Attorney Mental Health and Well-Being: The Case for Change | Practical Law The

The cataclysmic events of recent years have raised unprecedented challenges to businesses and individuals across the globe. Attorneys are suffering from depression, anxiety, and other mental health issues at startlingly high rates, and at rates that are higher than professionals in other industries. Burnout, already an issue for overworked attorneys well before the COVID-19 pandemic, has become an even bigger problem. Data from the Institute for Well-Being in Law (previously the National Task Force on Lawyer Well-Being) indicates that the suicide rate in the legal profession is ranked in the top ten among all professions, with attorneys dying by suicide at a rate that is 33% above the national norm. Putting aside the clinical issues, many in the profession report feeling isolated, detached, and physically and mentally exhausted, with accompanying feelings of loss of motivation, focus, and satisfaction.

The state of well-being in the legal profession was already at a crisis level for several years preceding the pandemic, and since the pandemic, attorneys, like other professionals, are facing new and even greater stresses. For some, stress comes from competing work and family demands. For others, the cause is isolation. For many, especially those in historically excluded groups, the culprit is the increase over the past several years in violence and hate crimes directed at their communities. For those working remotely, burnout is at an all-time high due in large part to the blurrier lines between home and work. For everyone, the stress that accompanies uncertainty looms large.

While some legal employers have taken certain measures to address attorney well-being, such as by implementing wellness initiatives and providing education on mental health and substance use disorders, traditional cultural norms in the legal industry have not changed in any meaningful way. This article describes the factors contributing to the current poor state of attorney well-being, sets out the business case for why law firms and other organizations should support and invest in the improvement of attorney well-being, and recommends practical solutions that legal employers can adopt to effectuate real change in the industry.

Industry studies that have examined the state of mental health and well-being in the legal field nearly universally show that it is at a crisis level. These studies provide valuable insights into the experiences of practicing attorneys and where to focus attention to improve attorney well-being going forward.

ALM’s 2023 Mental Health and Substance Abuse Survey, which surveyed 2,900 law firm attorneys and staff, found that attorneys who had already been struggling with stress and isolation pre-pandemic, were in worse shape from a mental health perspective in mid-2023 than they had been 12 months earlier. These results were surprising and upsetting, given the increased dialogue around mental health and well-being in the profession in the wake of the COVID-19 pandemic.

Respondents to the ALM Survey reported increased levels of depression and anxiety. In particular:

The ALM Survey also introduced a new set of questions on how individuals were feeling, which revealed that:

Respondents cited the following familiar reasons for their poor mental health:

Patrick R. Krill (of Krill Strategies, LLC) and Nikki Degeneffe, Kelly Ochocki, and Justin J. Anker (of the Department of Psychiatry and Behavioral Sciences at the University of Minnesota) published a study in June 2022 of 1,959 practicing attorneys to determine whether the perceived values of employers were differentially associated with attorney well-being, stress, and work overcommitment. The study found that attorneys who work in environments that value professionalism, skill, and humanity over productivity and availability are in better health and experience lower stress than their counterparts in other work environments.

Mental Wellbeing in the Legal Profession: A Global Study, conducted in 2021 by the International Bar Association’s (IBA’s) Presidential Task Force on Mental Wellbeing in the Legal Profession, examined the mental well-being of legal professionals at both an individual and institutional level. The report:

One of the recommendations of the IBA report was to create a permanent entity dedicated to continuing the work of the IBA’s Wellbeing Task Force. At the end of 2022, the IBA established the IBA Professional Wellbeing Commission, whose objectives are to:

In May 2021, the Institute for Well-Being in Law conducted an electronic survey of 771 attorneys and nearly 300 support staff on burnout and engagement.

In the study, 63% of the participating attorneys (and 51% of support staff) reported some level of burnout. The study found that attorneys are prone to burnout when what they want and expect with respect to certain factors does not align with their lived experience. These factors are:

In 2017, the National Task Force on Lawyer Well-Being (which in 2020 became the Institute for Well-Being in Law) published The Path to Lawyer Well-Being: Practical Recommendations for Positive Change, which triggered concern and made high level recommendations for the profession that focused on five key themes:

A 2016 study funded by the ABA and the Hazelden Betty Ford Foundation is recognized as one of the foundational reported studies on legal professional well-being. The study examined depression, anxiety, stress, and substance use and abuse in the legal profession based on a representative sample of over 12,800 practicing attorneys across 19 states. Of that sample:

Many states have formed their own task forces and committees to better understand and address the barriers to well-being within their jurisdictions and are publishing reports and recommendations setting out their findings (for recent examples, see Attorney Well-Being: Where We Are, the Business Case for Change, and Strategies for Getting There on Practical Law).

While the legal industry is not the only profession experiencing a mental health crisis, there are numerous reasons why attorneys are vulnerable to mental health challenges.

For many attorneys, mental health challenges first arose during law school, a period often marked by stress and competition for grades and prestigious job offers. These pressures mount at a point in students’ lives when many:

A National Survey of Law Student Well-Being, originally conducted in 2014 and updated in 2021, found, among other things, that:

(For more on the law student survey, including a Q&A with two of its three principal investigators, see Forging the Path to Law Student Well-Being on Practical Law.)

Factors that contribute to stress and poor law student well-being include:

Law school culture and students’ experiences in law school are relevant to the broader legal industry because:

Notably, the ABA adopted Revisions to the 2021-2022 ABA Standards and Rules of Procedure for Approval of Law Schools, effective February 2022, which, for the first time, includes law student well-being among the standards for accrediting law schools.

Some of the factors that put a strain on a practicing attorneys’ well-being include:

Culture, that is, the set of norms, beliefs, and socially transmitted behavior patterns that are learned and shared within social groups, informs societal and institutional issues in both positive and negative ways. In law firms, some of the traits that have been traditionally emphasized as part of the law firm (and especially Big Law) culture include:

While the well-being movement has gained considerable traction in recent years, and many law firms now offer well-being programs and tout their collegial culture on their website, without real and broad-based cultural transformation among the industry’s leaders, these changes are more likely to be band-aids than panaceas. Frustrated associates frequently point out that a free gym membership or yoga app is unlikely to be particularly helpful if they are so stressed and overworked that they are unable to use it. Further, returning to the office post-pandemic and getting back to “business as usual” does not negate the ongoing need for industry leaders to address the cultural issues that have been adversely impacting the mental health and well-being of attorneys and other legal professionals for decades.

Cultures that reward certain types of behaviors while penalizing others also inevitably inform identity. Unsurprisingly, some of the reported personality characteristics that are commonly found among the attorney population include:

Being a perfectionist and independent may make attorneys particularly susceptible to the unfortunate but well-known stigma against admitting that they are struggling with a mental health or substance abuse problem.

Renowned positive psychologist Dr. Martin Seligman has reported that of the many careers that he has studied, law is an outlier because attorneys who are by nature pessimists are more successful in law school and in their legal careers, as measured by grades and professional accomplishments. In all other careers, optimists were found to be most successful. While being a pessimist may be a great trait for excelling as an attorney, it is also a risk factor for unhappiness and depression.

Any attempt to improve attorney well-being must incorporate meaningful efforts to understand the experiences and the specific burdens and barriers to well-being faced by Black, Indigenous, and People of Color (BIPOC), Asian Americans and Pacific Islanders (AAPI), lesbian, gay, bisexual, transgender, and queer (LGBTQ+) attorneys, and attorneys from other underrepresented and historically excluded groups.

A 2021 report published by the Massachusetts Standing Committee, which compiled feedback from over 115 attorneys, law students, and judges in Massachusetts based on meetings with individual affinity group bar associations, clearly and painfully illustrates where DEI and well-being intersect.

In a 2022 interview with Practical Law, former Massachusetts Standing Committee Fellow Gavin Alexander summarized the report’s conclusions as follows:

(For the full interview, including more on this report, see Trailblazing Toward Better Mental Health & Well-Being in Law: Q&A with Gavin Alexander, Well-Being Advocate on Practical Law.)

Calls to change the underlying culture, make a greater commitment to attorney well-being, and take on and change the massive mental health problem in the legal industry have been made on moral, humanitarian, and even ethical grounds (focusing on attorneys’ ethical duty of competence) but have until relatively recently largely been ignored. However, there are reasons to be optimistic that the tide may finally be turning.

A combination of the following factors has increased focus on these issues within the legal industry and opened up a serious dialogue about addressing the problem:

Additionally, a growing number of organizations and legal professionals have joined the well-being movement and are vocal about mental health issues, and committed to cultivating positive change (for information on specific individuals, organizations, and initiatives dedicated to addressing well-being issues, see Attorney Well-Being: Where We Are, the Business Case for Change, and Strategies for Getting There on Practical Law).

Clients can play an important role in driving change. Clients are increasingly recognizing that creating a working relationship and culture that is more attentive to mental health and well-being benefits both themselves and their outside counsel. For example, when an important client sends an email late at night that results in hordes of stressed, overworked, and mentally taxed attorneys quickly scrambling to address the client’s request, it can lead to:

This issue was recognized by Barclays Bank, which, in founding the Mindful Business Charter, together with two of its panel firms (see Learn from Existing Frameworks, Resources, and Other Guidance below), recognized the stress and strain that they, as an important client, were placing on their outside counsel who were required to drop everything when they called and often work around-the-clock. Barclays recognized that these demands not only contribute to poor attorney well-being but could ultimately lead to mistakes and poorer overall work product.

To the more cynical among us, history indicates that law firms are slow to make sweeping changes until forced to do so by clients. But the history of corporate social responsibility, pro bono, and DEI also provides a roadmap for how clients may provide a top-down push to their law firm partners in the area of mental health and wellness.

If a large swath of clients impose a certain baseline level of mental health and wellness requirements among their law firm partners as a prerequisite to requests for proposals (RFPs) and in forming business relationships, as they did in the pro bono and DEI areas, this could create larger change. For example, in 2022, in-house leaders at US Bank recognized that mental health is an industry concern and began to craft wellness guidelines for its outside counsel.

US Bank created a pilot initiative to foster wellness among its outside counsel in which it worked with seven of its panel law firms to develop guidelines addressing:

These client-driven initiatives are models to create larger-scale change and hold much promise as a way to drive real and sustainable improvement in attorney mental health and well-being.

Providing a positive and thriving atmosphere for mental health and wellness is not just the right thing to do for moral or humanitarian reasons. It is good business.

Providing excellent, creative client service as advocates and advisers is at the core of what attorneys do. Additionally, recruiting and retaining talent are among the most critical issues confronting legal employers today. However, there is growing recognition that the traditional approaches to ensuring excellent client service and talent retention may no longer be working.

Mentally healthy attorneys do better and higher quality work. Workplaces with high levels of mental well-being are more productive, with surveys finding increases in productivity by over 12%. By contrast, unresolved hidden mental health issues create large, significant, and often untracked direct and indirect costs for law firms, including in terms of lost time and efficiency that impact the bottom line.

It has been noted that mental health disorders cost US employers (including legal employers) more than $200 billion each year (Professor Jarrod Reich, Capitalizing on Healthy Lawyers: The Business Case for Law Firms to Promote and Prioritize Lawyer Well-Being, 65 Vill. L. Rev. 361 (2020)). According to one study, businesses suffer more than $101 billion in indirect costs annually due to the absenteeism and “presenteeism” (working while impaired) of its depressed employees (see Paul E. Greenberg et al., The Economic Burden of Adults with Major Depressive Disorder in the United States (2005 and 2010), 76 J. Clinical Psychiatry 155-162 (2015)).

Other costs that can be attributed to poor attorney well-being include:

Creating a positive and healthy workplace that supports mental health and well-being is critical to attracting and retaining the best and brightest legal talent. Mental health problems and an absence of support for well-being can greatly contribute to attorney attrition, which adversely affects the law firm’s bottom line.

According to one estimate, the cost of replacing a departing associate ranges from $200,000 to $500,000 or roughly one-and-a-half to two times the annual salary of that attorney (see Nancy Levit & Douglas O. Linder, The Happy Lawyer: Making a Good Life in the Law (2010) at 162). Associate attrition costs a 100-attorney law firm $5.6 million and a 500-attorney firm $28 million annually. As attorneys are increasingly prioritizing their mental health and well-being and seeking nourishing, open, and inclusive work cultures, firms that heed the call should reap the reward.

The Thomson Reuters 2022 Stay-Go Report found that the reasons cited by attorneys for wanting to potentially leave their current law firms were not related to compensation. Instead, the report concluded that the firms that attorneys are choosing to stay at longer term (stay firms) are not always at the top of the market in terms of compensation but have found ways to lean into what matters to their attorneys, including:

Stay firms also have invested in support functions that their attorneys value, such as IT and marketing. Significantly, stay firms also generally fared better financially than their counterpart go firms for most of the past several years.

Data indicates that work-life balance, as opposed to higher compensation, is more likely to entice associates away from their current law firm. The Thomson Reuters Institute’s 2022 Report on the State of the Legal Market: A Challenging Road to Recovery found that the reasons cited by attorneys for wanting to potentially leave their current firm were unrelated to compensation. (For more on these findings, see Attorney Well-Being: Where We Are, the Business Case for Change, and Strategies for Getting There on Practical Law.)

Legal employers can take certain tangible steps to steer the future of attorney mental health and well-being in a better direction.

Legal employers should start by visibly committing to supporting and prioritizing attorneys’ well-being by:

Legal employers should take advantage of existing mental health and well-being resources and frameworks and the experiences of individuals in the legal profession. A number of organizations have laid out helpful guidance that lay the groundwork for improving attorney well-being and mental health. Some examples include:

Moreover, the well-being movement has gained traction in recent years in large part because individuals who are passionate about change have:

Many of these individuals are themselves attorneys who have struggled with mental health issues and are now speaking out about their experiences and committing to helping others and the profession at large in better addressing these issues. By joining forces and sharing their stories, networks, and ideas, they have contributed to a shared sense of meaning and purpose that adds greater momentum to the well-being movement.

Legal employers can learn from these well-being advocates how to:

(For an example of how attorneys are shaping the well-being movement, see Towards Thriving Together in New York: Q&A with Elizabeth “Libby” Coreno, Chair of the New York State Bar Association Committee on Attorney Well-Being on Practical Law; for more on the work of other well-being advocates in the legal industry, see Attorney Well-Being: Where We Are, the Business Case for Change, and Strategies for Getting There on Practical Law.)

It is critical to look at well-being in a holistic way. Well-being is not simply the absence of mental illness. Rather, it is a continual process of seeking to thrive across multiple dimensions of health, including:

Legal employers should consider and address all of these dimensions when designing their well-being policies and programs.

DEI issues are a core part of improving attorney well-being. The Law Firm Antiracism Alliance recognizes that attorneys and law firms are uniquely positioned to analyze and advocate to change laws and policies that encourage, perpetuate, or allow racial injustice.

To be part of that change, legal employers must:

Attorney well-being and mental health begins with leadership, as leaders at every level within the organization (including senior attorneys, law firm partners, senior and midlevel associates, and anyone who supervises others) play a pivotal role in creating and shaping culture.

A number of studies outside of the legal field have concluded that human-centered leadership is a key part of well-being at work. Organizations need leaders who empathize and communicate with employees and authentically share their own mental health challenges so that everyone feels supported. By being honest about their own struggles, leaders create a culture of psychological safety, which is essential for reluctant attorneys to genuinely open up about their personal experiences. Research has shown that being able to be authentic and open at work increases employees’:

It is also important to create a top-down culture of wellness and support where people know they can get help without feeling fear or stigma. Once there is high-level leadership buy-in and formal or informal champions who care about addressing these issues, organizations can proceed to developing an effective mental health and well-being program. This includes:

While top-down change and the tone of the organization’s leaders is critical, it is also important that change comes from the bottom-up. Rather than imposing a cookie-cutter mental health and wellness plan or program on attorneys, leaders should:

Supervisors are the lynchpin of each individual attorney’s experience and can play a key role in decreasing burnout and increasing engagement by:

Legal employers should aim to create a culture in which attorneys know that they can speak openly about their mental health by:

(For more on the role that stigma plays in attorney well-being, see Mental Health and Well-Being Challenges in Law Firms in the March 2023 issue of Practical Law The Journal.)

Legal employers can improve attorney mental health and well-being by leveraging technology to:

Legal employers should also consider providing information to their attorneys about the various apps available to support their well-being, such as:

Regular use of these apps can help attorneys to better integrate fitness, work-life balance, meditation, mindfulness, breathwork, and positive affirmations into daily life.

The Thomson Reuters 2022 Stay-Go Report found that lack of career progression prospects can contribute to an associate’s dissatisfaction and desire to leave their law firm. Providing career coaching and laying out a clear career path can:

Many attorneys report that they are unhappy in their current roles, but they are unsure what alternatives are out there for them. They therefore feel trapped, which can lead to languishing and depression. During on-campus recruiting at law schools, traditional associate roles at law firms are typically emphasized, however attorneys may not be aware of alternative legal careers and roles. Law schools and legal employers should consider highlighting opportunities for attorneys beyond the traditional associate track (for more information, see Career Planning for Non-Partnership Track Associates in the September 2023 issue of Practical Law The Journal and see Legal Operations, Professional Development & Well-Being Toolkit on Practical Law).

The well-being movement has gained so much traction in recent years in large part because individuals who are passionate about change have:

Industry leaders, well-being advocates, and legal professionals at every level within every type of legal organization all have important roles to play in:

By joining forces and sharing our stories, networks, and ideas, we can each contribute to a shared sense of meaning and purpose that will add even greater momentum to the well-being movement.

Michael would like to thank the Practical Law team for their collaboration on this article.