The practice of law is extremely demanding. It pervades almost all aspects of a lawyer's life, placing heavy and constant demands on individuals within the industry. While many lawyers likely expected a fast-moving and high-pressured career when accepting their first legal job, far fewer are likely to have known that they were entering a profession topping the league tables for loneliness, substance abuse, depression, anxiety, stress and suicide.

Although the issue is seldom discussed, many lawyers battle mental health concerns every day, often as a direct result of career-driven pressures. A 2016 study published in the Journal of Addiction Medicine by Patrick R. Krill, Ryan Johnson and Linda Albert surveyed almost 13,000 licensed, employed attorneys across 19 states and found that lawyers suffer from "problematic drinking that is hazardous, harmful or otherwise generally consistent with alcohol use disorders at a much higher rate [20.6 percent] than other populations." The study also found that attorneys suffer from severe levels of depression (28 percent of all lawyers surveyed), anxiety (19 percent) and stress (23 percent) when compared with other workforces, in addition to suffering from social anxiety, attention deficit hyperactivity disorder, panic disorder, bipolar disorder, suicidal thoughts, self-injurious behaviors and suicidal attempts.

Mental health concerns spare no demographic group, but the data suggests that lawyers in the earlier stages of their careers are at greater risk than lawyers who have been in the profession for 15 years or more. This data correlates with another study, written by Thomas Curran and Andrew P. Hill and published by the American Psychological Association in 2017, which suggests that millennials suffer more from "multidimensional perfectionism"—a combination of excessively high personal standards and overly critical self-evaluations—than other generations. Of course, more experienced lawyers are not immune from mental health challenges. Recently, Quinn Emanuel Urquhart & Sullivan partner Joe Milowic broke the silence around mental health in the legal industry by speaking publicly about his long-standing struggle with depression.

Why Are Lawyers Suffering in Silence?

In light of the prevalence and seriousness of mental health concerns in the legal profession, it is startling that the topic is still not adequately addressed in law firms. In preparing this editorial, The American Lawyer's Young Lawyer Editorial Board created a mental health questionnaire and circulated it to lawyers at all levels of seniority within the industry. The data obtained was limited but illuminating. Of the respondents, roughly 50 percent said their career in law had adversely affected their mental health, while 79 percent said that they would not feel comfortable seeking support from their law firm if they were suffering from a mental health concern. Of the latter responses, almost all explained that their answer was a result of "fear of being perceived as weak," "fear of it hampering career progression" or "fear of it reflecting negatively in performance reviews."

Interestingly, when the participants were asked whether they would perceive a colleague as weak if they suffered from a mental health concern, 62 percent said that they would not, 27 percent said they might, and 11 percent said they would. This data suggests that any efforts to tackle the stigma that exists around mental health in the legal profession must be a joint effort—one that we suggest is led at the institutional level by law firms and supported at the individual level by lawyers.

What Can the Industry Do?

Shaking the stigma attached to mental health concerns will require an ideological shift within the legal profession. This requires the full engagement of law firms and lawyers.

The first step is for law firms to educate themselves and their attorneys about the importance of mental health and the challenges their workforce faces. This should include law firms promoting services that are already available to attorneys but may be poorly publicized. Even if your firm already takes certain steps to inform attorneys about available resources, it may still be beneficial to encourage your management team to circulate a firmwide email listing the support available to refresh attorneys' memories and demonstrate a willingness to communicate openly about the issue. According to the data obtained from the board's questionnaire, 89 percent of attorneys said their firm was not doing enough to support employees with mental health issues, or that they were not aware of their firm offering any support to employees in this area.

Education may also include public awareness campaigns run within law firms to overcome negative perceptions of mental health and encourage peer-to-peer support. According to Larry Richard, a leading expert on the psychology of lawyer behavior and founder and principal consultant at LawyerBrain, the early warning signs of mental illness are often missed because people do not know what to look out for. As a solution, he suggests that law firms should engage in mental health first aid, which would involve training first-level contacts such as receptionists and secretaries who communicate with lawyers daily to look out for signals of mental health concerns. Such signals may include attorneys not opening their mail, giving away valuable objects, or an unwillingness to schedule meetings for more than a few days in advance. Richard suggests that if we are able to identify mental health concerns at the early stages of their development, we are far more likely to respond to them successfully.

The legal community is beginning to respond to this need for education. Certain state bars (for example, California and Illinois) now require lawyers to address mental health and substance abuse as part of their Minimum Continuing Legal Education requirements. Furthermore, in 2017, the American Bar Association's National Task Force on Lawyer Well-Being published its first report: "The Path to Lawyer Well-Being: Practical Recommendations for Positive Change." This year, the ABA passed a resolution asking stakeholders in the legal profession to make commitments to lawyer well-being. The resolution included encouraging law firms to create lawyer well-being committees, guidelines for addressing mental health, and guidance on how to identify mental health issues.

Although education is important, education alone is not enough to address mental health concerns in law firms. Law firms must tackle the underlying causes of mental health concerns, which ultimately requires law firms to improve the working conditions of attorneys. Law firms should look to create environments in which their talent can operate at their best—for the good of the attorneys and for the firm's clients, who depend on their advice.

According to Richard, law firms can improve mental health by fostering a work environment in which employees have autonomy and discretion in their work, meaning and purpose in the workplace, social connection and collaboration in the workplace, and a sense of mastery and competence in their work. This, he suggests, will encourage positive emotions in attorneys and thus reduce the likelihood of mental health concerns developing as a result of negative working environments.

A Call to Action

In "The Seventh Sense: Power, Fortune, and Survival in the Age of Networks," Joshua Cooper Ramo suggests that if pneumonia and cancer were the greatest existential threats to humanity in the 19th and 20th centuries, respectively, the 21st century will be defined by mental illness. It is, he says, "a wasting disease—carried by information, by cellphones, by packets of data, by every bitstream we jack into our lives—[that] will go right for our minds."

In order to minimize the damage done by mental illness, we call on law firms to implement necessary changes and to break the silence on mental health. We call on lawyers to support their firms in doing so and to show compassion to any colleagues who they suspect may be suffering from a mental health concern.

For lawyers suffering from mental illness, the ABA provides on its website a directory of lawyer assistance programs and confidential hotlines available throughout the United States. In the U.K., lawyers can call LawCare's free, independent and confidential helpline on +44 800 279 6888.

The views expressed here are personal to the authors and do not represent the opinions of their employers.

Board Members: Aaron Swerdlow, Alex Tarnow, Andrea Guzman, Andrew Warner, Anusia Gillespie, Aydin Bonabi, Bess Hinson, Blair Kaminsky, Brianna Howard, Brooke Anthony, Emily Stedman, Emma Walsh, Garrett Ordower, Geoffrey Young, Heather Souder Choi, Holly Dolejsi, Jennifer Yashar, Jessica Tuchinsky, Ji Hye You, Josh Sussberg, Kevin Morse, Kyle Sheahen, Lauren Doyle, Martina Tyreus Hufnal, Mauricio Espana, Nicole Gutierrez, Peter Buckley, Quynh Vu, Rakesh Kilaru, Reggie Schafer, Sakina Rasheed Foster, Sara Harris, Shishene Jing, Tamara Bruno, Tim Fitzmaurice, Timothy Perla, Todd Koretzky, Travis Lenkner, Trisha Rich and Wyley Proctor.