LAP participation doubles in two years, calls for counseling triple

By Nancy McCarthy
Staff Writer

Two years after launching a program to help alcoholic and drug-addicted lawyers, the State Bar reported last month that since the end of 2002, the number of participants has doubled and the number of calls for brief counseling services has tripled.

Most surprisingly, according to the Lawyer Assistance Program's annual report, was that a full one-third of the participants have mental health issues and about one-third have both mental health and substance abuse problems.

Thibault

The program is "growing better than we anticipated," said LAP director Janis Thibault. "With limited outreach, to have 200 people participating with signed agreements is very successful."

According to the report, which covers the year 2003, there was a notable increase in inquiries from lawyers who referred themselves to the program, a development Thibault called significant. "This is an achievement that is critical to moving the program toward the ultimate goal of attracting impaired attorneys prior to discipline involvement, thus preventing harm to clients and decreasing the overall number of cases that must be sent to the disciplinary process," the report concludes.

Thibault said the self-referrals were surprising at such an early stage of the program, particularly without widespread outreach. She attributed the self-referrals to a belief that people are more willing to ask for help than anticipated and welcome the support offered by the program.

LAP was created by the legislature in 2001 and began operations the following year, funded by a $10 contribution from every active lawyer, paid as part of bar dues. Participation is voluntary and confidential and attorneys may enter the program either during a discipline proceeding or by self-referral. Participants are assigned a case worker, attend weekly peer group meetings and more frequently attend local abstinence-based self-help programs.

Eighteen group meetings are held each week throughout the state, with continuous expansion and development of new group meetings.

In addition to the LAP services for substance abuse and mental health issues, every California lawyer is entitled to up to three free counseling sessions with a local therapist who specializes in working with legal professionals. The sessions address common problems like stress, burnout, marital conflicts and career concerns. More than 400 attorneys took advantage of this benefit.

The high number of lawyers with mental health problems reflects the belief among experts that the rate of depression among attorneys is four times higher than in the general population. A 1990 Johns Hopkins University survey of 105 professions found the highest rate of depression among lawyers. (The second-highest prevalence of depression was found in teachers and other counselors, followed by secretaries.)

Thibault said LAP counselors also are seeing a high rate of bipolar disorder among lawyers, but she said she did not know of any formal studies relating the disease with the legal profession.

About two-thirds of the LAP participants either are in the discipline system or expect to be disciplined. (Although there are no formal statistics on how much attorney misconduct involves substance abuse or mental health problems, anecdotal evidence suggests the number is between 60 and 80 percent.)

Indeed, the bar's discipline operation frequently refers attorneys to the LAP to get the help they need, although enrollment in the program is strictly voluntary. Three deputy trial counsel are assigned fulltime to handle the cases in which substance abuse or mental health problems appear to be an issue. If the matter is still under investigation, the targeted lawyer receives a brochure about LAP along with a suggestion the lawyer check it out. If the case has gone to an early neutral evaluation with the State Bar Court or charges already have been filed, the judge or prosecutor may offer the option of signing on to a pilot program through which the court offers lawyers the option of joining LAP and perhaps reducing the level of discipline imposed.

If the attorney agrees, he or she undergoes a 90-day evaluation, stipulates to misconduct, enters into a contract with the court and agrees to participate in LAP for five years and be actively monitored by the bar court for 18 to 36 months. If the attorney is in compliance with the court at the end of the monitoring period, he or she is eligible for a reduction or dismissal of the discipline that would ordinarily be imposed.

Sixty-eight lawyers facing 121 separate complaints currently participate in the court program, the only one of its kind in the country, and about three dozen more are potential participants. The cases run the gamut, from criminal convictions to complaints from the courts, client matters or situations in which attorneys abandon their practice or die. Because the pilot program has been operating less than 18 months, there's little data on its success, but so far no one has dropped out. The program currently is being evaluated and the court plans to make recommendations to the bar board of governors in May.

"There has been a sea-change in how these cases are handled," said Cydney Batchelor, a bar prosecutor assigned fulltime to cases involving substance abuse or mental health. "It's really a labor of love."

At the $10 per lawyer cost, the program collects upwards of $1.4 million a year, a sum Thibault says it expended. Much of the money was spent on start-up costs, she said. In addition to the 200 participants under signed agreement, another 100 lawyers received assistance from LAP in the past year.

For 2004, the bar budgeted an additional $672,000 to assist impaired attorneys, $300,000 for financial assistance and the remainder for a pilot program contract with The Other Bar to provide peer counseling and information about LAP. The cost of this front-end, early intervention is expected to reduce the damage impaired attorneys do to themselves, their clients and the administration of justice.

Said Thibault, "If those people were left untouched and their disorders progress, which we know they do, and they wind up in the discipline system, which we know they do, it's more expensive dollar for dollar to address them in the discipline system."