at the time, right? In fairness I didn’t really — I wasn’t getting that message so maybe if I had been hearing this or had been hearing that message I would have been able to avail myself of that different perspective. 

00:30:05

Because I think we can we can bring a lot of unnecessary stress and worry into our lives and pressure that is it’s just gratuitous and doesn’t really serve any purpose and we can find ourselves really sort of spinning about things that never come to pass. And so that’s one thing that I would say would have done differently is just you know, step back, take the long view and to not be so hard on yourself. 

Megan Steenburgh: How would you change the legal profession? You know, you mentioned earlier that when we were talking about law students and med students and a friend of mine who’s a med student said you know, there they collaborate, they work together, everyone’s success and that’s how we operate our study group, is everybody’s successes is ours. Would you get rid of the curve? Would you get rid of the bar? What types of things would you suggest? 

Patrick Krill: Well I guess I should say I don’t think there’s an answer here that would please everybody I mean some people and people have passionate views about some of the needed or proposed reforms to the profession beginning in law school and carrying over into the profession but I would say broadly, that collaborative environment that your friend reports you know, kind of experiencing in medical school, we would benefit from that, right? Now the legal system is adversarial and I don’t expect us to change our entire legal system in the us but to the extent that we can you know, create environments that allow for more psychological safety, where people feel that they’re able to take a risk and not necessarily be penalized if they ask a question and it’s not sort of the air quotes great question where there is less competition more collaboration because frankly when people collaborate they can really arrive at more creative solutions and come up with better ideas than individuals all kind of often in the room corner competing with each other and withholding information or insights and not wanting to kind of share their best idea with people, right? So ultimately you would be in service I think of our clients, of society that the legal profession plays such an integral role in. If we could work to be a little bit more collaborative and solution oriented rather than competitive and adversarial. You could make a fair case that there is a significant amount of overwork in the profession, right? And there’s a professor at Stanford Law School, not the Stanford Law School, Stanford Business School who published a book about three years ago called Dying For A Paycheck, and that examines kind of the phenomenon of overwork and work addiction and you know, how much people are working in society generally, in white collar environments it’s not about the legal profession but that is fully applicable to the legal profession. I don’t know if you saw it but the world health organization just published a study about two weeks ago, got a lot of attention basically saying that overwork is killing hundreds of thousands of people a year and we are very guilty of that as lawyers. And sometimes it’s because we’re passionate about what we do and you’re defending someone trying to keep them out of jail or off death row or you know, whatever and it’s intense but other times maybe the reasons aren’t as compelling aside from profits. And so in those cases I think we need to be more mindful of striking a better balance you know, so that ultimately people come into the profession and they are less likely to sort of burn out. 

Megan Steenburgh: As we conclude, I ask for one final piece of advice for law students and lawyers. 

Patrick Krill: One final piece of advice that’s pretty broad but I’ll keep it focused on the topic at hand which is well-being and I guess I would say try to view your own well-being and self-care through an incremental lens rather than binary black or white sort of it’s all — I’m either doing great in school, in my career or I’m taking great care of myself. Because frequently people think you know, what’s it going to matter if I get up for a 15-minute walk, right, or if I do something. They feel like it’s got to be all or nothing. A little bit of self-care is better than none at all and sometimes when you are able to start small take an incremental approach, you’re able to eventually over time develop more of a routine and more of a regimen and maybe that amount of self-care grows. But some is better than none and so really try to avoid that binary lens that we tend to view kind of our health versus our career through. 

00:35:06

So that would be the one piece of advice I would leave people with. Incremental is okay when it comes to trying to incorporate some change or some improvement to your health and well-being into your life. 

Megan Steenburgh: Patrick Krill. Founder of Krill Strategies, thank you for joining us and sharing your wisdom and may we all grow healthier. 

Patrick Krill: Megan it was a pleasure speaking with you and thank you for the invitation. 

Megan Steenburgh: And thank you for listening. I hope you enjoyed this episode of the Law Student Podcast. I’d like to invite you to subscribe to the ABA Law Student Podcast on Apple Podcasts. You can also reach us on Facebook at ABA for Law Students and on Twitter @abalsd. 

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Megan Steenburgh: That’s it for now. I’m Meg Steenburgh, thank you for listening. 

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