1. Hugh Grady ILAP Executive Director
Lawyers In Need of Assistance: The Impact on the Person, Ethics and the Profession
Hugh Grady
ILAP Executive Director

2. Today’s Outline Some facts about the profession
What exactly is an impaired lawyer?
Correlations between lawyer impairment and disciplinary chaos
Golden Rules

3. Scope of The Impairment Problem
Impact on the Person

4. Some Data 2015 ABA/Hazelden Betty Ford Foundation Study
Published in February 2016 Journal of Addiction Medicine
12,825 licensed employed attorneys & judges
Males 53.4%
Females 46.5%

5. Alcohol Use- AUDIT 10
20.6 % scored at a level consistent with problematic drinking-Using Audit 10 = problem behaviors and levels of use
Problematic drinking = hazardous drinking and possible dependence
More males (25.1%) than females (15.5%) among lawyers
Using the Audit 3 = levels of use
Physicians 15% problematic drinking
Lawyers 36.4%
More females than males among lawyers
Position in the field
Higher scores for those working in private firms
For our study we utilized the Audit 10 which has ten questions. The Audit ten focuses on amount, frequency and consequences of use. The physician study used the Audit 3 which has three questions and focuses on amount and frequency of use. We analyzed our data using just the Audit 3 so we could compare to another professional group, doctors. When we did this we found the rate of problematic drinking for lawyers increased to 36.4% compared to 15% for physicians. Possibly this is due to lawyers being self regulating and not under the scrutiny of physicians in their practice. In other words, lawyers “may” be able to drink larger amounts and more frequently and avoid the consequences whereas physicians are unable to do this without being detected. This is a theory only.
I do not know why lawyers in Bar Associations had higher levels of problematic drinking. The sample was small but it was a significant finding.

6. Self Reporting-Concerns
22.6% felt their use of alcohol or substances was a problem sometime during their lives
27.6% reported problematic use prior to law school
14.2% reported problematic use started during law school
47.7 % reported problematic use started within the first 15 years following law school
14.5% reported problematic use started more than 15 years after law school.
We asked the questions whether “you ever thought your use of alcohol or other substances was a problem: if “yes” then before, during law school, within 15 years after law school or more than 15 years out. Results above.

7. DRUG USE-DAST Smaller sample 26.7% completed the DAST n= 3419
Low rates of abuse = 76%
Intermediate = 20.9%
Substantial = 3.0%
Severe = .01%
The Drug Abuse Screening test was developed in 1982 and is still an excellent screening tool. The DAST has exhibited valid and psychometric properties and has been found to be a sensitive screening instrument for the abuse of drugs other than alcohol. We had a much smaller sample, 3,419 people completed this instrument. We don’t know if concerns about revealing use of illegal substances or abuse of prescription medications lowered the willingness of people to participate or if markedly fewer lawyers engage in this behavior. However, it was still a large group and noted is that of that group 24% were in the intermediate to severe range of drug abuse.

8. Depression, Anxiety and Stress Scale = DASS-21
Males higher levels of depression than females
Same inverse relationship
Rates decreases as age increased
Junior positions = higher rates
The DASS is a 21-item questionnaire which includes three self-report scales designed to measure the negative emotional states of depression, anxiety and stress. Men higher levels of depression than females

9. ANXIETY/STRESS Anxiety 19% Stress 23%
Females higher than males
Stress 23%
Higher scores on Audit correlated with higher scores on the DASS
DASS scores deceased as age and years in the field increased- similar to Audit
Females higher level of anxiety than men

10. Self Reporting of Mental Health Concerns
Anxiety 61%
Depression 45.7%
Social Anxiety 16.1%
ADHD 16.1%
Panic Disorder 8.0%
Bipolar Disorder 2.4%
Self report Question relates to mental health concerns over the course of their legal career. Interesting that most reported anxiety even thought the instruments picked up depression at a higher percentage. Possible that some people may interpret their symptoms of depression as anxiety versus depression, with ruminating thoughts, sleep problems or general unrest.

11. Suicidal Thoughts and Self Harm
11.5% reported suicidal thoughts during their career
2.9% reported self injurious behaviors
0.7% reported at least one suicide attempt
I have not been able to find a current study on the rates of depression among different professional groups. Even though CNN is reporting that the CDC has this study I have been unable and also my colleagues have been unable to locate any such study. So I don’t know that we know definitively where attorneys fall on this spectrum. Our study demonstrated that 11.5 % have had thoughts of suicide which is a lot of lawyers. This goes hand in hand with the high rates of depression with the legal profession.

12. Help Seeking Behaviors- Two Common Barriers
Not wanting others to find out they needed help-Stigma
Concerns regarding privacy or confidentiality
No one can know
The question was asked separately for AODA and MH. “have you ever received services, treatment or help for your alcohol or drug useage? This included self help groups, religious services etc. The rates were very, very low considering the high rates of problematic drinking and depression and anxiety.

13. SIGNS AND SYMPTOMS OF IMPAIRMENT

14. Attendance Routinely arrives late or leaves early
Regularly returns late from or fails to return from lunch
Fails to keep scheduled appointments
Fails to appear at depositions or court hearings
Decreased productivity
Has frequent sick days and unexplained absences

15. Job Performance Procrastinates, pattern of missed deadlines
Neglects prompt processing of mail or timely return of calls
Decline of productivity
Quality of work declines
Overreacts to criticism, shifts blame to others, withdraws
Smells of ETOH in office or during court appearances
Client complaints
Co-mingles or “borrows” client funds

16. Look/Feel Familiar?

17. Personal Behavior
Gradual deterioration of personal appearance/hygiene/health
Loses control at social gatherings or where professional decorum is expected
Distorts the truth, is dishonest
OMVI, public intoxication arrest or possession of illegal drug
Poor time management, failure to timely file tax payments
Pattern of family crisis
Pattern of mood swings

18. IMPAIRMENT AND DISCIPLINE

19. Rule 32:1.3 Diligence
A lawyers work must be controlled so that each matter can be handled competently.
Perhaps no professional shortcoming is more widely resented than procrastination.

20. Rule 32:3.2 Expediting Litigation
Reasonable efforts to expedite litigation
Consistent with interests of client
Dilatory practices bring the administration of justice into disrepute
Realizing financial or other benefit from otherwise improper delay in litigation is not a legitimate interest of the client

21. Rule 32:3.3: Candor Toward The Tribunal
A lawyer shall not knowingly make a false statement of fact or law to a tribunal.
Or fail to correct a false statement of material fact or law previously made.

22. Rule 32:5.1Responsibilities of Partners,Managers, and Supervisory Lawyers
Reasonable efforts to ensure compliance with Rules of Professional Conduct
Knowledge and ratification of specific conduct
Failure to take remedial action

23. Rule 32:8.3 Reporting Professional Misconduct
Knowledge requires reporting when one lawyer has knowledge of another
Judges
Iowa Lawyers Assistance Program exception
Confidentiality

24. What Hurts More than Helps?
Alcohol or Drug abuse or dependence
Gambling or other addictions
Depression or other mental illness
General sense of imbalance which decreases intrinsic motivation-may lead to the above
Lack of purpose or connectedness

25. “They didn’t teach us in law school that people are crazy!”

26. Impact of Stress=Imbalance
Georgetown Journal of Legal Ethics cited depression as a significant factor in lawyer discipline
Louisiana study found 80% of their Client Protection Fund cases involved addictions including gambling.

27. A D O
G’S L I F E

28. The 20 Golden Rules Richard S. Massington, Miami Fl.
Behave yourself
Answer the phone
Return your phone calls
Pay your bills
Hands off clients money
Tell the truth
Admit ignorance
Be honorable
Defend the honor of your fellow attorneys
Be gracious and thoughtful
Value the time of your fellow attorneys
Give straight answers
Avoid the need to go to court
Think first
Define your goals
There is no such thing as billing 3000 hours a year
Tell your clients how to behave
Solve problems – don't become one
Have ideals you believe in
Call your mother