Can Big Law meaningfully change its mental health culture? Will the stigma associated with depression, alcohol abuse, and anxiety only come with generational change at law firms? What can a law firm leader do to encourage lawyers to come forward, even confidentially?

A slate of attorneys and legal leaders examined the issue of stigma at law firms on Tuesday during a panel titled "Real Talk: Addressing the Stigma Around Mental Health in the Legal Profession" at LegalWeek New York 2020.

A 2016 study conducted by the American Bar Association and the Hazelden Betty Ford Foundation found that attorneys suffer from mental health disorders at a higher frequency than the general population: 21% of employed attorneys qualify as problem drinkers; 28% show signs of depression; and 19% exhibit signs of anxiety.

In the years since the study, mental health and wellness programs have spread within law firms and state bar associations, yet the stigma associated with mental health issues and addiction has proved to be a formidable obstacle that continues to impede the effectiveness of the new programming.

And it all begins in law school, said panelist Eileen Travis, director of the New York City Bar Association's Lawyer Assistance Program.

"Students are scared of the character and fitness implications and of potential employers. They're told and trained all throughout school to be the person people come to with their problems," Travis said.

The stigma continues after employment, stoked by a culture in law firms that breeds rumors and isolates lawyers, said panelist Elena Rand, a former executive coach and CMO of midsized firm Wiggin and Dana.

"Associates don't know if they're doing well or not. Lawyers don't know when or if they'll make partner. … It's a perfect cocktail for perpetuating silence," Rand said.

Panelist Kim Koopersmith, chairwoman of Akin Gump Strauss Hauer & Feld, said she combats this culture by frequently and openly talking about mental health at Akin Gump, telling stories about herself and her family, in the hopes that her attorneys use the resources the firm offers, such as in-house counseling (which she constantly stresses is confidential).

"It's fundamental to talk about yourself," Koopersmith said. "It's important for people to know that it's happening in everybody's life and that it's OK."

Brian Cuban, an attorney in recovery and a fierce advocate for mental health in law, raised what he called the "big elephant in the room": that many law firm leaders don't care about mental health if it affects revenue. Cuban told of a managing partner he met who put it plainly him: "It's not my problem. If you can't do it, I'll find somebody who can."

"This isn't an uncommon opinion. So how do you get people to care?" Cuban said.

But there are signs that attitudes are changing. Travis noted that the number of presentations about mental health-related issues that her organization gives has doubled in the last few years. She highlighted efforts by the New York state bar to remove mental health questions from New York bar applications.

Rand added that advocates must continue to tie mental health to revenue.

"Fundamental wellness is required to perform the functions required of lawyers, like networking and business development."