Mental health issues disproportionately affect the legal profession, and stark data on suicide rates amongst attorneys calls our attention to the great need for increased awareness. In this State Bar of Texas podcast, host Rocky Dhir talks to Terry Bentley Hill and Chris Ritter about their passion for helping attorneys learn how to recognize and get help for mental health issues. Terry and Chris openly share their painful personal experiences with these matters, shedding light on the types of symptoms in yourself, colleagues, or loved ones that signal a need for intervention. They discuss the services offered through the Texas Lawyers’ Assistance Program and encourage lawyers to seek their confidential support at 1-800-343-TLAP.
Chris Ritter is the director of the Texas Lawyers’ Assistance Program.
Terry Bentley Hill is a nationally recognized mental health advocate and a criminal defense attorney in Dallas.
State Bar of Texas Podcast
Suicide in the Law: A Problem We Can’t Keep Ignoring
Intro: Welcome to the State Bar of Texas Podcast, your monthly source for conversations and curated content to improve your law practice, with your host Rocky Dhir.
Rocky Dhir: Hi and welcome to the State Bar of Texas Podcast. I have a confession to make. I love doing this podcast. I do, I really do. It’s one of the highlights of my work. I love that we talk every month about how to improve our law practices, how to improve the legal system, and what we can learn from some of our legal legends.
But this month is a little different. We are going to talk about saving lives, either your own or someone else’s. September is National Suicide Prevention Month, and we here at the State Bar of Texas know just how important this topic is.
For Terry Bentley Hill this topic is personal. She lost her first husband and nine years later their 14-year-old daughter, both to suicide. Out of that personal tragedy, Terry, who practices Criminal Law in Dallas has made it her quest to understand and teach about mental health. Her work has earned her a Presidential Citation by the State Bar of Texas for her work with attorneys struggling with mental health and substance use disorders.
Mental health issues hit our profession more than most others, and too many of us, suffer in silence or are unaware of the warning signs of someone who needs help. So what can each of us do to help?
Chris Ritter might have some ideas. He is the Director of TLAP (the Texas Lawyers’ Assistance Program). He is not only an attorney who has practiced in big and small offices, he also holds a Master’s degree in Clinical Mental Health Counseling. Chris has also authored an article in the September 2019 edition of the ‘Texas Bar Journal’. His article is titled, “Technology and Mental Health”. If you didn’t think there was a connection between those topics, you need to pick up a copy and read what Chris has to say.
We are fortunate to have both Chris and Terry with us today. Chris and Terry, welcome to the podcast. Thank you both for being here.
Terry Bentley Hill: Thank you for having us. I am so glad we can talk about this topic. It’s so important.
Chris Ritter: Really appreciate it.
Rocky Dhir: Absolutely. Now, Terry, let’s start with you. It sounds like — it sounds like you have got quite a story to tell us. If you don’t mind, what happened all those many years ago?
Terry Bentley Hill: You are right. It is a very sad and difficult subject for a lot of people to hear. I have lived with it now for 25 years and basically what I am is I am a survivor of Suicide. I am one of those who have been left behind and two of my family members have taken their lives as you mentioned. And what started my passion and my drive to participate in attorney wellness is, my first husband was the elected District Attorney in Amarillo, Texas. And he was charismatic, he was smart, he was great in the courtroom. He had everything going for him. He had been State representative in that District for two terms and was well-known and well-respected.
I started dating him after covering the courthouse in the Police Department as a reporter for the CBS affiliate up in Amarillo and I just fell in love with him and was just swept off my feet by him. And the thing that I didn’t know was when we married Danny was all of those wonderful things but he was also struggling with alcoholism. And because my own experience with alcohol was limited to the University of Texas because we didn’t socially — have social drinking in my home when I grew up, everybody drank and got drunk, and so that was my normal.
So when we dated and we went out and I would stop drinking and he wouldn’t and he got drunk, that was not a red flag for me. So what that led to is 11 years of keeping a secret because he was an elected official and we were afraid and I say, “We”, because it is a family disease, we were afraid that if either one of us reached out for help it would affect his career, and we lived in the shadows of shame. And so it is well-known that when you suffer from a substance use disorder or oftentimes an untreated mental health disorder, it could be fatal.
And in the case of my husband, after 11 years it took a toll on our marriage. I had filed for divorce and he was an elected official, who had started drinking at work and after work and had a car accident. And so, there was a removal suit that had been filed against him, and so he was about to lose the thing that was also the most important and that was his job and his identity and his ability to serve others, and he also again was struggling with depression and the alcoholism.
So the triggering event basically was that he was about to lose his job and he was losing his marriage, and on Palm Sunday 1995 he walked into our bedroom and he took his life. And our four daughters —
Rocky Dhir: In front of you?
Terry Bentley Hill: Yes.
Rocky Dhir: Did he do that in front of you?
Terry Bentley Hill: Yes, yes.
Rocky Dhir: Oh my goodness, okay.
Terry Bentley Hill: Yes. And while my four daughters were sleeping I had just put them down to sleep that night when he walked in. And so when he died, part of me died with him. And I was not a lawyer at the time. I immediately became a single mom and I was a single mom for 20 — had been a single mom basically for seven-eight years and then when I remarried a lawyer, he had said, Terry, you have always wanted to go to law school, why don’t you go to law school? So that is my story of becoming an attorney.
But a sidenote, and a very tragic sidenote is, I had enrolled at the age of 46-years-old, so I had a lot of insecurities about whether or not I could do this law school business to begin with. Did I have the concentration, did I have what it takes, etc., all those self-doubt questions, but I was going to just try to make it work.
Well, two weeks into my first semester I got a phone call as I’m reading legal research and writing that my 14-year-old daughter, my youngest daughter had taken her life, and so I withdrew from law school that year, and nine months later the law school called me and said, are you going to come back? If you’re not, we are going to fill your spot. And I went to my therapist because that’s one of the things I had to do after my first husband died, is I had to get into therapy.
Rocky Dhir: Sure.
Terry Bentley Hill: I had to treat all of my depression as a result. And so, I said to her, I said, “I don’t know if I can do this. I don’t know if I can go to law school.” And she said, “I am going to tell you something, Terry; I usually don’t tell my patients what to do. I let them figure that out for themselves, but I am going to tell you right now you’re going to go to law school and you’re going to take that one semester at a time. And when you walk across that stage in three years and collect that diploma, you’ll know there is nothing you can’t do.”
And that is exactly what I did and she was exactly right. And when I passed the Bar in 2009 at the age of 50, one of the very first phone calls I made was to TLAP because I was going to become a TLAP volunteer because somewhere in my gut I thought if Danny had had that peer support that he could relate to lawyers who had struggled just like him, if he had that support, maybe things would have been different.
Rocky Dhir: Now, Terry, let me ask you, going back over your — over this, the saga that you have shared with us, and first of all, thank you for enlightening us about your story, but as we go back over this, now it sounds like with Danny, with your ex-husband you had at least some warning signs that there were problems. At some point you realized alcohol was an issue, what about with your daughter, did you see any indications that maybe she was suffering from depression or there was something going on or was that a surprise?
Terry Bentley Hill: No, it was not a surprise, because one thing that I have learned through this healing process is that people with depression speak the language of depression. There is a language that they speak. They speak in terms of black-and-white, all or nothing terms. I didn’t speak the language of depression when I was married to my husband. He gave me all the information I needed. He walked around with a suicide in his toolbox and eventually pulled it out and used it, but I didn’t understand what he was saying because I didn’t understand the language of depression.
Rocky Dhir: Can you give us examples? What are some languages that people use?
Terry Bentley Hill: A specific instance was very early on in our relationship. He was trying a capital murder case, and the shooter was a 17-year-old young man who shot a police officer, so it was a capital murder and he was going for the death penalty and instead of getting the death penalty, the shooter was sentenced to life in prison.
Rocky Dhir: Okay.
Terry Bentley Hill: My husband was so distraught over that. He felt he had let every — he let everyone down and he just could not get over that.
And one of the things he said to me is, I have let everyone down, I might as well just kill myself.
Well, I looked at him like, what? That made no sense to me. Why would you kill yourself just because that verdict — you didn’t get the outcome that you were hoping that you would get? See, my mind didn’t go there because I wasn’t speaking the language of depression, I didn’t understand that. So that was a particular instance but there were other signals and signs all through our marriage that I missed because I didn’t seek my own help.
One time I told him, I am going to have to go get some help and he said, what the new module file for divorce because the minute you seek the help, people are going to know I have a problem and they will ruin me. And so, it stopped me during my tracks and our secrets kept us sick, and to the point where it caused his death, or secrets caused his death.
And so I am with my girls, especially because there was a predisposition to addictions, to substance use disorders, to mental health issues, and just the trauma that we’ve all been through.
As you can imagine in our home, I watch my girls very, very closely, and I am going to tell you that all four of them suffers from depression, all of them have struggled with a variety of mental health issues and so, yes, I knew my daughter was struggling and we were trading it, but again, even at that time, this has been 15 years ago, almost exactly 15 years ago, I still wasn’t proficient at the language of depression because these are the things that she said to me in the eighth grade, “I don’t have any friends, nobody likes me, no one sits with me in the cafeteria”, and I knew that wasn’t true, because I knew all of the kids who invited her over to spend a night, I knew how much they liked her, and just to prove her wrong, I went and volunteered in the cafeteria to see for myself whether or not she was sitting by herself in that cafeteria, and of course she wasn’t.
But you know what I have learned, is it didn’t matter what I thought, it was what she thought, and so it was her reality that I missed and it was – that’s why the suicide rate for children from the ages of 10 to 25 are off the chart. It’s a second leading cause of death. They go to a place that if we do not pick up on that, then it can lead to their death as well, and I need to say this before we go on, this is very important and I’ve learned this.
When a parent dies by suicide the odds of a child following in that parent’s footsteps dramatically increases. It’s almost as if when that person dies, they give a present to their child and in that present there is a note that their parent wrote, and it said, I am now giving you permission to take your life, because a child who suffers from depression now has an option to that pain. And oftentimes you’ll hear that suicide runs in families; well, that is one of the reasons why, it’s because there is an option now that has been put on the table that oftentimes a child may not even think about except for their parent led the way.
Rocky Dhir: Now, Chris, Terry’s story is, I can’t speak for everybody listening in, but it’s kind of shaking me to my core. This is some pretty heavy and momentous information and just illustrations that we are getting from all this.
In your September 2019 ‘Texas Bar Journal’ article, where you talk about technology and mental health, you start off with some pretty startling statistics about the legal profession. Can you tell us a little bit about that? It sounds like lawyers have a pretty serious mental health problem as a group; can you talk to us about that?
Chris Ritter: Sure and I would really like to set this up by letting people know, attorneys know, law students know that these problems are not uncommon, these struggles are very common. I used to think when I was in law school, poor me, but at least I am not medical school. The legal profession is very unique, we are handling everybody’s biggest problem. All of our clients, we have 50 cases, we have got 50 people, their biggest problem in life, on our shoulders and then we are also trying to manage our mental health. In the legal profession we are in the 96 percentile for anxiety.
We don’t get training in law school, we are starting to, but we haven’t historically gotten training in law school about how to manage the anxiety of being an attorney from a psychological point of view. Most of us spend our early career trying to figure out how to do this and some of us, I am one person, found a pretty good solution which was drinking. It worked for me for a little while. And all of a sudden it was causing more anxiety when my — I guess my tolerance got to a certain ridiculous level that I was having to drink so much to feel relief, but we self-medicate with alcohol or sometimes other habits or drugs, but I just want to say this.
You know a lot of attorneys, how many admit that they have problems, very few want to because it’s a competitive world. 46% of 13,000 attorneys admitted that they’ve struggled with depression. We know that the actual number certainly got to be higher than that, and so to me this statistic alone is mind-blowing because it’s saying, most attorneys have no healthy way to manage stress and I didn’t know this until really I started getting into a master’s program for clinical mental health work. If you stay stressed out chronically, you are going to have depression.
So most of us also have struggled at times with depression were really extreme workers, that’s how we got to law school, but I think the thing that Terry by her sharing this story, she’s sharing a story that many of us in the legal profession have experienced in our families or in our own lives, and I can tell you, it’s the third leading cause in one study for attorneys. Suicide is the third leading cause of death, in a study I found we are number one in 105 professions for incidents of depression and I believe that it’s rooted in and a real need maybe for some cultural change but a need for us to learn how to manage this? How to get help and how to help each other? And this topic today is very personal to me.
In 2007, I got a divorce, also lost — I was raised by my grandmother and she unexpectedly passed away. I was burned out, I heard about another attorney that I had a case with that had driven off the road and died by suicide and I thought that day that I found out, he’s lucky. I also was fortunate enough to have people around me noticing that I wasn’t myself noticing that I was sad and I visibly showed people apparently that I wasn’t doing well, I had several people ask me how I was doing, and I told each of them, I am fine, don’t need any help.
I went to secretly a therapist parked down the street, was afraid for people to see, my car — I was in Lubbock, Texas and I went to a therapist I found in the phonebook, there was a child therapist. I found that out at the first hour that I wasted because I didn’t go to someone that was appropriate for what I needed, although, getting to any therapist is going to help because that person connected me to a person that was suited but I wanted to start by saying attorneys have a unique, a very unique life, we have very limited time for self-care. I think the article you mentioned, are talking about, were shackled to our computers, in our cell phones and all of this thing, having the ability —
Rocky Dhir: Moves on.
Chris Ritter: Oh yeah, and having the ability to develop some boundaries, having the knowledge to do self-care and I would like us to spend if we could and, Terry, please jump in and help me, talk about what we can do to help each other to diminish and to really address the rate of suicide, the number of suicides that happened in the legal world and I wanted to share one study and then we could talk about other.
In the Air Force which the military has tremendous problem with suicides, they have, they implemented a universal training which is essentially the ask training and reduce the rates of suicide by 21%, and to me the key to this, the key to our making improvement in this is Terry TLAP, getting out there and affecting people to know what to look for and to know what to do if they see something that worries them.
Rocky Dhir: So actually I did want to talk about those two things Chris, because it sounds like those are going to be the two key takeaways for anybody listening to this, how to identify a problem in someone else or themselves and then how do you broach that topic? So if you guys have ideas, I think we would all like to hear them. So how do you tell the difference between somebody who is just experiencing normal work level stress versus someone who is really, really needing or possibly crying out for help? Can you guys guide us through those?
Terry Bentley Hill: There are some telltale signs for sure and what I have started emphasizing is that we have to stop minding our own business. In this country we are very sensitive about people telling us what to do, asking us questions, and I am saying we have to stop minding our own business, this is why.
People who do have depression, they exhibit symptoms of depression. Oftentimes the number one symptom is isolation. And so when a person goes into their cave, they are separating themselves from others, they may not answer the phone. They may not open their mail. They lose interest in things that they used to enjoy doing. They may be volatile. They may be crying. They will show you signs, your gut will tell you something is not right, that lawyer never used to go into his office and shut the door, now that door is shut all of the time, if he even comes to work. So there are signs.
So then what Chris was alluding to, the Ask Program, you ask the question, are you okay, I am concerned, this is what I see, and not in a judgmental way, but in a caring way. And then if the question is answered, I am not okay, then you can ask the second question, are you thinking of hurting yourself or are you thinking of going away? Is life too hard?
And if the answer is yes, then the third question is, do you have a plan? Ask the question, don’t be afraid to. Oftentimes that is one of the hardest things for people to wrap their mind around is asking those questions.
Suicidal pressure can be looked at like a balloon filling up with helium, it gets — it expands as the pressure increases and oftentimes what we need to do is release that pressure, and by asking those questions oftentimes that releases the pressure and we can get the person who is suicidal to pause and not take that tool out of their toolbox.
Chris Ritter: I really think it’s important because I have, because of my work at TLAP asked this question many dozens of times, virtually anyone that contacts us that we have a discussion about how things are, about what’s going on in their life, most often leads to me talking about this. I was terrified to ask people in fear when I started that it would plant a seed or plant the idea that their life is terrible if I asked those questions. And I want you to know the research out there is very clear that asking these kinds of questions does not plant the seed, does not give them the idea.
And almost all of the time that I ask this question there is a great relief on the caller or the person I am talking to. I normalize it before I ask it, just because it is very common. I say many attorneys I know have thought about this, have you thought about suicide, are you considering hurting yourself, those questions have made so many people I have talked to, just like was mentioned by Terry just now, the balloon deflates a little bit, they feel relief, and it opens the door where we can just listen and then follow up with what’s needed in response.
Many have said no, I haven’t gotten to that point, I have thought about it in passing, but so often they are like yes, I have, I think about it frequently. Then we talk about, is there a plan and so forth, but I just wanted to add to what Terry shared, asking is a good thing and it’s very hard to do when you don’t do it a lot. At TLAP we would be happy to talk to anybody about how to go about that or the suicide prevention line is available at all times.
Rocky Dhir: Now, but let’s go to the other possibility. So I appreciated Terry going through the questions to ask and if they say yes, then this, if yes, then this, but what happens if they say no? You go to somebody and say, are you okay and they say, yeah, I am fine. You know, do you need any help and they say no, and like Terry said, in your gut you know something is wrong or you feel something is wrong, but they just don’t want to open up. What do you do then?
Terry Bentley Hill: Well, I can tell you I have had that situation occur and one of the things you can do and is available to lawyers, to any lawyer or support staff or anyone is, then you can make a phone call to TLAP and you can say hey, look, I am really concerned about this lawyer. I asked the questions and the answer was no, my gut is telling me something is going on, I want you all to know because then you all may be able to help. And so that is what I have done before, and then Chris and the staff at TLAP, then they can get on that and call in also their volunteers who can ask that question again as well.
Chris Ritter: And likewise, in addition, being when we have close colleagues and friends that we know well and know something is wrong, and this is a wise thing before we have this conversation, to have resources that we are prepared to give that person, if we are worried about that person. So sometimes before we have the conversation, if we are worried about them, we won’t already have a mental health professional that we might be able to connect them to, but if they say no, I am fine and they clearly are not, we encourage, yes, TLAP can help.
Sometimes people refuse help, but we can also as friends, we can also be supportive and normalize what they are going through, tell them about resources. We have support groups around. We also can plant the seed of letting them have some information so they may do some self-assessment, which is to give them hope. And that was one of the big symptoms that I wanted to mention, because we know what this means.
Hopelessness, if we see hopelessness in the people we love, there is something to notice about that and it’s really the goal to help people, to give them hope, to give them the resources, that’s our goal, but oftentimes when they say no, sometimes if we can just encourage them to share what’s going on in their life and to be able to listen. Listening is a really tough thing for lawyers to do. We are so busy often directing things, but to listen and let people vent is a huge thing.
Terry Bentley Hill: Yeah. You know, I think what’s really effective and which is so important, people respond to you when you tell them your story. That is why I am so public with my story and my journey of recovery, because when I tell my story and they go okay, she knows what I am talking about, she has been there, she is in depression, remission herself, she has been to therapy, she has been to the peer support group, she has done the medication deal, she has been through hell and back, then they are more likely to open up and feel the courage or the encouragement to get help themselves.
So we have to tell our stories. All of us have a story and it’s very important to help those who are struggling and you can help by just telling your story.
Rocky Dhir: Now, what if you don’t have experience with this? If you have never been to therapy, if unbeknownst to you, you don’t have any kind of depression or anything like that, or at least you don’t think you do, you don’t have a story to tell, so what do people in that situation do?
Chris Ritter: With a person that they notice, that they work with, an attorney or a loved one, that they notice something wrong, being able to ask the question, are you okay, being able to listen, being able to connect that person to some resources, offer some resources, and if a person is in those shoes, the National Suicide Prevention Lifeline can be a great help; TLAP, we are happy to walk people through some strategies to try to get help to the ones they love.
It is almost unbelievable how easy this process can be if we engage the person in a loving way and ask a couple of questions and listen, because people who are having suicidal ideation are uncomfortable with what’s going on and they want change to happen. It’s a condition of the mind, it’s not — and I hear so many things said, especially on social media that are judgmental about it. It’s an illness of the mind, the mind is overwhelmed, with the — the chemistry and the mind gets overwhelmed and it’s a perspective problem that they are out of control of. And there is a way to get them help.
But I do think anybody that doesn’t feel comfortable should use these resources, 800-273-TALK is the National Suicide Prevention Lifeline, 800-343-TLAP is our line and we are happy to give some help. And there are some things, and Terry, please share some things not to do.
Terry Bentley Hill: Well, to piggyback on what Chris said, I shared my story in Corpus Christi and I got an email from a person in the audience and the email made everything that I do worth it, because this woman said, I heard you talk about asking those questions and I think because I asked those questions to my 14-year-old, it saved her life. She said, I asked her the question, are you okay? The answer was no. Are you thinking of hurting yourself? Yes. Do you have a plan? Silence. She said it was the loudest, most deafening silence she has ever heard and so they were able to get her the help. So those questions are very important.
The things that you don’t want to do is you don’t want to say just get over it, everybody goes through what you are going through, those questions invalidate the person’s feelings, and what they need is they need someone to understand the incredible pain they are in. People don’t die because everything is okay, they are in incredible amount of pain, and so to validate that pain is very helpful to the person who is suffering and also can give them hope. There is always hope, that’s the message that you give, that you don’t minimize what’s going on with a person ever. Don’t you agree Chris?
Chris Ritter: Absolutely. And trying to correct their feelings is a mistake. Empathizing, understanding that what appears hopeless is very painful, instead of which lawyers are really good at, arguing and saying, oh, well, you really don’t have as bad a problem as this person over here or saying, but think about your family and all of the people, because from their perspective, and I have been there, it would be a gift to others, because I am a complete burden on the world when I am in that mindset.
And I am also in severe agony of trying to get peace and I can’t, and that’s why we have to be listeners and their feelings are valid, even if they are mistaken thoughts, and that’s one of the things that lawyers often don’t get across, it’s hard to — my rational mind can make mistakes, but the feelings are real and that’s what can cause people to take steps like that, and I just — I really — I can’t say enough about not being judgmental, validating, validating, because it is real what they are feeling.
Rocky Dhir: Now Chris, if there is a lawyer that needs to reach out to TLAP, it’s my understanding that any conversations they have with TLAP are confidential, is that correct?
Chris Ritter: Absolutely. And just let me say it this way, people can call us, we have judges call us. People can call us anonymously. We just want to help. We have been through a lot in our lives, we can share our stories, but we can connect them to really good professionals in their community. We can connect them to people, volunteers like Terry that have been through it. We can connect people to support groups. We can connect people to resources for funding, to get therapy or other treatment needed. And we just want to help. We have over a thousand volunteers statewide that all have something to offer, to help someone out, to be a mentor, to be a partner, and TLAP is a great resource. You can call us anonymously, 1-800-343-TLAP.
Rocky Dhir: Okay, yeah, I was going to ask you for that number again, so you are reading my mind, so I appreciate that Chris.
Well, this is a very important topic. We could talk for days about it and probably just scratch the surface, but that is unfortunately all the time we have for today.
I want to thank my guests Chris Ritter and Terry Bentley Hill for joining us and of course I want to thank you for tuning in. If you need help or know someone who might, please reach out to TLAP and don’t hesitate.
If you liked what you heard today, please rate and review us on Apple Podcasts, Google Podcasts or your favorite podcasting app.
Until next time, remember, life is a journey folks. I am Rocky Dhir signing off.
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