So far, the Lawyer Assistance Program sounds like a pretty good deal. Instead of suffering the full and undiluted consequences of the Bar’s powerful disciplinary process, attorneys may be able to avoid punishment, perhaps entirely, by entering a treatment center or program. The same concept underlies California’s general drug diversion program which, presumably, reduces jail populations by sending addicts for treatment rather than to jail.

Based on the assumption that 20% of all active attorneys are addicted to drugs or alcohol, which is widely accepted in the scientific community, California has approximately 35,000 attorney addicts. And that’s not all. Based on a study that showed a 26% mental illness rate among attorneys, there should be almost 50,000 attorneys seeking treatment for mental illness (although these populations largely suffer from both substance abuse and mental illness). However in 2008, only .4% of California’s attorneys participated in the program. Of that number, only 25% entered voluntarily (i.e. not already under a disciplinary proceeding or investigation). Sadly, what looks good on paper for substance abuse treatment often does not work in reality.

Perhaps participation is low due to the fact that those behaviors and personality traits that are common among some attorneys, such as aggression and perfectionism, also foster denial and inhibit the ability to admit there their is a substance abuse problem. Also, the stigma associated with drug or alcohol abuse could ruin or impair an attorney’s career. However, perhaps the main reason attorneys do not seek treatment for alcoholism or drug addiction is that they cannot afford to.

Administration for the LAP is costly, especially since staff therapists and counselors work directly for the Bar. The cost of administering the program comes from State Bar dues – $10 from each of California’s roughly 170,000 active members. But those fees do not cover the cost of enrolling in a treatment center, attending professional counseling sessions, drug testing, or professional evaluations.

Each attorney must pay for the costs associated with participating in the program, including the cost of enrolling at an addiction treatment center. Although financial aid is available to those who cannot afford the cost of treatment via low-interest loans, the maximum amount one can borrow is fairly low relative to the cost of treatment. Last year, twenty percent of participants took advantage of LAP’s financial assistance plan, which is offered based on income for an initial 12-month period. After a year, the availability for financial assistance for continued treatment is evaluated on a case-by-case basis. After completion of the program, participants are required to repay the loan over five years at 7% interest. If they fail to complete the program, the balance becomes due and payable immediately. By the end of 2008, the financial assistance plan had loaned out approximately $1.75 million to cover the cost of treatment center attendance and other recovery-associated items.

However, I suspect that low voluntary participation in the LAP is largely a result of the enormous financial hit an attorney would take if he or she were to suspend practicing law to enroll in a formal program at an addiction treatment center. In order to fully realize the benefit of the program, more financial assistance needs be offered not just for treatment, but also for income replacement while attending a treatment center. If that becomes a reality, we might see the number of attorneys participating in the program increase dramatically.

Millie Anne Cavanaugh, Esq. is a Los Angeles immigration lawyer and former insurance defense attorney licensed to practice law in California and Massachusetts. The information contained herein is provided for informational purposes only, and should not be construed as a solicitation for your business or as legal advice on any subject matter. You should not act or refrain from acting on the basis of this information without seeking independent legal advice.
 

The California Lawyer Assistance Program (LAP) is a comprehensive program of professional support and structure including expert assessment, arrangements for enrollment at addiction treatment centers, monitored continuing outpatient treatment, random drug and alcohol testing, and professionally facilitated or peer support groups. The program also offers limited, free short-term counseling to all attorneys for stress, burnout, or career challenges.

A twelve-member committee oversees the program and can adopt the rules and regulations needed to run it, including guidelines for acceptance or denial into the program, criteria for identifying successful completion or termination for failure, and recommendations for rehabilitation criteria. The State Bar is tasked with outreach to make attorneys, the legal community, judges, and the general public aware of the program. Outreach programs include continuing legal education (CLE) courses related to prevention, detection, and treatment of substance abuse, as well as speaking engagements at law firms, bar associations, and other law-related venues.

In order to enter the program, an attorney can either self-refer, be referred by a concerned family, friend or colleague, or be referred via a disciplinary body such as the Office of Chief Trial Counsel or State Bar Court. A main qualification of participation is that the issues must not involve actual harm to the public or clients and stem from self-administration of drugs, nonviolent procurement of drugs for self-administration, or mental illness only.

California’s Lawyer Assistance Program cooperates with the attorney discipline and Bar admissions programs and reports participation treatment status and treatment violations. The State Bar Court Alternative Discipline Program refers attorneys with pending disciplinary proceedings and investigations related to the consequences of substance abuse or mental health issues. The State Bar Committee of Bar Examiners uses the LAP where substance abuse or other mental health issues exist in State Bar applicants whom examiners feel could become contributing members of the Bar after treatment.

Participation in the California LAP does not absolve an attorney of the requirements of the disciplinary system. Upon entering the program the attorney may be required to change his or her bar status to “inactive” and refrain from practicing law for a period of time, or submit to practice restrictions or limitations. However, if an attorney is not already under the jurisdiction of the disciplinary system, self-referred and colleague-referred participation is strictly confidential and should not trigger any sort of investigation.

Each attorney participant is assigned a local case manager who is a licensed clinician experienced in substance abuse and mental health. Initially, the case manager’s role is to immediately address life threatening issues, handle medical needs, and provide emotional support. A new participant attends closed professionally facilitated support groups and local self-help programs. Within a week, the participant undergoes comprehensive assessment by the case manager. The assessment can lead to a referral to medical professionals, psychiatric professionals, or addiction treatment center for further evaluation.

Each attorney meets with an evaluation committee composed of health professionals and a local attorney who has experience in recovering from drug or alcohol abuse. After the committee reviews reports generated by initial evaluations, individualized components of the long-term recovery program are finalized. Progress in the program is monitored by the case manager, group facilitator, and the evaluation committee.

For those suffering from more mild mental health issues, such as stress, burnout, relationship struggles, or career concerns, California lawyers can receive two free counseling sessions with a local therapist who specializes in working with legal professionals in order to prevent manageable problems from escalating into full blown meltdown.

A team of professionals facilitate support groups around the state, with locations in Santa Rosa, Agoura, Los Angels, Chico, Fresno, Torrance, Oakland, San Francisco, Tustin, Laguna Niguel, San Jose, Palo Alto, Fresno, Palm Springs, Santa Barbara, North Hollywood, Pasadena, Tarzana, Claremont, Riverside, Woodland Hills, Seal Beach, San Diego, Santa Monica, Sacramento, and Davis. The program also employs peer counselors, who have intimate knowledge of substance abuse in the legal profession.

Successful completion for some participants will result in eligibility for full reinstatement, elimination of restrictions, and either dismissal of the discipline case or a recommendation for a reduction in proposed discipline. The entire foundation of the program rests on the fact that information obtained during the course of participation is strictly confidential and not discoverable or admissible in a civil or disciplinary proceeding for those who successfully complete the program.

The incidence of mental illness in California’s legal community, either on its own or in combination with substance abuse, has stunned program administrators. Depression is, by far, the most common mental health issue facing attorneys today in a profession whose depression rate exceeds that of any other career. Administrators of the LAP have found that almost three quarters of new participants have a mental health diagnosis; this required the LAP to increase the number of qualified clinical staff and intensify delivery of treatment services in recent years. Only 30% of new participants suffer from substance abuse without an underlying mental illness.

Millie Anne Cavanaugh, Esq. is a Los Angeles immigration lawyer and former insurance defense attorney. She is licensed to practice law in California and Massachusetts. The information contained herein is provided for informational purposes only, and should not be construed as a solicitation for your business or as legal advice on any subject matter. You should not act or refrain from acting on the basis of this information without seeking independent legal advice.

Attorneys are also less likely to voluntarily seek admission to a treatment center, fearing job-related complications, harm to professional reputations, and financial problems. Denial is also a huge problem for attorneys; because they are often looked to for assistance and strength in their professional lives, attorneys are also less likely to admit that they have a problem and to seek treatment for it.

States have acknowledged the increased incidence of substance abuse or mental illness in the legal community and have taken steps to reach out to attorneys who need help, offering incentives to enter a treatment center instead of the disciplinary system. Many states have enacted Lawyer Assistance Programs (LAP) either through the State’s attorney regulating body (called the "State Bar" in many places) or through independent organizations that are authorized to act on the Bar’s behalf.

A Lawyer Assistance Program seeks to identify troubled attorneys and help them find a treatment center for their particular problem, with an emphasis on confidentiality. How they go about accomplishing this goal, and the particular ramifications for an attorney’s career, vary from state to state. Most LAPs offer intervention, peer counseling, professional counseling, and referral to addiction treatment centers or addiction treatment professionals. In some states, participation in the LAP will help the attorney eliminate or reduce discipline for harm suffered by clients due to their addiction. In other states, treatment will not help an attorney avoid the disciplinary process but may help them retain their right to eventually practice law again.

The American Bar Association is a big proponent of the state LAP system, offering an independent LAP program evaluation process, guidance, and resources. States look to the ABA model system and other state programs when developing strategies for dealing with alcohol and drug addicted attorneys in their own states. State bars and lawyer oversight organizations have very large incentives for keeping their attorneys off drugs and alcohol. Alcoholism and drug addiction in the legal community not only cost the general public millions of dollars each year due to incompetent or inefficient lawyering, but it also reduces the public’s trust in the legal system overall.

A review of state lawyer assistance programs, such as Arkansas’, reveal that some LAPs partner with addiction treatment centers to offer customized treatment to this unique class of alcoholics and drug addicts. Some treatment centers offer specialized professional health programs (PHP), where doctors, lawyers, businesspeople and other professional individuals can receive treatment that is tailored to the issues that typically affect those in high-stress professions. These treatment centers are often more flexible with treatment protocols, schedules, and in-patient requirements than other mainstream addiction treatment programs, recognizing the need to allow the patient to participate in business matters, when necessary, to preserve his or her career and to encourage them to finish the treatment. The treatment centers also focus therapeutic techniques on those particular behavioral or personality characteristics that make professionals, such as doctors and lawyers, so much more vulnerable to substance abuse than the general population.

While the avenues now exist for attorneys to get help with their substance abuse issues, encouraging participation in the programs is still a huge hurdle. Unless the attorney has formally entered the disciplinary system, and sees the LAP as a way to reduce or eliminate discipline, attorneys have been reluctant to voluntarily enter state-sponsored LAPs either because they do not think they have a problem, do not know or trust that the program is confidential, or cannot afford the time or money it will take to get clean.

To address this problem, many states allow a colleague or judge to refer someone to the LAP, whereas before this the options were either entering through the discipline system or through self-referral. When the LAP receives a third-party referral, a counselor usually contacts the attorney to gently offer assistance or to help determine if there is, in fact, a substance abuse problem. While enrollment at a treatment center is often recommended for those with substance abuse issues, less structured treatment such as weekly professional or peer counseling sessions can go a long way in helping someone cope with the stress or depression that can result from a high-pressure career.

State bars and attorney regulatory authorities should be lauded for this important step toward addressing the issues of alcohol or drug abuse and mental illness in the legal community. In order to meet the growing need for accessible treatment for attorneys, however, more needs to be done to both educate attorneys on the benefits of voluntary participation and to provide badly need financial assistance when getting sober means having to stop earning money for a period of time in order to enter a treatment center.

Millie Anne Cavanaugh, Esq. is licensed to practice law in California and Massachusetts.She is a former insurance defense attorney and is currently an immigration attorney. The information contained herein is provided for informational purposes only, and should not be construed as a solicitation for your business or as legal advice on any subject matter. You should not act or refrain from acting on the basis of this information without seeking independent legal advice.
 

At any given moment, a typical drug or alcohol treatment center will have patients from all walks of life. Vast differences may exist in age, sex, education level, family status, job type and socio-economic status. However, the treatment center participants are all united in their addiction and the desire to get and stay sober. But, if we were permitted to take a closer look, I bet we’d find that lawyers are represented no more frequently than any other type of worker. In fact, they probably enter addiction treatment centers less often than other individuals.

Why is this bad? Why should we not applaud the fact that attorneys are not in rehab as often as everybody else? Simply put, a lawyer is twice as likely to need an addiction treatment center than a non-attorney. The fact that attorneys are not taking up their fair share of treatment center beds, and then some, should be cause for great concern.

Roughly 10% of American adults suffer from alcoholism, which is defined as a frequent intoxication that negatively impacts health, quality of life, and professional ability. However, a very conservative estimate puts the number of alcoholic US lawyers at approximately 20%. This is an enormous problem that cannot be easily solved and likely results from a combination of alcoholism risk factors and personality.

Worse still, the alcoholism often presents with other mental health issues, the most common one being depression. A 1991 Johns Hopkins University study found that lawyers were the most depressed out of roughly 12,000 workers. It has been suggested that lawyers are three times more likely (26%) to experience symptoms of clinical depression, a condition that also leads to client neglect and legal malpractice, than other workers.

So, why is it that lawyers are twice as likely to become addicted to drugs or alcohol and three times more likely to be depressed? Although genetics can clearly play a role in both depression and substance abuse, the legal profession is a magnet for people with addictive personality traits and exploits risk factors.

Lawyers are often responsible for the property, freedom, or even lives of their clients. Clients, opposing counsel and judges expect them to be an expert in their field, no matter how long they have been practicing or the depth of their experience. This is a huge responsibility that carries with it inevitable stress and burnout. Add to it constant adversarial interactions with opposing counsel, expectation of billable hours, and, unlike in other careers, the catastrophic consequences of missed deadlines or simple mistakes, it is easy to see why lawyers become depressed and turn to alcohol or drugs to relieve the constant pressure.

Career burnout is extremely common in the legal community and often results in clinical depression. High levels of stress over a period of time lead to apathy, negative feelings about the legal professional in general, a decline in productivity, increased illness, and difficulty getting along with others. These feelings are constant, affecting the lawyer’s career, performance and personal life. Given the strong connection between depression and alcoholism, it is important to be aware of the increased risk of drug or alcohol abuse in a burned out or depressed attorney.

While by no means a truism for all lawyers, certain individuals and personality types are drawn to the practice of law. Some attorneys believe that they need to be aggressive, confrontational, and downright boorish to be a zealous advocate for the client. Although I disagree that this approach actually wins cases, it doesn’t change the fact that these lawyers exist. However, when the lawyer goes home at night to deal with her family she must leave that version of her personality at the office or risk alienating or harming loved ones. This need to regulate emotion often pushes the individual toward drugs and alcohol as a way to counteract the aggressive behavior waiting just underneath the surface. If unable to make the transition between office and home personalities, the lawyer will likely experience relationship and familial issues, leading to separation, divorce and, likely, either depression, substance abuse or a combination of the two.

Given that roughly 25% of all attorneys in the United States suffer either from depression, substance abuse, or a combination of both, it is not surprising that the legal community has acknowledged that a problem exists. Each US state, as well as Canada and the UK, has established a Lawyer Assistance Program (LAP) to help attorneys deal with substance abuse or mental health issues. Many programs work with state bar disciplinary bodies to offer admission to addiction treatment centers or some sort of outpatient addiction treatment program as an alternative to suspension or disbarment for malpractice or incompetence that results from depression or addiction. While the comprehensiveness and success rate of each program varies, these Bar associations should be applauded for endeavoring to protect the integrity of the legal system, individual clients, and the careers of addicted lawyers.

Millie Anne Cavanaugh, Esq. is a Los Angeles immigration lawyer and former insurance defense attorney. She is licensed to practice law in California and Massachusetts. The information contained herein is provided for informational purposes only, and should not be construed as a solicitation for your business or as legal advice on any subject matter. You should not act or refrain from acting on the basis of this information without seeking independent legal advice.

Why did Jane’s attorney fail to show up to the hearing? It turns out that she slept right through her alarm clock. Having had his fill of the attorney’s constant lackadaisical regard for his courtroom and his calendar, the judge refused to rescind his order or grant a continuance when she finally showed up after lunch. Jane will likely have a malpractice claim against her attorney and, at the very least, should report the attorney to the State Bar. Given the history between this attorney and the judge, perhaps the judge will report her as well. Such a dereliction of duty may result in the attorney being suspended or losing her license to practice law. Not only will this require her other clients to find new counsel to handle their cases, which could be costly and harmful to them, but it will likely destroy the attorney’s career.

But what if it turned out that the attorney slept through her alarm on the morning of Jane’s hearing, and on the mornings of all of the other missed hearings, because she is an alcoholic or depressed? Should she be subject to the same disciplinary system as attorneys who steal client funds or commit fraud? If she admitted her alcohol abuse prior to Jane’s hearing, and entered a treatment center voluntarily, would word have gotten out that she was an alcoholic and ruined her practice? These are issues that currently plague State Bar associations and attorney disciplinary bodies who must reconcile the competing interests of encouraging attorneys to voluntarily seek treatment for alcohol and drug addiction or depression without ruining their careers, against the need to protect clients such as Jane, Dylan, and Maddie.

Studies show that there is a direct correlation between attorney alcoholism and malpractice or discipline. It is estimated that 60% of all disciplinary actions and malpractice claims involve an attorney who is addicted to alcohol. Given that depressed individuals are more likely to avoid communication with others, disregard deadlines, fail to get up in the morning, and become apathetic toward keeping appointments or life in general, it is no surprise that depression also makes an attorney vulnerable to malpractice or discipline. Case deadlines get missed, clients become angry when unable to communicate with their attorney, and entire cases are lost when an attorney is not paying attention to the minutia of the practice of law.

The harm associated with undisclosed alcohol and drug abuse or depression in the legal community is not limited to those particular clients who are directly affected by attorney incompetence or misconduct. The nature of the adversarial process hinges on the idea that each party is competent and knowledgeable about the case and the legal principles upon which the case hinges. When the scales tip in favor of one party simply because opposing counsel has a drug or alcohol problem, the system not only breaks down, but loses respectability and predictability. The public, as a whole, no longer trusts that justice will or can prevail.

In a perfect world, the answer would be to develop a system where lawyers who are suffering from alcohol and drug addiction could seek confidential help while insulating clients from potential harm. For instance, a solo attorney would feel comfortable picking up the phone and requesting that the State Bar transfer her case load to a qualified back-up attorney because she needs to enter a treatment center, telling the clients that a “medical issue” came up. There would be unlimited financial resources to pay for the treatment center, as well as the income that the lawyer would lose while not working. Or, in the alternative, the lawyer would be able to continue working under the supervision of a monitor and enroll at an outpatient treatment center or a treatment center where patients live in the facility but are allowed to leave for work.

However, as we do not live in a perfect world, the above scenarios seldom play out. A characteristic shared by both substance abuse and depression is the inability of the inflicted individual to see that there is a problem while there is still time to treat the issue with minimal harm to career or client. This burying of the head in the sand is intensified by the strong, type “A”, personality shared by many attorneys who either will nor or cannot admit that they have lost control over a situation and need to enter a treatment center or treatment program for help. In addition, other attorneys, judges, or members of the legal community are loath to “rat out” a colleague to the State Bar as they understand that careers can be ruined when the Bar becomes involved. Also, clients seldom realize that there is a problem until it is too late to do anything about it, often trusting that the attorney knows what he or she is doing, even in the face of seemingly bizarre behavior or an utter lack of communication.

Even lawyers who recognize that they should start avoiding those late drinking lunches and start searching for addiction treatment centers rarely do so voluntarily. Some lawyers believe that the stigma involved in being deemed an “addict” or “depressed” will negatively affect their career if clients, potential clients, or colleagues were to find out. And they are probably right. Also, especially with solo practitioners, the attorney will be unable to pay the bills if he or she takes 30 or 60 days to enter a treatment center, even if the cost of that treatment were covered by health insurance.

Instead of seeking badly needed rehab, attorneys continue to live and work with their alcohol and drug addiction until they hit rock bottom, often taking clients down with them. By the time the State Bar becomes involved, the authorities are unable to overlook instances of incompetence or malfeasance and thus, even if enrolling in a treatment center becomes part of the discipline plan, the attorney’s record with the Bar will not remain unscathed. Lives can be harmed or, in the case of criminal defense attorneys, even lost due to a lawyer’s depression or addiction.

Millie Anne Cavanaugh, Esq. is a Los Angeles immigration lawyer and former insurance defense attorney. She is licensed to practice law in California and Massachusetts. The information contained herein is provided for informational purposes only, and should not be construed as a solicitation for your business or as legal advice on any subject matter. You should not act or refrain from acting on the basis of this information without seeking independent legal advice.

This is the first in a series on addiction treatment for attorneys.