The demand to treat lawyers facing substance abuse or mental health issues is skyrocketing.

It hasn't gone unnoticed. A cottage industry appears to be developing around the field of well-being services for lawyers, partly sparked by an American Bar Association pledge last year to which more than 100 big firms, law schools and corporate legal departments have signed on, agreeing to take steps to prioritize well-being.

Some services are run by doctors and other professionals who physically meet with lawyers. Others services offer wellness training through video conferencing with coaches or around-the-clock access to doctors through an app.

Some providers are marketing their services to help firms meet the pledge. Mental health experts express caution to vet the services carefully, especially for more nontraditional treatment services, wary of anyone looking to gain a quick profit on the movement.

Patrick Krill, an attorney and drug counselor who led the pledge campaign, said it would "go against the spirit and intent of the ABA pledge" to view the list of signatories "as a marketing list" for vendors. "It's critical for lawyers, legal employers and law firms to vet" resources, he said.

Still, Krill and others said it's helpful that legitimate resources are emerging to help lawyers and firms cope with the devastating high rates of substance abuse, depression and anxiety in the industry.

Law firms will have to spend some money to meet the pledge goals, Krill said, as it's likely they don't have internal resources for the types of training, support or counseling that lawyers and staff may need.

Lawyer-Geared Programs

Even traditional clinical providers are seeking to curate programs around lawyers. Dr. Sarah Church, a clinical psychologist who specializes in the treatment of alcohol and substance use disorders, left the Albert Einstein College of Medicine in New York last year and opened a group psychotherapy practice, Elevate360, with five other psychologists. Church said she was surprised when she opened her practice doors that many patients were attorneys. No other profession appears as frequently in her practice, she said.

Now she's seeking to launch a group psychotherapy practice in New York tailored to attorneys and others in the legal field who are in recovery after alcohol or substance use disorders. This treatment group would provide support and offer skills and strategies for preventing relapse and coping with stress and negative moods.

Meanwhile, other services are offering attorneys videoconferencing, apps and other tech tools to reach lawyers on the go. For instance, Happy, a lawyer-created app, just launched—connecting users with more than 2,000 peers who are trained to be "compassionate listeners," ALM reported last month.

Another service, Healthpiper, which calls itself a virtual mental health provider, wrote in a recent LinkedIn post that it was "poised to help lawyers in their industry-wide campaign to address mental health" and linked to the ABA's own efforts. The program offers an app in which users can meet with a doctor via video chat, agree on a treatment and have medication shipped to their door, while participants can text message with the doctor through the secure app. The program offers a combination of cognitive-behavior therapy and medication for depression and anxiety.

Fred Kipperman, chief operating officer of Healthpiper and a lawyer himself, said the app allows doctors and patients to have an ongoing dialogue. Kipperman said Healthpiper's customer base is much broader than lawyers, but he believes Healthpiper can be particularly helpful to legal industry professionals. "We want to be one of many treatment options that lawyers can choose that's right for them. We're not trying to be a one-stop shop for everybody," he said.

Kipperman said participants can be assured of Healthpiper's own credentials by its participating doctors with board certification. He noted that its founder, by Dr. Joshua Freedman, a graduate of Yale Medical School, is a clinical professor of psychiatry at UCLA and a supervising psychiatrist at the UCLA Mood Disorder Clinic.

Another service, Life Cross Training (LIFE XT), also isn't shy about advertising its services to help firms meet the ABA pledge. Its website says:  "Avoid lawyer burnout outlined in the ABA Wellbeing Pledge….Contact LIFE XT now for help achieving your pledge goals!"

LIFE XT, which formed seven years ago, offers law firms one-on-one coaching with lawyers and staff through video-conferencing, for the goal of "increasing resilience to stress and maximizing joy, meaning, and productivity," the program says.

Law firm participants meet with LIFE XT coaches on a video call about five times in a four-month timeframe, while also being guided by written, video and audio practices in between coaching, said LIFE XT founder, Nate Klemp, who was previously an assistant professor of political science and philosophy at Pepperdine University.

As an example, coaches teach meditation tools, how they can integrate meditation in their schedule and make it into a long-term habit, Klemp said.

LIFE XT isn't suitable for everyone, Klemp said, adding when coaches encounter a participant experiencing anxiety or depression, they recommend participants seek medical treatment.

But "for a lot of attorneys," Klemp said, "they're just looking for ways to be more optimal and to get tools that will help them be more resilient and manage stress more effectively — that's our sweet spot."

With a pledge like the ABA's, Klemp said, "there are always going to be people interested in taking action and firms that are wanting to help. I don't think there's anything inherently nefarious that is serving a demand," Klemp said, adding that LIFE XT has been working with firms long before the 2018-written pledge. Klemp also noted that LIFE XT uses 13 assessment tools to measure the effectiveness of the program, by polling participants before and after the coaching.

The company has worked with about seven law firms in the last few years, including Seyfarth Shaw and previous work with Kirkland & Ellis. (The firm's chairman, Jeffrey Hammes, was on the board of LIFE XT's main investor, venture capital fund Abundant Venture Partners.)

Speaking from his own experience, Brett Bartlett, a Seyfarth Shaw partner, said LIFE XT's program helped him change the way he looks at the legal profession and develop more coping mechanisms.

Bartlett and Klemp declined to provide details on LIFE XT's prices to firms, but Bartlett called its services "a material investment" at Seyfarth. "It is not something that a firm's partners would simply shrug at," Bartlett said. "It's intended to be a broad-reaching initiative. The return of the investment is a little challenging to track but we feel the monetary investment we have put into it has indeed paid off."

Red Flags

Krill, who declined to comment about any particular service provider and doesn't endorse any single program, recommends lawyers and law firms conduct due diligence by asking about a service's prior experience working with legal industry professionals and asking other law firms and lawyers whether they've had good experience with any particular resource. If a business is purporting to offer mental health services, quasi mental health or addiction treatment services, but they don't have licensed clinical staff, that's a red flag, Krill said.

Meanwhile, Krill said, it's "important for lawyers to recognize that their coach is not their therapist."

In an era of digital start-ups, resources can come and go quickly, making vetting even more imperative. One service that was being marketed to law firms, Annum Health, was a digital startup that called itself an alternative to rehab for heavy drinking. The service closed in January, citing an "unforeseen change in our financial circumstance," according to healthcare industry site MedCity News.

Bartlett, at Seyfarth, said he's not concerned about "the fly-by-night lower end folks coming in and ruining" the new awareness of mental health priorities in the legal industry. "I think they're going to be strained out by the lawyers' natural resistance to this kind of new mindset in the first place," he said, adding he hasn't noticed "a surge of con men or bad business people."

Ultimately, once a wellbeing resource is vetted by a law firm and agreed upon, Bartlett said, it's important that those at the top of the firm champion it.  "If there's not adoption of what's being offered, if there's not championship or credibility, then it (could) fall flat on its face," he said.

Read more: Minds Over Matters: An Examination of Mental Health in the Legal Profession