The Volokh Conspiracy
Mostly law professors | Sometimes contrarian | Often libertarian | Always independent
In 2017, the American Bar Association released a 73-page report condemning "the level of toxicity that has allowed mental health and substance use disorders to fester among our colleagues." Concluding that the legal profession "is falling short when it comes to well-being," the ABA report issued over 60 reform proposals and launched a "campaign of innovation to improve the substance use and mental health landscape of the legal profession." A parallel empirical study to the ABA report found that lawyers abuse alcohol and are depressed, anxious, and stressed much more frequently than the general population. The ABA is not alone in its conclusions: headlines ask "Why Lawyers Are Miserable," "Why Are Lawyers So Unhappy?," and "Why Are So Many Lawyers So Unhappy?"
Unfortunately, these conclusions rest on a weak empirical foundation, as explained in our recent article, "Measuring Lawyer Well-Being Systematically: Evidence from the National Health Interview Survey". The ABA study's design is representative of the methodology used by most studies of wellbeing among lawyers. These studies have four flaws:
- They rely on volunteer respondents, rather than a random sample of lawyers.
- They often have low response rates, meaning that non-response bias can pose a problem to interpreting the results. Together, flaws 1 and 2 mean that studies of wellbeing in lawyers draw conclusions about all lawyers from a sample of lawyers who may be unrepresentative of the legal community at large.
- They survey only lawyers, rather than the whole population. Because surveys of the entire population may use a different methodology or instrument to measure mental illness, comparing mental illness or substance abuse between survey participants and other populations may not be appropriate.
- They only survey lawyers at a snapshot in time, making analyses of trends over time impossible.
Several articles have observed that the "unhappy lawyers" narrative has been driven by a reliance on nonrandom survey data. But they have failed to change the state of the art for studying lawyer mental health. It is easy to see why: surveys of groups of randomly selected lawyers are much more difficult to conduct than volunteer surveys. As a result, they have remained relatively rare and ad hoc, often focusing on unrepresentative groups of lawyers, such as lawyers in a single city or individual law school in a single year.
A large public dataset from the Centers for Disease Control, the National Health Interview Survey (NHIS), provides a useful alternative. It avoids the four problems plaguing current data on lawyer wellbeing:
- Rather than relying on volunteer respondents, it surveys a random sample of the U.S. population.
- Rather than featuring low response rates, it has a relatively high response rate—more than 70 percent—and uses survey weights to mitigate the problem of non-response bias.
- Rather than surveying only lawyers, it surveys the entire U.S. population using the same survey, allowing researchers to compare data for lawyers with the general population or other relevant subgroups.
- Rather than offering only a snapshot of lawyer wellbeing, it has asked the same questions for many years, allowing comparisons of lawyer wellbeing over time.
Using the NHIS, we find that, contrary to conventional wisdom, lawyers do not suffer from extraordinary levels of mental illness. Rather, they suffer rates of mental illness much lower than the general population's and not significantly different than that for doctors and dentists. However, rates of problematic alcohol use among lawyers are high and have grown increasingly common over the last fifteen years. These sometimes surprising and nuanced findings demonstrate the value of relying on more reliable data such as the NHIS.
These findings do not mean that recent emphasis on attorney wellbeing is misguided. The incidence of mental illness, alcoholism, and suicide is too high for the entire US population, lawyers very much included. By paying attention to lawyer well-being, the profession can reduce the prevalence of mental-health-related maladies and improve the lives of all who practice law or work in a law firm. Nevertheless, we need to be precise about the problems that lawyers face and what remedies we should employ.
Over the next two days, we will elaborate on the NHIS and the unique difficulties it suggests that lawyers do or do not face. Thursday will focus on the NHIS's findings related to attorney mental health and alcohol abuse, and Friday will conclude.