By Deborah Cho
We’ve come a long way in the area of mental health over the past several years. Notably, the Mental Health Parity and Addiction Equity Act of 2008 did great work to place mental health on more equal footing with physical health in the health insurance arena. Still, there is much work to be done to raise awareness and decrease stigma so that treatment is sought appropriately.
A few weeks ago, I was speaking with a physician about some of the difficulties in addressing mental health with his patients. He expressed disappointment at a recent conversation he had with a patient who refused to take his psychiatric medications. As the physician recounted the story to me, he was frustrated with his patient’s misconception that “successful people don’t have mental health problems.” Even worse, that misconception seemed to imply that in order to be successful, when one does have a mental health issue it is better to suffer through it than it is to seek help. At the time, hearing this story was particularly upsetting for me as a law student because I felt that we were receiving and even propagating a similar message during a rather remarkable final examinations period.
After the grand jury decisions in the Michael Brown and Eric Garner cases, countless articles and posts emerged regarding the requests of law students to reschedule final exams (note that there are many other articles casting the requests in an inaccurate and unfavorable light that will not be cited here). Columbia Law School was among the first of the institutions to allow rescheduling of exams for students affected by the decisions. As the wisdom of allowing extensions, or even discussing extensions with students, has already been hotly debated elsewhere and is minimally relevant to this blog, I would like to discuss a different aspect of the issue with this post.
In addition to exam accommodations, students requested and institutions provided support through trauma specialists and grief counselors. Some of the more appalling opinions either overlooked or ridiculed the support system that I can only believe from anecdotal evidence was a genuine response to a genuine request. What was worse, however, was that these opinions seemed to be shared and cited by lawyers and bar associations. As one lawyer stated, “If law students cannot function with difficult issues like these, maybe they should not try and become lawyers.”
As I stated in an earlier post, before coming to law school, I attended medical school. I see many similarities in the medical profession and the legal profession. Both require a great amount of mental and emotional dedication to the work as well as sacrificing large amounts of time to the service of others. But there are also many striking differences. My former classmates who are now in their residencies do not often hear similar messages of “if you can’t deal with tough issues, maybe you should not be a doctor.”
Instead, one resident, when she had a difficult time coping with her first unexpected patient death early in her residency, was provided the time and resources to receive counseling in order to continue on in a healthy and productive manner. She was never told that she should look into another career because she seemed unable to cope with death and that doctors need to be tougher. Another resident struggled to adjust to the demanding hours, constantly missing family functions and becoming more and more isolated from friends and anything other than the hospital. His program was supportive – even scheduling meetings with the director to discuss viable alternatives to the taxing schedule. He was never told that he signed up for that lifestyle when he decided to take the noble route of helping others. One program that I am familiar with, and I suspect many others around the country, requires its residents to check-in regularly with psychologists and social workers.
This pattern isn’t unique to residency. In medical school, we had one morning each week dedicated to developing us as people and often focused on our personal well-being. It wasn’t because the student body asked for it or because something traumatic had happened. It was because of the belief that in order to help others, we also had to be properly taken care of and we had to be healthy.
It perplexes me that the culture in law, or at least one of the most vocal cultures in law, seems to be a contrary one when it is clearly unsustainable (with some additional information on this subject here). We hear that in order to represent others, you should be self-sufficient and that you should be able to “get over” difficult times without any help. Propagating these false notions does not make us better representatives for our clients. Instead, it hurts our law students and our lawyers while reinforcing the lie to others that “successful people don’t have mental health problems.”
Thanks for sharing this and shedding a much needed light on this subject.
As Professor Larry Kreiger of FSU has observed on this topic, what makes lawyers happy is not the message law students are receiving. See his paper, What Makes Lawyers Happy at https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2398989.
Also, early research by Andrew Benjamin at Washington School of Law on law student wellbeing from 1990s (see ppt: chrome-extension://gbkeegbaiigmenfmjfclcdgdpimamgkj/views/app.html).
Findings similar to the Benjamin study are showing up in the preliminary analysis of a 2014 law student wellbeing survey funded by the Dave Nee Foundation and the American Bar Foundation and led by Prof. Jerry Organ of St. Thomas Law in MN and David Jaffe (Dean) at George Washington College of Law,
Bottom line. Law students experience higher rates of substance abuse, depression and anxiety than their peers in medical school and other professional and graduate programs. More troubling, law students are not seeking help. Dave Nee Foundation surveys indicate that 64% of law students will not seek help for fear of professional consequences.
The law school culture perpetuates the stigma against help seeking for any range of mental health issues. It is changing as the conversation continues, but the change is happening slowly. More advocates must join to accelerate the change.
Thanks for the posting. I wanted to correct a few content errors. First, David Jaffe is with American University, Washington College of Law. Second, the link to Benjamin’s research may not be working. The citation for the article based on the law student survey is here: G.Andrew H. Benjamin, Alfred Kazniak, Bruce Sales & Stephen Shanfield, The role of legal education in producing psychological distress among law students and lawyers, 1986 Am. B. Found. Res. J. 225, 225- 252 (1986).
Again, thanks for the initial blog. The more folks we have talking about this, the more likely we can start to shift the conversation and eliminate the stigma.
Rachel, thanks for reading and for your comment. I agree that we need to change the conversation in order to make progress in this area. I hope that this blog entry was a helpful step forward.