Skip to Content
Mechanisms for Advancing Public HealthMechanisms for Advancing Health Equity

A Tribute to Wellness

November 5, 2024

Overview

Mental health in the workplace is a racial and gender justice issue across professions and attorneys are no exception. Women attorneys and attorneys of color report higher rates of stress than their counterparts, and studies have shown higher rates of problematic (or hazardous) drinking among attorneys compared to other populations. Institutionalizing wellness in the workplace will require radical change, and will allow us to be better advocates for ourselves and others.

During the pandemic conversations around mental health and burnout became increasingly normalized when the world was forced to pause and re-think what “business as usual” looked like. Institutions had to become more intentional in how they operated, and many people became more introspective about what wellness meant for them. This forced reckoning laid bare the simple truth that what appeared to be objective and natural were just arbitrary social constructs. This includes the 40 (plus) hour in-office work week and the little social and economic value placed on what turned out to be highly valuable essential jobs. These are structures and norms that have operated for so little of human history, not even equivalent to a blink of an eye on the historical timeline, that one wonders how such an unhealthy system had come to be widely accepted as not only normal and desirable, but also deemed to be the reflection of a well-functioning society.

As individuals and organizations, we have long had many signals that all is not well in the workplace. The plethora of workplace legal protections— including for people with disabilities (Americans with Disabilities Act), who experience racial harassment (The Crown Act), who want to discuss their pay with co-workers (National Labor Relations Act), who need extended time off for health conditions whether their own or as caregivers (The Family Medical Leave Act), who need shade and water to protect against heat stroke and death (limited state protections), who need access to sick leave (patchwork of protections)— are just a few signifiers that the workspace we enter, whatever that looks like, has long been in desperate need of wellness reforms.

A closer examination of my own profession (attorney) shows that workplace wellness needs serious attention. There is not much data, but what does exist indicates it is a profession that fosters poor mental health in ways that are shaped by racism, sexism, and other factors.  An often cited 2016 study showed attorneys had significant rates of depression (28 percent), anxiety (19 percent), and stress (23 percent), reaffirming earlier research that found high rates of depression and anxiety among attorneys.

Attorney wellness is a racial justice issue. A survey by the American Bar Association found  women attorneys of color were more likely to experience stress at work because of their race or ethnicity (54 percent) compared to White women (6 percent). Our workplace is where we bring our expertise and knowledge, yet this same report found that White attorneys reported experiencing “’being heard’” at work meetings the most, followed by attorneys of color, and lastly women attorneys of color (43, 33, and 25 percent, respectively).

Attorney wellness is a gender justice issue. A 2020 survey of lawyers in California and D.C. revealed that women attorneys, compared to male attorneys, had significantly higher rates of moderate to severe stress (67 versus 49 percent) and anxiety (23 versus 15 percent). Moreover, women “contemplated leaving the profession due to mental health or burnout” at higher rates than men—about 24 compared to about 17 percent.

In the workplace, as in other areas of life, alcohol and drug use often co-exist with poor mental health. Both the 2016 and 2020 studies showed greater rates of problematic (or hazardous) drinking among attorneys compared to other populations. The earlier study found higher rates in men, and the latter in women. A 2016 survey of law students found that 14 percent of law students used prescription drugs without a prescription, largely motivated by the desire to improve academic performance. This suggests that attorney drug use may be influenced by professional norms, which are not helped by an educational culture that fosters poor health in the formative years of attorneys’ careers. This is perhaps why some have concluded that attorney drug use can be linked with the demands of the profession (e.g., those factors contributing to stress, anxiety, and depression). In fact, one study found a connection between certain forms of burn out and drug use.

But I do not need a study to tell me what I already know. I knew an attorney who worked, worked, worked. She simply could not escape. Even when she was hospitalized. Once she represented clients at two virtual court hearings, on the same day, from her hospital bed. A year or so later, back in the hospital, she did a virtual job interview. She was praised for the things that led her farther from the path to health, the 5:00 a.m. hearings, the late-night briefings. But that was the problem. Her health always came second, third, or last; and she was in a profession where that is not all that unusual. A few months ago (in what can feel like years, minutes, and even seconds to me) she overdosed on drugs and died. Did work alone kill her? No. But the social norms around work, professionalism, and obligation inflicted serious harms. She was a fierce advocate who deserved better. I share this because I know it reflects the experience of many, in the legal profession and beyond, as evidenced by the needless proliferation of drug overdose deaths that is showing signs of abating for some, but not all. And because the stigma of drug use does not just attach itself to people who use drugs, but also the people who grieve their loss. And so, sharing that which is deeply personal is an act of social rebellion to de-stigmatizing mental health, serious drug use, and grief. Rebellious only because it is not what many would consider to be “professional” discourse in the workplace or even relevant to work. But this brings me back to where I began: re-imagining what wellness looks like.

The question that organizations and leaders must ask themselves is: have their efforts to create the conditions to support wellness resulted in the kind of radical change that is required to really institutionalize wellness at work? Radical because the reforms that are needed require a fundamental shift in how most organizations function, and in the often-biased values that underly what it means to be all in on wellness.

Where to start? Two resources are the U.S. Surgeon General’s 2022 report on “Workplace Mental Health and Well-Being.” One of the things that makes this a valuable resource, is that it is grounded in human needs for safety, security, social support, belonging, autonomy, flexibility, meaning, dignity, accomplishment, and learning—underscoring that our human needs follow us wherever we go; we do not check them at our workplace “door.” For attorneys, another resource is “The Path To Lawyer Well-Being: Practical Recommendations for Positive Change.” It underscores the centrality of work culture to well-being, stating: “[a]ttitudes are formed not only by an organization’s explicit messages but also implicitly by how leaders and lawyers actually behave.”

But the most important starting point is asking people who work for, and with, you what they need, since they are the ones with direct experience of what is working and what needs reform. And then it is important that leaders do what we value as public health professionals—be responsive and accountable. It is not an overstatement to say that for many, workplace wellness is a matter of life and death. As public health professionals, we are in the business of supporting healthy communities. Let’s start with our own. As attorneys we are in the business of advocacy. Let us be advocates for the health and well-being of our colleagues, our loved ones, and ourselves.

This post was written by April Shaw, Deputy Director of the Network for Public Health Law’s Health Equity Team. It is dedicated to my sister, Christina, an attorney, full of light, laughter, and kindness, who died too young.

The Network promotes public health and health equity through non-partisan educational resources and technical assistance. These materials provided are provided solely for educational purposes and do not constitute legal advice. The Network’s provision of these materials does not create an attorney-client relationship with you or any other person and is subject to the Network’s Disclaimer.

Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.