A Better Way to Study Lawyer Well-Being
Instead of suggesting that lawyer well-being is uniquely bad, future studies should rely on more up-to-date and accurate datasets to develop effective interventions.
In our previous two posts and in the article on which those posts are based, we described how data from the National Health Interview Survey partially contradict the conventional wisdom about lawyer well-being and substance abuse. The ABA's Task Force on Lawyer Well Being, relying on surveys made available to all members of a State Bar but completed by a small fraction of the population, expresses concern about extraordinary rates of depression in the legal profession. Our more representative data, which allows us to compare measures of well-being across professions, indicates low rates of mental illness within the legal profession relative to the median American and comparable rates of mental illness to other professionals such as doctors and dentists. Rates of alcohol abuse among lawyers are much higher than rates in comparable professions.
Unfortunately, we think that the ABA task force's problematic conclusions were not caused only by using the wrong survey. All empirical studies are flawed, ours very much included, and data is hard to interpret. Rather, we think the task force conclusions are driven by a tendency for lawyers to believe that we struggle uniquely with well-being. We lawyers suffer, but not uniquely. Indeed, our data indicate that we suffer much less serious and moderate mental illness than the typical American.
Two commonly cited "facts" about lawyer well-being illustrate that the problem is not simply one of data interpretation. First, articles about mental health in the legal profession regularly assert that "lawyers are 3.6 times more likely to suffer from depression than nonlawyers." This fact comes from a 1990 paper in the Journal of Occupational Medicine, using a dataset from the early 1980s that included only 52 lawyers (10 of whom were depressed). The 95% confidence interval for lawyer depression rates includes the possibility that lawyers suffer less from depression than the average person in the sample as well as the headline conclusion that regularly gets cited. Moreover, the paper finds that the lawyers in the sample are 2.2 times more likely to suffer depression than the average person in the sample. The 3.6 times figure that is most often cited today "controls" for the fact that lawyers have higher socio-economic status, which may in part be "caused" by becoming a lawyer and so should not be controlled for if we want to know the effect of becoming a lawyer on mental health.
How does a tiny study using almost 40 year old data become a regularly (but incorrectly) cited piece of evidence about lawyer well being? There are many larger and more recent studies of lawyer well-being that could be used instead. If one is already inclined to believe that lawyers suffer uniquely from mental illness, however, than the article provides confirmation, making it an attractive source.
A similar story applies to commonly repeated facts about suicide rates in the legal profession. In discussions of suicide in the legal profession, there are many statements of fact that give the impression that lawyers commit suicide at extraordinary rates. One regularly cited statistic is from a 1992 OSHA study finding that "male lawyers in the US are two times more likely to commit suicide than men in the general population" or that "lawyers rank 5th in incidence of suicide by occupation." Needless to say, the 1992 study is not up-to-date. It is a thin foundation at best for a narrative about high suicide rates in the legal profession.
The most recent CDC data, by contrast, indicate that males working in the "legal" occupational category commit suicide at low rates. Across all industries and occupations, the CDC calculates that men committed suicide in 2016 at a rate of 27.4 annual suicides per 100,000 people. Males in the legal occupation, however, committed suicide at a rate of 16.3 per 100,000 in 2016 (41% lower than the mean rate for all occupations). Of 22 occupational categories listed by the CDC, male lawyers had the 17th highest suicide rate.
The male suicide rate in the legal profession looks particularly low when compared with other professions. The male suicide rate in the "healthcare practitioners and technical" occupation was 23.6 per 100,000, 50 percent higher than the rate for lawyers. Suicide rates in the "architecture and engineering" occupational category were 23.2 per 100,000, again much higher than the rate for those working in the legal occupation. The most recent data thus indicates that male lawyers have low suicide rates compared to both the general population and compared to similarly highly educated professionals working in other occupations.
Female lawyers, by contrast, committed suicide at a higher rate than females in the general population. Across all occupation, women committed suicide in 2016 at a rate of 7.7 per 100,000. The rate for female lawyers was 7.9, 2.6% higher than the average rate for females and the 9th highest rate of the 20 industries reported by the CDC. Because men commit suicide at much higher rates than women and the male lawyer suicide rate is so low, the combined rate of suicide for all genders in the legal profession is well below the average rate for all occupations.
Why does a 1992 government study of suicide rates by occupation receive so much attention in the legal community when much more up-to-date government data is one click away? We cannot know for sure, but one possibility is that the older studies confirm the narrative of lawyers suffering uniquely. The more up-to-date data, however, complicate this narrative. Suicide is far too prevalent in all occupations, including law. But there is no evidence that being a lawyer raises the risk for suicide. Indeed, becoming a lawyer is associated with low suicide risk.
The empirical studies most often cited in discussions of mental health in the legal profession, such as the two just discussed, share one thing in common—they suggest that well-being in the profession is uniquely bad. This, more than the inevitable flaws associated with any empirical study, is problematic. To improve well-being in the legal profession, we first need to understand it. Claims of uniquely suffering lawyers may bring needed attention to the issue of lawyer well-being, but they get in the way of development of effective interventions to improve well-being. We hope that our paper, and these blog posts, represent a small step in the development of a more accurate empirical description of the problem.