Close to ten years ago, the members of the Consortium for Professional Recovery Programs began discussing a collaborative project to survey North Carolina professionals. This consortium, comprised of representatives from medicine, law, dentistry, pharmacy, psychology, nursing, and social work, met regularly to discuss methods to improve the behavioral health issues experienced by their professionals. The consortium members believed that both services and policy could be improved if they had current data about the behavioral health and occupational issues facing their memberships. Over the next several years, the consortium members worked together to develop a comprehensive set of issues that were relevant to all the professions, along with issues that were idiosyncratic to each discipline. The results of this collaborative effort provided the foundation for the development of Work and Well-Being: A Survey of North Carolina Professionals. Through the tireless efforts of consortium members, the project was refined through an iterative process, ensuring the scientific validity and the professional relevance of the findings. The results of this project, ultimately funded and implemented last year, are summarized herein.

We mailed questionnaires to a probability sample of members of the North Carolina State Bar, and we received 390 usable responses. The questionnaire was lengthy, and it included occupational items about workplace and workload, behavioral health questions about alcohol and other drug use, depression, and burnout, along with demographic items. The survey was anonymous; that is, the identity of the respondents could not be connected to the information they provided. As a result, most respondents answered all the items, and many provided written comments as well.

The demographics of the respondents were well distributed. Lawyers’ ages ranged between 27 and 90, and the average respondent was 50 years old. Most were married (80.5%), white (91.7%), male (61.1%), and straight (97.4%), and the mean household income was between $100,000 and $150,000 per year. Personal income is detailed in the table.

More than 20 different areas of practice were represented, but a large number of respondents practiced in real estate law (12.7%), criminal law (11.9%), family law (11.4%), and general practice law (9.0%). Other areas of practice included business litigation (6.1%), corporate law (6.1%), trusts and estates (4.8%), plaintiff’s personal injury (4.5%), and a variety of additional practice specializations. Although the majority was in solo practices (28.9%), many practiced in small firms of two to four lawyers (24.0%) or four to eight lawyers (12.0%), and others practiced in firms of 20-50 lawyers (16.9%) and firms of over 50 lawyers (18.3%). Respondents’ clients were largely city-dwellers (58.0%), and most respondents practiced in private firms (72.5%). Respondents had, on average, 22 years of professional experience. The NC State Bar does not collect demographic information about its members, so we have no way of knowing whether this sample adequately represents the population of lawyers in North Carolina. However, the sample resembles the membership of the American Bar Association in terms of mean age (48), gender (67.1% men), and race (88.7% white). The wide range of demographics in our sample gives us some confidence that no one group is dramatically over-represented.

The lawyers in this sample work very hard. Weekly billable hours reported ranged from 0 – 75, with a mean of 29.5 hours. Average number of hours worked per week ranged from 0 to 80, and although 47% reported no on-call responsibilities, 25% reported being on call 20 out of the previous 30 days. In addition, 42% reported taking work home frequently or daily, and 79% reported taking only 15 or fewer days of vacation in the previous year. Although the average number of vacation days reported was 12.8 in the previous year, 5% took no vacation days at all. Despite all the hard work, 67% of respondents were somewhat or extremely worried about their future income because of changes in the profession, and they provided these responses before experiencing the full impact of the current recession.

The lawyers in this sample also faced a number of challenges in the workplace. For example, one quarter of respondents either agreed or strongly agreed that they faced pressure to compromise on professional ethical issues, and another 13% reported a “neutral” response.

Most respondents (74.5%) reported having the material resources that they needed to do their jobs. However, 64.5% believed that they had enough support from co-workers, 36.7% reported having sufficient supportive supervision, and another 31% reported having no supervision. This is important, because material and social kinds of support tend to be mitigating factors for occupational stress. Without a doubt, lawyers in this sample were feeling occupational stress – 38% agreed and 24.6% strongly agreed that their workplace was stressful, while only 15.6% disagreed or strongly disagreed that they worked in a stressful environment. A number of respondents also wrote about the stressful nature of their work, as represented by the following comments:

“In my view a litigator’s life is designed to be stressful. Clients are upset about being in a lawsuit. Opposing counsel are (sic) usually stubborn for no reason. And courts are looking for every reason to sanction lawyers for missteps. The key to lawyer well-being is working at a firm or other workplace where a balanced life is valued more than profits. Good luck finding that.” 

“Attorneys have a tremendous amount of pressure – some external and some internal. We are expected to hear and see things that the rest of society doesn’t want to know about – especially in the criminal law setting. Many people get into the profession thinking that it automatically brings a six-figure salary – it is becoming more of a job than a profession, which is sad…”

“They never told me in law school how hard it would be to balance work, family and God. I am sort of getting there, but find that most of these life issues are taboo, something my fellow lawyers do not want to talk about.”

With regard to the experience of sexual harassment and discrimination in the legal profession, it is advantageous to be a man, and to be a white man in particular. As illustrated by the table, men experience lower levels of harassment and discrimination. All women experience higher rates of both, but women of color are particularly disadvantaged.

It is not surprising, then, that 39% of this sample of lawyers scored at or above the cutoff score for burnout and only 53% scored above “neutral” in professional life satisfaction; 6% of the total sample scored quite high, but 17% reported very low professional life satisfaction. Similarly, the average score on commitment to the lawyer role was only slightly more than “neutral.”

In addition to limited professional satisfaction and commitment to the lawyer role, respondents also appeared to be experiencing some depression as well. As measured by the Center for Epidemiological Studies Depression measure, 10.3% of the respondents scored at or higher than the cutoff for depression. Respondents also entered the profession with a history of behavioral health issues. For example, 20% reported alcohol or other drug abuse by a biological parent, 17% had an emotionally or psychiatrically troubled parent or caregiver, 16% reported being emotionally abused, 5.4% were physically abused, and 3.3% were sexually abused. Growing up in a troubled family certainly can place people at risk for their own behavioral health problems, so these statistics are cause for concern. It is not surprising, then, that 16% of lawyers reported their current mental health as fair or poor, that 12.4% reported taking a prescription for stress or anxiety, and that 11.4% reported taking a prescription for depression.

Not all lawyers in the sample handled their anxiety or depression with prescription medication. Instead, 44% reported relieving their depression or anxiety by drinking or using drugs in a way not prescribed by a physician, with 4.4% of these drinking or using drugs for relief either often or daily, and another 11% doing so “sometimes.” Several respondents commented on this.

“…over the last number of years I have had a tendency to drink too much, but I find that it is more of a habit to relieve stress than a chemical dependency.”

“…I can see how the sorry state of our profession exacerbates stress, depression, and a general lack of satisfaction with one’s career choice. And for persons with a tendency to drink and/or do drugs, it is quite easy to understand how this profession could escalate their consumption.”

“Getting out of the law firm grind and into solo practice was one of the best actions I’ve taken for quality of life but I was 9 yrs in AA before having the courage to make the move.”

Drinking among lawyers was extensive, as demonstrated by the 72.5% of respondents who reported drinking at least weekly. Lawyers, like other professionals, tend to under-report the amount that they drink, as they want to give a good impression of themselves, even in an anonymous survey. Despite this tendency to answer in a socially desirable manner, 25.4% reported drinking 5 times a week or more, and 13% of the entire sample reported drinking daily. In addition, 53.2% drank until “high” one or more times in the last 30 days, 19.8% drank until high once a week or more, and 8.6% drank until high three or more times per week.

High-risk or “binge” drinking is a serious issue, as this pattern of drinking places the drinker at high risk for serious, adverse consequences like traffic accidents and health problems. Defined by the National Institutes of Health (NIH) as drinking 5 or more drinks at one sitting for men, 8.3% of men reported binge drinking once a week or more, and 34.7% of male respondents reported binge drinking once during the previous month. The statistics for women were even more troubling. The NIH definition of binge drinking for women is drinking 4 or more drinks at one sitting, and although 29.2% of women reported binge drinking at least once during the last month, 9.1% of female lawyers in the sample reported binging once a week or more.

Historically, drinking has often been a part of the legal profession – while having a meal with prospective clients, for example. Although only 7.3% of respondents believed that their firm encouraged drinking, 28.5% believed that the profession’s attitude is that drinking is a part of being a lawyer. This is illustrated by one respondent’s comment that,

“At almost every attorney function there is an open bar and a lot of drunk attorneys and their spouses are there.”

Among all respondents, 9.4% reported drinking on the job at least once during the last 12 months and 3.8% reported going to work after drinking alcohol in the previous 12 months. It is important to note that these statistics likely reflect the aforementioned social desirability bias in reporting personal behavior. Similarly, the reported drug use at work was quite low at slightly less than 2%, but most respondents also reported that it would be easy or very easy to obtain and use drugs at work.

The news about drinking among lawyers is not all cause for concern, however. Although 5.4% reported active alcohol or other drug abuse issues, 7.9% considered themselves to be recovering or recovered from past alcohol or other drug abuse. The length of continuous recovery ranged from less than one to 50 years, with a 15-year mean length of recovery. This may be, in part, a result of the work of the Lawyer Assistance Program (LAP). A remarkable 97.4% of respondents reported knowing about the LAP, and 70.2% felt confident or very confident that they would refer colleagues to the LAP. Professionals tend to be reluctant to seek help for themselves, and the participants in this survey were no different. Nevertheless, 36.8% felt confident or very confident that they would use the LAP for their own personal issues – perhaps because most respondents (55.8%) felt that their use of it would remain confidential.

Unfortunately, the lawyers in this sample were not inclined to seek other kinds of professional help. In fact, the numbers were so low that they would not support statistically valid analysis. This reluctance was likely a consequence of lawyers’ individual opinions and characteristics. For example, less than half of respondents (42.7%) believed that the profession sincerely encouraged counseling, and although 54.2% of respondents personally believed that counseling was a good way to deal with personal problems, another 41.4% had mixed feelings about counseling. Most telling, perhaps, is that 48.4% either agreed or strongly agreed that they have difficulty asking for help.

Additional evidence of lawyers’ reluctance to seek help was that although only 4.4% of the sample sought formal help for their alcohol or drug misuse, 7.7% of the entire sample reported using informal strategies. The most common techniques utilized included exercise, relaxation techniques, and talking with friends or family.

Law schools appeared unlikely to address alcohol and other drug misuse in their curricula. Sixty-seven percent of respondents reported having no training at all on the psychological aspects of chemical dependency, and another 14.8% reported having only one part of a class lecture on the topic. Only one-half of 1% reported having a course on the alcohol and drug misuse. Continuing education is, however, available to lawyers. Among the respondents to the survey, 33.1% reported that the CLE presentations on mental health and addictions have been helpful or very helpful to them personally, but the typical response was “slightly helpful.” Given the ongoing problem of alcohol and drug misuse among lawyers, it might be useful to consider developing current, evidence-based curricula for dissemination in law schools and continuing education environments.

A major concern for the legal profession, of course, is whether stress and other behavioral health issues impair their professionals’ practice. Because of social desirability, it is difficult for lawyers and other professionals to self-report this kind of professional impairment, as so much of their identity and self worth is tied to their occupation. As a result, professional impairment is commonly measured by a response on a single survey item – I have worked when I was too distressed to be effective. Among all respondents in this sample, 42.4% agreed or strongly agreed that they had worked when they were too stressed to be effective at their job.

Despite the concerns raised in this survey, most lawyers in this sample were not ready to leave the profession. When asked how likely it was that they would stop practicing law in the next few years for reasons other than retirement, 68.8% said that it was not at all likely, and only 8.7% said that it was likely or very likely. This may be evidence of their commitment to the profession, despite the occupational and personal stressors they were feeling. However, when asked if they would advise their children to become lawyers, 41.9% said that they would not. This survey item, often considered to be one of the best measures for assessing overall career satisfaction, highlights the ambivalence that many lawyers must be feeling about their work, also represented in the following written comments:

“Practicing law is extremely rewarding and extremely stressful. I would only encourage a child of mine to become an attorney if they had some knowledge of what the work environment would be for them. I love what I do, but it wears hard on a person.”

“Law is an exhausting profession. Many times I am drained by my work. However, sometimes it is very satisfying. I think it is pretty much the same for all professions / employment.”

In contrast, several lawyers were quite clear about their feelings.

“I will discourage my children from this profession, and hope to God they never consider it.”

“I wish I had never gone to law school. My life is controlled entirely by my law practice. I have no free time. I am a slave to endless mounds of work. I hate the way judges tear into lawyers and are so cranky all the time, and disrespectful. I hope to get out of this profession as soon as possible. Too much risk. Bad for my health. My life is slipping away and I don’t have time to enjoy it. Yes, I help people, but there’s a cost—my health + livelihood. My personal life. It’s not worth it.”

“Very frankly, I would not go to law school today if a young person. The profession has become much more specialized and is more stressful.”

 “It is tough feeling that you have people’s lives in your hands sometimes. But I believe the Lord has enabled me to do this, and I view law as a serious and noble calling.”

“I love that I got a chance to be a member of one of the noblest professions on earth—the practice of law.”

This overview of the initial findings from the Work and Well Being survey suggests that North Carolina lawyers face a significant number of occupational and personal challenges. Because the survey provided a very rich data set, we anticipate future articles with more in-depth analysis on a variety of topics to provide further insight into the well being of North Carolina lawyers. For now, the bottom line is that the level of stress and occupational dissatisfaction is high. The tendency of lawyers to take medication has dramatically changed, but their reluctance to seek counseling remains very great. The good news from the survey is that the Lawyer Assistance Program is universally known. In addition, the substantial number of lawyers self-reporting as being in recovery from alcohol or drug abuse is noteworthy, likely indicating that the Lawyer Assistance Program is effectively carrying out much of its mission. On the other hand, there is still much room for improvement in creating less stressful work environments for lawyers and in providing an atmosphere within the profession where those needing assistance can more readily be willing to reach out for it.

– by Darcy Clay Siebert, Ph.D.*

*Darcy Siebert, Ph.D., is an Associate Professor at Rutgers School of Social Work