Lawyer Burnout Has Finally Been Quantified. The Implications Are Troubling

Originally published on Law.com, this article is part of the exclusive insights and analysis available to subscribers. We are pleased to make it available here to a wider audience.

Editor’s Note: This is the first in a three-part series examining the results of the new ABA/Krill Strategies lawyer mental health research project, the 10-year update to the landmark ABA/Hazelden Betty Ford Study also co-authored by Patrick Krill.

A search of various databases suggests that upwards of 2,500 English-language articles about lawyer burnout have been written over the last 10 years. For that reason, it may then surprise you to learn that until only a few weeks ago, there were no large-scale estimates of just how prevalent the condition truly is among practicing lawyers.

That all changed with the release of When Demands Equal Distress, An Updated Understanding of Lawyer Mental Health and Well-being, the largest-ever study of mental health in the legal profession, recently published in the Journal of Affective Disorders. Among its many important findings, the study makes clear that all the ink spilt about burnout was justified, although perhaps to limited avail.

Based on a randomly selected sample of nearly 37,000 actively licensed and practicing lawyers across all geographic regions of the U.S., our research showed that roughly half (47.4%) were experiencing high or very high levels of work-related burnout. Such a percentage is difficult to dismiss as anecdotal or a problem limited to a vulnerable few. And to be clear, that figure is not based simply on whether lawyers said they were "burned out"—a term so ubiquitously applied and subjectively understood as to make such an inquiry interesting but not particularly useful.

Rather, the results are based on how lawyers scored on the Copenhagen Burnout Inventory, a widely validated burnout assessment that measures physical and psychological exhaustion that a person perceives as related to their work. Once someone's score on that assessment creeps into the high or very high/severe ranges, the impacts on their life and career are generally not theoretical.

On a physical level, they are likely to experience persistent tiredness or low energy. Cognitively, it would be typical to experience difficulty concentrating, slower thinking, and feeling mentally foggy or overwhelmed. On emotional and functional levels, increased irritability and frustration, decreased patience and motivation, and needing more effort to perform ordinary tasks would also be expected. If you have not already, now would be a good time to pause and reflect on the implications here—for lawyers, their employers, and the clients they serve.

Problematic and performance-handicapping as those consequences of burnout are, however, it is burnout's striking connection to elevated psychological distress among lawyers that makes it feel more urgent. Specifically, our results showed that as burnout increased, so did symptoms of moderate-or-higher depression, anxiety, and stress, with the relationship becoming especially pronounced at the highest levels of burnout. This held true even after accounting for differences in age, gender, type of practice, whether someone’s practice involved litigation, and how many hours they worked.

While the research does not prove that burnout is the cause of that distress, it does provide unambiguously strong evidence that high work-related burnout and significant mental distress are closely intertwined among lawyers and that, in practical terms, lawyers experiencing high burnout are far more likely to be carrying meaningful levels of depression or anxiety than their colleagues with lower burnout scores.

And while it could appear to some that I have buried the lede here, it should also be noted that roughly one in five lawyers also screened positive for moderate-or-higher symptoms of depression or anxiety—more than double the prevalence seen among U.S. adults in recent estimates. Compared to the 2016 national study this research was designed to update, these figures are noticeably higher, with the percentage of lawyers experiencing moderate or worse anxiety doubling from the prior estimate. More than a quarter of lawyers also screened positive for higher-risk hazardous drinking and for all measures—burnout, psychological distress, and drinking—younger lawyers exhibit the highest risk.

The fact that younger lawyers are experiencing the highest risk levels may surprise some who would expect burnout and psychological distress to emerge following many years of cumulative exposure to the various stressors inherent in the practice of law. But in fact, that is not what is happening, and instead we found a protective association with older age that was steep and consistent across all mental health outcomes we examined.

How poorly these age-related disparities bode for the profession becomes clearer when viewed through the lens of a well-studied concept in public health and gerontology known as "compression of morbidity." The basic idea is that if people can remain healthy, functional, and capable for longer, the period of serious illness and decline can be compressed toward the end of life. Clearly that is a worthy and important goal that most would aspire to.

The pattern we are seeing among lawyers, however, may represent something closer to the opposite: a frontloading of career morbidity. Rather than preserving a long period of healthy functioning followed by a relatively brief period of decline, many younger lawyers are experiencing substantial levels of burnout and psychological distress much earlier in their careers. If that pattern persists, it could mean not just more distressed lawyers, but a shortening of the period during which lawyers experience their careers as sustainable, healthy, and rewarding. Regardless of its cause, that is a dynamic that must be confronted and disrupted.

After a decade of increased awareness and discussion of mental health and well-being in the legal profession, we continue to experience outsized challenges. That much is clear. How we will respond to and address the issues remains to be seen, but the profession now has something it has lacked—a clear, large-scale prevalence estimate of work-related burnout and evidence of how tightly it is woven into lawyers’ mental health. For employers and the profession, connecting those dots should now be a reasonably straightforward endeavor.

I will add that I am not overly discouraged by our findings. While I wish the results were different, I continue to view the problems the study identifies as largely solvable. To make meaningful progress and capitalize on the robust evidence base our research now provides, however, it is imperative to move beyond the type of efforts best described as consequence management.

During the time I spent as director of a treatment program for lawyers, judges, and law students, one of my colleagues had a particularly incisive question he would ask patients whose ambivalence towards lifestyle change loomed large in their therapy sessions: Do you actually want to be sober, or do you just want to be able to drink with fewer consequences? The difference between those two paths is, as you might sense, profound. The rewards waiting at the end of each path are also profoundly different. Often to the surprise of those courageous enough to attempt it, the path of change is frequently far less exhausting and frustrating than continuing to try to control the aftermath of unhealthy choices and risky behaviors.

For employers who do want a different and healthier future—as opposed to a maintenance of the status quo, but with fewer consequences—their efforts going forward should be far less conceptual and far more tactical. Place less emphasis on the nice-sounding but ultimately vague and equivocal concepts like "culture," and more emphasis on modifiable behaviors. Observable, measurable, and modifiable behaviors. Behaviors that cause unnecessary stress. Behaviors that burn people out. Behaviors that create risk, foment turmoil and dysfunction on teams, and make people want to leave. Because it is what people do, not what leaders claim the "culture" is, that impacts the well-being of those within an organization. And it is what people do that has the potential to finally start turning the tide on mental health in the legal profession.

Patrick Krill is a lawyer, board-certified addiction counselor, and researcher who has initiated and helped lead many of the legal profession’s efforts to improve mental health and well-being. He is the founder of Krill Strategies, a behavioral health consulting firm for the legal profession.

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