Substance Abuse and Mental Health Toolkit for Law Students and

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S U B STA N C E A B U S E &

M E N TA L H E A LT H

TO O L K I T for Law School Students and Those Who Care About Them

A collaborative effort of the ABA Law Student Division, the ABA Commission on Lawyer Assistance Programs (CoLAP), and the Dave Nee Foundation

“ C o p a k e S u n s e t ”. L i c e n s e d u n d e r C C BY- S A 2 . 5 v i a Wi k i m e d i a C o m m o n s

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Contents

(click on italicized text to go to that section)

Introduction

3 The Nature of the Problem Facing Law Students 5 Root Causes of Common Law Student Mental Health Issues 5 Risk Factors: Substance Abuse 7 Indicators 8 Signs and Symptoms of Substance Abuse 9 Signs and Symptoms of an Episode of Depression 10 Signs and Symptoms of Anxiety 10 Signs and Symptoms of Stress 11 Panic Attacks or Anxiety 11 Suicide Risk 12

For Pre-Law Advisors 14 For Those at the Law Schools

16 Admissions Staff 16 Students 17 Student Bar Associations 25 Administration 28 Faculty 31

Resources 33 Seeking Treatment 33 Selected Articles and Media Resources 35 Resources for Law Schools to Promote Wellness 36 What Some Law Schools Have Done/Are Doing to Promote Wellness 39 Intervention 41 Assessment Tools 41 Courses and other law school programming 41 History and Sources 43 The materials contained herein represent the opinions of the authors and editors and should not be construed to be those of either the American Bar Association or Section unless adopted pursuant to the bylaws of the Association. Nothing contained herein is to be considered as the rendering of legal advice for specific cases, and readers are responsible for obtaining such advice from their own legal counsel. These materials and any forms and agreements herein are intended for educational and informational purposes only.

“none of us got where we are solely by pulling ourselves up by our bootstraps. we got here because somebody bent down and helped us pick up our boots.” - thurgood marshall INTRODUCTION Stress, depression, anxiety, chemical dependency, substance abuse, and other mental health conditions and impairments among law students are problems that continue to spark a national dialogue among faculty, administrators, and students. While students enter law school suffering from clinical stress and depression at a rate that mirrors the national average, the rate sharply increases during the first year of law school.1 Through the duration of their legal education, the rates of law students grappling with substance abuse and mental health problems increase dramatically. If unrecognized and untreated, these issues can carry into their professional careers. Consider the following from the 2014 Survey of Law Student Well-Being:2 -

89.6% of respondents have had a drink of alcohol in the last 30 days. 21.6% reported binge drinking at least twice in the past two weeks. 20.4% have thought seriously about suicide sometime in their life. 6.3% have thought seriously about suicide in the last 12 months. 17.4% of respondents screened positive for depression with 20% indicating that they had been diagnosed with depression at some time in their life. - Roughly one-sixth of those with a depression diagnosis had received the diagnosis since starting law school. At the same time, well-being can be achieved by law students as well as in the legal profession. Consider, for example, the article “What Makes Lawyers Happy? Transcending the Anecdotes with Data from 6200 Lawyers”: http://ssrn.com/abstract=2398989. The purpose of this toolkit is to provide caring pre-law advisors, law school administrators, counseling personnel, faculty, students, student leaders, and lawyer assistance programs with a user-friendly resource to deal with mental health and substance abuse within their schools. The pages that follow identify signs and risk factors for mental health and substance abuse, and then suggest ways that these health concerns can be addressed. The kit is organized around a law student timeline, starting with prelaw advisors and ending with resources available for practicing lawyers. This guide is for informational purposes only and is not designed to be a substitute for independent research, professional assessment, or mental health treatment. 1 See, e.g., G. Andrew Benjamin, “The Role of Legal Education in Producing Psychological Distress Among Law Students and Lawyers,” Am. B. Found. Res. J. 225, 240 (1986). 2 2014 Survey of Law Student Well-Being (co-piloted by David Jaffe and Jerry Organ and funded by the ABA Enterprise Fund and the Dave Nee Foundation).

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A Brief History The American Bar Association created the Commission on Impaired Attorneys in 1988. In August 1996, its name was changed to the Commission on Lawyer Assistance Programs (CoLAP) to better describe the Commission’s expanded services to include stress, depression, and other mental health problems, and to avoid any stigma that its former name may have implied. CoLAP’s primary goal is to advance the legal community’s knowledge of impairments facing lawyers and its response to those issues. Each state and the District of Columbia have some variation of a lawyer assistance program which provides free and confidential counseling and assistance to lawyers, judges, and law students. This kit aims to supplement the work of these programs so that anyone affected by and/ or concerned about an impaired student can assist in addressing the challenges that arise. Significant data shows an alarming increase in mental and chemical illness at the same time as the start of one’s legal career: during law school. Many students, however, are unaware of the multitude of resources available in their communities to assist them with these common issues. At the 2007 ABA Annual Meeting in San Francisco, student bar association presidents expressed great concern for the mental health of the students in their student bodies and decided it was time to take action. The result was the ABA Law Student Division Mental Health Initiative, followed shortly thereafter by a Student Toolkit. The ABA Substance Abuse in Law Schools Toolkit, originally designed for law school administrators, was the result of an initiative of the ABA CoLAP which found that ten years after the Report of the Association of American Law Schools Report on Problems of Substance Abuse in the Law Schools (see “History” for additional information) little had been done to implement the recommendations of the report and that during the interim, the problem of substance abuse and dependency in law schools had grown. The Toolkit did not try to reinvent an analysis of the problems or solutions, but became a collection of available and proven resources to assist law school administrators. While the focus of the original Toolkit was on substance abuse and dependency, the resources provided for herein are also helpful resources for a variety of issues, including other mental health problems. In 2014, the merging of the ABA Law Student Division Toolkit and the ABA Substance Abuse in Law Schools Toolkit resulted in a resource to provide access to all related and overlapping issues in this one location.

2014-2015 ABA Commission on Lawyer Assistance Programs www.americanbar.org/groups/lawyer_assistance.html

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THE NATURE OF THE PROBLEM FACING LAW STUDENTS Root Causes of Common Law Student Mental Health Issues This section addresses three primary sources identified by law students nationwide that lead to law student burnout, a host of common mental health issues such as stress, anxiety, and depression, and abuse of and/or dependence on alcohol and/or other substances. Law students who begin law school with no major pre-existing mental health conditions frequently acquire mental health impairments as a result of their experience. For law students who begin law school with pre-existing mental health issues (such as chronic depression and anxiety, bipolar disorder, or an eating disorder), and those in recovery, the stressors of law school may intensify the conditions. 1. The Crush of Hopes, Dreams, and Aspirations Entering law school is a major life decision for most students, one that is carefully weighed and considered. Many students move their families, quit their jobs, or put off other employment to pursue a legal degree. Usually there is a real personal motivation or passion that causes students to do this. Law students often come to law school with a certain passion and purpose that they hoped their legal education would fulfill. Whether it was a desire to serve as a voice for the poor and underprivileged, to help abused and neglected children, or perhaps to land a high-paying job at a big Wall Street firm, some of these students at one point come to the realization that - whether owing to high student debt, low grades, or job availability - they will not be able to fulfill their dream. The resulting sense of loss and emptiness can be staggering. At the same time, there are students who enter law school because they were at a loss of what to do next, or who had family pressure and/or expectations imposed upon them. This group of students may lack the passion and purpose of their classmates, leading to an even earlier sense of loss. Many students also enter law school with a strong sense of what they believe is right and wrong. Over time, however, professors and the law teach these students to “think like a lawyer”, and that there is no real “correct” answer, but rather that the right answer is determined by who can make the best argument. This can cause students to lose their passion and initial desire for coming to law school.

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2. Living an Unbalanced Life Law students are notoriously known for living “unbalanced” lives, and many students almost take pride in the fact that law school consumes an enormous amount of their time. A student’s actions, especially in the first year, are seen not as the beginning stages of burnout but rather as the signs of a hard worker. Law school is known for late nights, high doses of caffeine, ignoring one’s family, and locking oneself away in the library for a month to study for exams. The reality is that few law students take the time to make a priority of living a balanced life. Yet, it is this very neglect of the other areas of one’s life that can lead to the host of mental health conditions described above. Being out of balance in areas of your life will make it extra difficult to excel in law school. Those living an unbalanced life no longer make time for the personal activities that previously served as stress relievers and added fun and excitement to their lives. The neglect of one’s health while dealing with a heavy course load and busy schedule can make it more difficult for the body to fight off stress. Add to that a constant “on the go” eating routine, lack of regular exercise, and poor sleeping habits and one can quickly see why law students are easily susceptible to stress and anxiety. The neglect of one’s spiritual needs can also negatively affect mental health. For many law students their faith in something greater than themselves is what gives meaning and purpose to their lives. For others, the fellowship keeps them connected with others and provides a support network.

“you are never strong enough that you don’t need help.” - cesar chavez Neglecting one’s social life can also add stress and anxiety. Everyone needs time to unwind with friends, and meaningful relationships with others can greatly help during tough and stressful times. This goes for one’s family as well; neglecting time with your spouse or children as you study late in the library can create extra stress and tension at home. To cope with the stressors of law school, it is important to maintain balance in all areas of life: spiritual, physical, mental, and social. Note that “balance” does not necessarily mean equal division of ALL the time; it should mean, however, that when you DO get or make the time to engage in balancing activities, that you are truly present in the moment. So, for example, you may not be able to spend as much time with your family as you do working at law school, but when you are with your family, you are completely present – not checking the phone or reading, etc. Many practicing attorneys fail to achieve any semblance of a work-life balance, and they pay a high price. If law students fail to learn and instill this important skill while in law school, they risk letting it affect their career and ultimately their personal fulfillment and happiness in life. 3. Law School Becomes One’s Identity Another major cause of law student mental health issues occurs when law students allow their success in law school to define their own personal value and worth as a human being. For most law students there is a huge amount of pressure to succeed. This pressure can come from family members, friends, professors, or even oneself. 6

It is often believed, albeit falsely, that unless a students perform well in law school they will never be able to land that high-paying dream job, and their life, as a result, will end up a failure. Often, the results of exams become measures of a student’s own value and worth as a person. With so much on the line, there is no wonder that law students experience high amounts of stress and anxiety. When students allow their success or failure in law school to define who they are as a person they are in a no-win situation. It is self-evident that 90% of law students will not be in the top 10% of the class. Neither will most law students end up on Law Review. Yet many lawyers who had mediocre grades in law school end up enjoying highly successful careers practicing law. Law students must realize that their performance in law school is not the end-all, be-all guaranteeing their career and future happiness. Law school is simply one of many steps on the road to a long and successful career3.

RISK FACTORS: SUBSTANCE ABUSE One of the main risk factors associated with mental health disorders is substance abuse. The most commonly used “substance” among law students is believed to be alcohol, although prescription drug use has been on the rise on law school campuses. Substance abuse is not only a rampant problem among law students, but also among practicing attorneys. Law students often become dependent on and use substances to cope with or to place a band aid over an underlying mental health condition with which they are dealing. Such “coping” mechanisms almost always make the underlying mental health condition worse. The effect of substance abuse and dependency issues on academic performance There has been little research on the effect of substance abuse on a law student’s academic performance, although many have witnessed the adverse consequences not only in that area, but on professional licensing requirements, personal matters, and more. There is ample research in this area on the college student population, which suggests that college environments need to change for students to recognize the consequences of their behavior; see for example http://www.hsph.harvard.edu/news/magazine/winter09binge/, and note the various studies cited within. When not addressed, students often assume a partying lifestyle is appropriate and acceptable. These students will 3 For more information on the areas addressed in this section, see Krieger; Sheldon, “Understanding the Negative Effects of Legal Education on Law Students: A Longitudinal Test of Self-Determination Theory”, 33 Personality & Social Psychology Bulletin 883 (2007).

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later find it significantly more challenging to break this mold when arriving at law school. By adding the additional stressors unique to law school with this carry-over behavior a student who has not “matured out” of that lifestyle or mindset may find ongoing and/or additional reasons to continue this negative pattern. The effect of the law school environment on substance abuse and dependency It has been well documented that the nature of legal education creates an excessively stressful environment for some students. A significant percentage of law students are at risk of abusing alcohol or other substances, or becoming dependent on alcohol or other substances as a means of relieving that stress. • • • •

Moderate levels of stress have a positive impact on performance while excessive levels of stress have a negative impact on performance.4 Up to 40% of law students and alumni suffered from depression.5 Law students experienced increases in depression within 6 months of starting law school.6 One coping strategy used by law students is an increased use of alcohol.7

Changing the law school environment to reduce stress is a daunting task; nevertheless, educating law students about the types of jobs and stresses involved in the legal profession may reduce stressors and increase coping skills.8

“My makeup wasn’t smeared, I wasn’t disheveled, I behaved politely, and I never finished off a bottle, so how could I be an alcoholic?” - Betty Ford INDICATORS The following indicators and symptoms of prevalent mental health issues are in a format that can easily be converted into fliers and onto SBA/law school websites. Making website space open to advertising these symptoms can prove useful to students who overlook many of them. Publication of fliers may also relieve some of the stigma associated with these issues. In addition, discussion of these signs could be incorporated into an orientation packet or presentation. 4 See, e.g., Glesner, B.A., “Fear and Loathing in the Law Schools”, 23 Conn. L. Rev. 626, 635 (1991) (citing Yerkes & Dodson, “The Relation to the Strength of Stimulus to the Rapidity of Habit Formation”, 18 J. Com. Neurology & Psychology 459 (1908). 5 Benjamin, supra, 1. 6 Krieger, “Institutional Denial About the Dark Side of Law School, and Fresh Empirical Guidance for Constructively Breaking the Silence”, 52 J. Legal Educ. 112 (2002). 7 Daicoff, “Lawyer, Know Thyself: A Review of Empirical Research on Attorney Attributes Bearing on Professionalism”, 46 Am. U. L. Rev. 1337, 1382 (1997); (citing Association of Am. Law Schools, Report of the Special Committee on Problems of Substance Abuse in the Law Schools, 44 J. Legal Educ. 35, 42-43 (1994). 8 Alfini, Van Vooren, “Is There a Solution to the Problem of Lawyer Stress? The Law School Perspective”, 10 J.L. & Health 61, 66-67 (1995-96). (citing Alex M. Johnson, Jr., “Think Like a Lawyer, Work Like a Machine: The Dissonance Between Law School and Law Practice”, 64 S. Cal. L. Rev. 1231, 1240 (1991)).

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Dispelling Myths about Mental Health



Mental illness is not due to personal weakness or inadequate will-power.





Mental health is integral to and inseparable from overall health.

• Chemical regulators in the brain called neurotransmitters are responsible for sending messages between nerve cells. Research has demonstrated that impaired regulation of key neurotransmitters correlates with both mental illness symptoms and physical symptoms such as pain. •

Like other medical conditions, mental health illnesses fall along a continuum in terms of duration and severity; some types of mental illness are transient and others are persistent and severe and require long-term treatment.

Signs and Symptoms of Substance Abuse Is my drinking / drug use: • Interfering with my work according to my clients, associates, or support personnel? • Filling a need to face certain situations? • Often done alone? • Causing me to have memory loss? • Decreasing my ambition or efficiency? • Necessary before meetings or court appearances to calm my nerves, gain courage, or improve performance? • Increasing in quantity / frequency and something I believe I need to hide? • Causing me to miss closings, court appearances or other appointments? • Making me feel guilty, depressed and anxious? • Interfering with my personal relationships: my family, friends and my personal well-being? • Leading me to questionable environments or acquaintances? • Causing me to neglect my office administration or misuse funds? • Forcing me to become increasingly reluctant to face my clients and colleagues? • Leading me to lie to hide the amount I am consuming? • Making me feel shaky, sick or fatigued the next day? Answering “yes” to any one of these questions indicates a serious or potentially serious consequence from use of alcohol or other drugs. Based on your answers you may need to get a professional assessment to help you understand more completely the effects of your use and the healthy ways you can learn to solve personal problems.

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Signs and Symptoms of an Episode of Depression

(If experienced for two weeks, representing a change from a students normal mood) Physical • Poor appetite or overeating • Low energy or fatigue • Sleep disturbances Psychological • Feeling hopeless • Low self-esteem • Self-critical thoughts • Feeling that no one values you • Feeling no purpose to existence • Recurring thoughts of death Academic • Decreased motivation • Difficulty concentrating

Emotional • Feeling sad, empty, alone, or hopeless • Excessive crying • Excessive worrying • Feeling more tense or anxious than usual • Overreacting to situations Social • Decreased interest in activities you enjoy • Decreased trust in others • Easily irritated • Wanting to spend time alone • Difficulty relating to people

Signs and Symptoms of Anxiety Physical • Dizziness or faintness • Dry mouth/thirst • Fatigue • Gastrointestinal problems (diarrhea/ constipation) • Headaches • Hyperactivity • Hypertension (high blood pressure) • Hyperventilation • Knotted stomach/ tense muscles • Loss or increase in appetite • Nausea/vomiting • Rapid or irregular heartbeat • Sexual problems • Shaking hands or tremors • Shortness of breath or chest tightness • Sweating (especially of the palms) • Tingling in extremities (“pins and needles” feeling)

Psychological • Aggressiveness • Compulsive shopping • Difficulty concentrating/inability to focus • Disruptive eating (over- /under-eating) • Fear or panic • Feeling apprehensive or worried • Hyper-alert (easily startled/jumpiness) • Impatience • Inability to relax • Increased smoking or alcohol consumption • Irritability • Isolation • Reckless behavior • Restlessness • Sleep disturbances

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Signs and Symptoms of Stress Physical • Headaches • Tight muscles • Back or neck problems • Sleep disturbances • Stomach distress • Change in appetite • More colds and infections • Fatigue • Rapid breathing and heart rate • Shortness of breath • Dry mouth/thirst • Sexual performance problems Thoughts/Cognitive • Memory difficulties/forgetfulness • Indecisiveness • Racing thoughts • Difficulty falling asleep • Difficulty concentrating • Poor judgment • Fears of failure • Self-criticism

Feelings/Emotional • Feeling out of control • Overwhelmed • Irritated and angry • Anxious • Restless • Helpless • Trapped • Hopeless • Desperate Behavioral • Crying • “Snapping” or picking fights • Alcohol/drug use • Skipping or sleeping through class • Acting impulsively • Losing things (i.e., cell phone, keys) • Forgetting important meetings and appointments

Panic Attacks or Anxiety? While both panic attacks and anxiety are categorized as anxiety disorders, there are some distinctions; by understanding the differences, law students may be better able to make informed decisions about the types of help or treatment needed. People often say “I panicked” or “I had a panic attack.” However, technically speaking, a panic attack involves an episode in which a person experiences at least 4 of the following symptoms within a 10-minute time period. • Heart palpitations • Sweating • Trembling • Real or perceived shortness of breath/smothering • Feeling choked • Chest pain • Nausea • Dizziness • Numbness • Chills • Feeling detached from self • Fear of losing control • Fear of dying 11

While panic attacks can be expected or unexpected, they are usually sudden and are very intense. An example of an expected panic attack would be if a person has a phobia or fear such as stage fright. An example of an unexpected panic attack would be if the attack seemed to come “out of the blue.” It is possible that people who experience panic attacks may be experiencing clinically significant anxiety. Therefore, it is helpful if people can monitor the frequency of the attacks and even try to monitor the specific onset for them. Are panic attacks and anxiety the same thing? After looking at the above markers of a panic attack, it is helpful to know that anxiety can be a different experience. The differences between panic and anxiety are best described in terms of the intensity of the symptoms and length of time the predominant symptoms occur. While symptoms of anxiety are very similar to the symptoms of panic attacks, anxiety is less intense and often persists for days, weeks, or months and may include: excessive worrying, restlessness, feeling “on edge”, irritability, muscle tension and sometimes sleep disturbances. It is important to note that the key difference between a regular and healthy amount of anxiety and a possible anxiety disorder is whether or not the anxiety interferes with a person’s ability to function. In the case of law students, feeling nervous or worried about an exam is not in and of itself problematic. However, if you as a student have appropriately prepared for the exam yet become so anxious that you cannot actually take the exam, that is an interference with daily functions. Both panic attacks and anxiety are very treatable with a variety of methods including but not limited to: cognitive behavioral therapy, mindfulness meditation, deep breathing, and/or medications (in consultation with a medical doctor). If you are not sure if your experience would be classified as panic or anxiety, reach out to a mental health professional who can best guide you, or consider using one of the assessment tools found later in this Toolkit. (Reference: Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association (5th ed., Washington, DC, 2013))

Signs that Someone May Be At Risk for Suicide - Talking directly or indirectly about suicide or wanting to die - Creation of a suicide plan – the more specific the plan, the more serious the threat - Suffering from serious depression - Experiencing changes in academic or job performance or behavior - Engaging in other actions that could potentially cause harm to self, including taking too many pills - Purposely injuring one’s self (such as cutting or burning) - Taking unnecessary or life-threatening risks (e.g., driving recklessly) - Reporting a history of suicide attempts or gestures - Saying goodbye to friends or giving away prized possessions - Shifting from serious depression to sudden happiness – this might be a sign of deciding to “take care of problems” by committing suicide If you believe a classmate is in danger of committing suicide: -Do not leave the classmate alone. Call 911 or, if you think you can do so safely, take the classmate to the nearest hospital emergency room. Your dean of students may be able to assist, and may have emergency contact information for the classmate. If a classmate appears to be thinking about suicide, even if suicide is not an immediate danger, you can: -Encourage the person to seek treatment. Someone who is suicidal or has severe depression may not have the energy or motivation to find help. If your friend or loved one doesn’t want to consult a doctor or mental health 12

provider, suggest finding help from a support group, crisis center, faith community, teacher or other trusted person. You can help by offering support and advice — but remember that it’s not your job to become a substitute for a mental health provider. -Offer to help the person take steps to get assistance and support. For example, you can research treatment options, make phone calls and review insurance benefit information, or even offer to go with the person to an appointment. -Encourage the person to communicate with you. Someone who’s suicidal may be tempted to bottle up feelings because he or she feels ashamed, guilty or embarrassed. Be supportive and understanding, and express your opinions without placing blame. Listen attentively and avoid interrupting. -Be respectful and acknowledge the person’s feelings. Don’t try to talk the person out of his or her feelings or express shock. Remember, even though someone who’s suicidal isn’t thinking logically, the emotions are real. Not respecting how the person feels can shut down communication. -Don’t be patronizing or judgmental.  For example, don’t tell someone, “things could be worse” or “you have everything to live for.” Instead, ask questions such as, “What’s causing you to feel so bad?” “What would make you feel better?” or “How can I help?” -Never promise to keep someone’s suicidal feelings a secret. Be understanding, but explain that you may not be able to keep such a promise if you think the person’s life is in danger. At that point, you have to get help. -Offer reassurance that things will get better. When someone is suicidal, it seems as if nothing will make things better. Reassure the person that these feelings are temporary, and that with appropriate treatment, he or she will feel better about life again. (Taken from the Mayo Clinic, http://www.mayoclinic.org/diseases-conditions/suicide/in-depth/suicide/art20044707) Resources: Dave Nee Foundation (www.daveneefoundation.org) Suicide Hotline: http://www.suicidepreventionlifeline.org/; 1-800-273-TALK Dr. Paul G. Quinett’s “Suicide, The Forever Decision” (free, http://www.qprinstitute.com/forever.html)

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FOR PRE-LAW ADVISORS Your Role and Why It Matters Helping prospective law students become aware of the importance of disclosing relevant past chemical or mental health related behavior in law school applications, the prevalence of chemical dependency and mental health concerns in the profession, and the benefit of addressing these concerns now can be crucial to a student’s success. You are at the head of the pipeline and have access to these students before law school admissions, law school staff and faculty, the Board of Bar Examiners, and the practicing bar. The further a student advances toward becoming a practicing attorney, the more his or her life will be negatively affected. It is not too much of a stretch to suggest that your intervention could prevent real problems with future clients and with your student’s future family. A student who avoids disclosing relevant substance abuse or mental health issues because of shame or fear of not getting admitted will probably either: - be discovered during at the law school admission phase or bar admission phase and create issues involving lack of candor atop the underlying issue, or - will not have the issue raised but end up experiencing consequences later in practice and in life. As a result, education about candor in disclosing and addressing the matter cannot come early enough. Included in the conversation should be a frank exchange about the increasing stressors, from undergrad to law school and from law school into the practice. What Can You Do? Have the conversation early on, either in a general way (”are there any matters of concern to you that have not been disclosed to date”) or specifically as related to information that has been provided to you. Be caring, but direct. Understand in advance the reporting obligations for information received, and be prepared to share that obligation up front. Students will appreciate your candor in asking to share theirs. Explain the relevance down the road. The relevant Board of Bar Examiners, through their Character and Fitness questionnaire, likely will query the student’s law school with specific questions about the student’s application to law school and whether it is consistent with the student’s bar application; an increasing number of Boards of Bar Examiners now request of the law school a copy of the bar applicant’s law school admission application.

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Bar Examiners will also ask questions that may require disclosure of mental and chemical health concerns. Students should be made aware that Bar Examiners view an applicant’s efforts to address any mental and chemical health concerns more favorably than applicants who have mental or chemical health concerns but have not sought help. Let the student know that there is support and resources for whatever issue is confronting him or her. Good: Private counseling. However, private counseling can be pricey. Better: Law school counseling service. Law school counseling services often fall under many university insurance plans (at least initially). Law school counselors are more likely to be plugged into the stressors facing students in law school. Best: Lawyer Assistance Programs. Lawyer assistance programs understand law school stress and are in the best position to counsel lawyers about what the future holds about the issues confronting them. LAPs can be very helpful to students under their care regarding the bar application process and relevant questions. Most times the services are free or at reduced rates. Let the student know he or she will be okay, and he or she will always fare better in the long run if disclosure and assistance is sought early. Atop everything already suggested, the student will not have a cloud over his head, something on his conscience for which he needs but is not receiving assistance. Unless the matter is at a fairly extreme level, admissions should not be a problem and should not prevent the student from seeking help. Finally Address honesty and disclosure head-on. Share with your student that “I thought if I disclosed it I wouldn’t get in,” “I didn’t think it was important since it was so long ago,” or “I was embarrassed to even write down [the incident]” are not acceptable excuses. Candor is paramount here; indeed, the issue with law school and subsequent bar applications is more often about the honesty and candor in reporting than the underlying incident. If your student is straightforward and takes responsibility, he or she is best positioned to overcome any potential obstacles. Also, if your student has serious concerns about potential character and fitness issues, he/or she might be encouraged to meet with an attorney who represents bar applicants in that process, even if for a few hours to put their mind at ease. Resources: “Are you Fit to Be a Lawyer?” Life & the Law Committee of the Minnesota State Bar Association, http://www. americanbar.org/content/dam/aba/administrative/lawyer_assistance/ls_colap_are_you_fit_to_be_a_lawyer. authcheckdam.pdf New York State Lawyer Assistance Trust, http://www.nylat.org/publications/brochures/documents/CharacterandFitnessBrochure09.pdf

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FOR THOSE AT THE LAW SCHOOLS ...............

ADMISSIONS STAFF Your Role and Why It Matters Law school admissions offices and their committees have the first look at each entering class of students’ backgrounds and profiles. A number of applicants, upon proper counsel from their prelaw advisor or mentor, will disclose past or recent issues involving substance abuse or related to mental health, or may disclose conduct that suggests chemical or mental health concerns. What You Can Do Most commonly, these chemical or mental health concerns should not prevent the student from being admitted. However, they should not be ignored; if left unaddressed, mental health or substance abuse concerns have an increased chance of resurfacing during law school when any number of new pressures can serve as a trigger or relapse to former behavior. Admissions officials are in an ideal position to counsel or refer these admitted students for resources. They can raise the issue head-on with the student, refer the student to the dean of students, or provide the dean of students a list of names for outreach post-matriculation. A well-informed and educated official should have this conversation in a productive, positive way: first, acknowledge the student for having provided the information; second, assure the student that he or she can, and will have the opportunity, if necessary, to prove to the bar that they are fit to practice law and they can put their prior decisions behind them; finally, inform the student of the availability of resources and how to access them, sharing that the official is a resource, and identifying others who are available should the student ever need assistance. A conversation of this type, if handled properly, will allow the entering student to feel good about the steps she has taken already, and appreciate the support offered by the law school.

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STUDENTS Your Role and Why It Matters Individual students, when empowered with the appropriate knowledge and tools, have the greatest ability to prevent chemical abuse or a mental health condition from progressing to the point where it consumes their life while in law school. Fellow students may also be the most adept at noticing changes in their classmates. One of the key aspects to prevention is the ability to maintain “balance” in all areas of one’s life while pursuing a law degree. Learning how to cope with the stressors of law school in a healthy way, and ensuring that one’s identity is not tied to how well one does in law school, are essential to preventing common mental health disorders and impairments. Stress, anxiety, depression, and the like can quickly progress and consume a law student’s life before he or she realizes it, often as consequences of the pursuits of a “successful” soon-to-be-attorney (i.e., for law review, a high paying law firm, summer associate job). Some students will not even realize that stress and anxiety have become major, often debilitating, challenges for them because others around them are competitively striving for the same goals and experiencing the same level of stress and anxiety in pursuit of those goals. What You Can Do

1. Maintain a Balanced Life For students to deal with the rigors of law school and to prevent stress and anxiety from taking over their lives, it is vital that they achieve balance in all areas of life. Think about it: when do law students feel the most stressed out? It is not usually in the middle of the semester when finals seem a long time away, but at the end when students are in the midst of finals. Not surprisingly, this is also the time when students are least likely to be maintaining any semblance of a balanced life. You might feel like you can get away with living an unbalanced life momentarily, but eventually, if not addressed, an unbalanced life will wear you down and burn you out. Each person is unique, some needing more attention to certain areas than others, but it is important for each student to set aside time every day for each area of his or her life. 17

- Spiritual - Whether this involves attending weekly church services, quiet meditation in the morning, or simply believing in something bigger than yourself, it is vital to set aside time to care for your soul. - Physical - For law students this is often the most neglected area. Remember to do what you know you are supposed to do: eat right, get enough sleep each night, exercise, avoid smoking, monitor your caffeine intake and, if you drink alcohol, do so in moderation. If you are not addressing your physical needs, try doing so; especially if you get into a regular positive routine, you will be amazed at how much better you will begin to feel. - Social - Remember to set aside time for some plain old fun. All work and no play will soon wear you down. Everyone needs a social outlet or community where they feel welcomed and accepted, and where there are people in whom they can trust and confide. - Mental - You might think that law school should take care of this part, but caring for your mind -mindfulnessa technique and practice to raise self-awareness and be fully in the moment - includes your own thoughts and “self-talk,” as well as your awareness- of thoughts, habits, and emotions that are not serving a positive purpose.

“Watch your thoughts; they become words. Watch your words; they become actions. Watch your actions; they become habit. Watch your habits; they become character. Watch your character: it becomes your destiny.” - lao tzu Constantly saying defeatist things like “I’m so stupid,” “this is impossible,” “it probably will never work,” suggest that you need to change the way you talk to yourself. Challenge beliefs: “If I don’t make law review, life is over – or I will never get a good job, etc...” Is this a rational statement? Check out Ellis’s 12 irrational beliefs and see if they apply: http://changingminds.org/explanations/belief/irrational_beliefs.htm. Negative thinking and a defeatist attitude can create stress and ultimately lead to depression. Try reading a few books on positive thinking (for example, “Man’s Search for Meaning”). See also “Mindfulness and the Law”: http://nwlawyer.wsba. org/nwlawyer/april_may_2014/?pg=9#pg1 - Personal - When is the last time you did something just for you? Many law students do not know how to set aside time for themselves. Remember to do things that will lead you to grow as a person, and do not forget about those old hobbies that you really enjoyed before law school.

2. Cope with Stress in a Healthy Way All law students will experience stress. It is a part of life. The key indicator of success though is once you experience stress, how do you cope? If your normal way of coping with a long stressful day is to grab a bottle of alcohol - then you are not really coping, you are escaping. Law students and lawyers in general are notorious for their drinking habits. The profession revolves around happy hours and cocktail events, and a number of law schools also sustain these events – both officially and unofficially. Many times, law students even rationalize their heavy drinking based on the fact that law school is so stressful and tough. This is a dangerous road to travel and can lead to a whole host of other problems. 18

Unhealthy Ways to Cope With Stress: Compulsive Behavior - overindulging in eating, drinking, gambling, sex, drugs, work, etc. Impulsive Behavior - irrational behavior, acting without thinking of the consequences Withdrawing - from friends, family, hobbies (often a sign of depression) Substance abuse Irrational Worry - Do you have control over the subject of concern? Has it occurred yet or are you projecting a catastrophe? Avoidance - suffering from the stressor instead of dealing with it. Includes doing things that take you out of your emotions, thoughts, “right mind”; anything that you lose yourself in, including the internet, gambling, drinking, sex, pornography, etc. Procrastination Healthy Ways to Cope With Stress: Exercise to relieve tension, improve your mood, and release endorphins! See http://www.mayoclinic.org/ diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495 Practice relaxation techniques. Try meditation, yoga, deep breathing, or muscle relaxation. Whenever you feel tense, slowly breathe in calmness and breathe out tension for a few minutes. Be easy on yourself. Make sleep a priority. Find a quiet and peaceful place and go there - in person or in your head. Keep a journal - or even just a list - and write out what is stressing or worrying you. Talk to a close friend or family member about your stress. Become aware of your own reactions to stress. Let go of negative, discouraging self-talk. Avoid the “snowball” effect of dwelling on the negative. Learn from past “mistakes” and move forward Practice positive, encouraging self-statements. Train your brain for positivity (see, e.g., http://www.youtube.com/ watch?v=jA3EGx46r4Q) Focus on your good qualities and accomplishments. Develop assertive behaviors. Think about what has brought you joy in the past – hobbies/things you have always wanted to try. Recognize that there may be time constraints with school, so plan accordingly, rather than over scheduling and becoming more anxious that you don’t have time. Example: you always wanted to go hiking but are not ready to commit too much time early-on? Start by reading up on the hike, and maybe start walking to build up endurance. Plan ahead for a day trip after mid-terms or finals. Maintain a daily balanced diet. Change worry into action. Focus on the next step. Learn to use your time wisely. When studying for an exam, study in short blocks, and stay focused. Take frequent, short breaks. Make a weekly schedule and try to follow it. Set realistic goals. Take one step at a time. Avoid unnecessary competition. Recognize and accept your limits. Remember that everyone is unique and different. NOTE: Be aware of the danger of using drugs such as Adderall that have not been prescribed to you. Practice Stress Hardiness: http://www.njlap.org/AboutStress/StressHardinessfullarticle/tabid/83/Default.aspx Consider also how the brain takes a toll on stress and what law students can do to combat it; see for example 19

“Killing Them Softly: Neuroscience Reveals How Brain Cells Die From Law School Stress And How Neural SelfHacking Can Optimize Cognitive Performance”, at http://loynolawreview.com/wp-content/uploads/2014/04/ Austin-FINAL.pdf

3. Maintain Your Identity and Never Lose Your Passion or Your Purpose When law students tie their own self-worth to their success in law school, they set themselves up for increased amounts of stress, anxiety, and disappointment. It is important to know who you are and that your value as a person is not dependent on how well you do in law school. Thoughts and pressures placed on yourself such as, “If I do not get onto Law Review, land a great summer clerkship, and secure a top job at a large high-paying firm I will not be successful,” do nothing but create unnecessary stress and anxiety. Defining your life and identity as a person by how well you do on a few exams is not only irrational but will place a huge amount of pressure and stress on you that will actually keep you from performing at your best. It is also vital for law students to remember why they came to law school. Do not forget your passion and purpose, whatever it may be. Loss of purpose is one of the first steps towards depression. If you are passionate about practicing maritime law you may not want to settle for another more comfortable job doing something else. At the same time, don’t fall into the trap of believing your passions can only be carried out in your day job. If your purpose for going to law school was to serve as a voice for abused and neglected children, remember that and work toward it.

“It doesn’t interest me where or what or with whom you have studied. I want to know what sustains you from the inside when all else falls away. I want to know if you can be alone with yourself. And, if you truly like the company you keep in the empty moments.” - the invitation; author unknown

4. Be Aware of and Proactively Address Mental Health Concerns Challenge the negative thoughts in your head. Depression can make you feel alone or worthless. You might find yourself thinking that nothing good ever happens, that no one cares about you, or that things will never get better. Realize that these thoughts are coming from depression – not you. Be aware of your stress levels. Now is not the time to take on new projects and responsibilities. Consider paring down what you are doing to make your schedule more manageable. Take care of your body. Try to eat nutritious meals, get exercise, and get enough sleep (7-8 hours a night). Surround yourself with supportive people. Friends who have a negative outlook will only make you feel more 20

negative. Take life one day at a time. Do not get consumed with thoughts of the future: make small goals and do not think about the whole semester. Try to add more structure to your life. Avoid alcohol. It is a depressant, and will only amplify your depressive feelings. Become involved. Don’t take on a huge commitment, but do find something you enjoy. Volunteering to help others might help you to focus more on the positive. Remember depression is treatable. You may need to talk with a counselor, but you can learn how to effectively deal with depression. Express your feelings. Do not keep your emotions bottled up. Find a vehicle to experience feelings that is comfortable for you – talk to someone (friend, family member, counselor, religious leader, professor, etc.), write in a journal, go to a support group (see, for example, Recovery International (http://www.lowselfhelpsystems. org/), or check with your local LAP).

Cope with Anxiety Reach out to others. Spend time with friends or loved ones, and share your fears, feelings, or uncertainties. Express your feelings. Do not keep your emotions bottled up. Find a way to experience them that is comfortable for you – talk to someone (friend, family member, counselor, religious leader, professor, etc.), write in a journal, go to a support group. Focus upon a realistic assessment of your personal situation, without magnifying your concerns. Remember Ellis’s 12 irrational thoughts. Try to stay organized. Keep a planner so that you know when papers and exams are approaching. Make sure to plan time for yourself away from work, class, and studying. Cut down on alcohol and caffeine. These can increase symptoms of anxiety. Take care of your body. Try to eat nutritious meals, get exercise, and get enough sleep. Identify and minimize stressors. Learn what situations or events cause you the most stress, and how to cope with them. Realize that life can be difficult, and that it is not so much a matter of what events have occurred, but what meaning we give to those events. We cannot eliminate stressful events, but we can learn to contain them. Learn stress management and relaxation techniques. Try yoga or meditation to help you focus on being calm. Experiment with muscle relaxation exercises, deep breathing, and mental or guided imagery. Challenge the critical voice in your head. Anxiety can make you feel like you are not normal or that you are a failure. You may find yourself believing that other people are able to manage their stress or are not as scared as you, or that you are a bad student or person because you cannot handle all of your responsibilities. Realize that these thoughts are coming from the anxiety – not you. Also remember that the way others look often does not show how they really feel. 21

MANAGING PANIC ATTACKS Step 1: R-e-l-a-x... One step that helps lots of people get a handle on their panic attacks is to learn and practice relaxation strategies. Here are three different types of relaxation strategies you can try: First, try changing your breathing patterns. Stress often causes us to breathe shallowly. Unfortunately, breathing shallowly can actually prolong stress by depleting your oxygen supply and increasing muscle tension. This can lead to headaches, nervousness and a lowered threshold to panic attacks. To overcome this, practice monitoring your breathing and noticing when it becomes shallow or rapid. When this happens, take a minute to slow down, get comfortable, and breathe deeply. Begin this process by slowly but forcefully blowing all of the air out of your lungs, deep-down into your belly. This allows you to slowly and effortlessly “refill” your lungs with fresh air. Try breathing in through your nose and focusing on filling the bottom of your lungs first before filling the top. As you breathe in, your abdomen should rise slowly; and, as you breathe out, it should fall slowly. Gradually breathe more deeply and more slowly until you reach a comfortable plateau. A second technique is to scan your entire body, tensing and relaxing all your muscles. Begin by sitting in a chair with your feet flat on the ground. Focus on your feet and notice any muscle tension in your feet or toes. Tense your feet muscles by curling your toes like you’re trying to dig into the carpet. Tense the muscles for a five-count, then allow them to go limp and release all the tension. It helps to exhale deeply and think the word “relax” at the moment you release the tension. After relaxing your feet, move up to your calves, tense and release. To your thighs, tense and release, and so on. Try to move through all of the following muscle groups: your feet, calves, thighs, “glutes,” abdomen, lower back, chest, upper back, neck and shoulders, and finally, facial muscles. To tense up your facial muscles, squint hard and press your lips together (think Clint Eastwood), then just let your face go slack and expressionless. When you’ve completely covered your entire body, your muscles should feel warm and relaxed. Finally, try taking a “mental vacation.” No, not a trip to a rehabilitation clinic-just an imaginary visualization of a peaceful place. Mental imagery can be a great way of creating peaceful feelings. Start by imagining a peaceful, serene setting. Perhaps this will be some place you’ve gone before where you felt totally calm and relaxed. Or maybe it can be a fantasy place with all the ingredients to help you relax and unwind. Once you’ve imagined this fantasy place, take a “sensory inventory” by asking yourself: “What do I see that’s peaceful or beautiful?” “What do I hear that’s soothing?” “What do I smell that reminds me of pleasant, peaceful feelings?” “What do I feel on my skin (is it warm, cool, breezy, still?)” and “What do I taste?” For example, someone who loves the beach might think about seeing a beautiful sunset over the water, hearing the waves gently lapping at the shore or the seagulls peacefully calling, smelling the scent of suntan oil, feeling the warmth of the sun and the gentle breeze, and tasting the salty air... Imagining each of these sensations in detail actually helps to create the same peaceful feelings in your body that you’d experience if you were actually at the beach. By themselves, deep breathing, muscle relaxation, and mental imagery can be very powerful. When you put them all together, you’ve got a combination that can melt away your physical tension and anxious thoughts and replace them with peace and relaxation.

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Step 2: Change Habits Sometimes it helps to make some changes in your daily routine, like adding exercise and reducing or eliminating stimulants like caffeine, nicotine and sugar. Exercise helps to burn off excess tension that might otherwise come out as anxiety or panic. Eliminating stimulants, like caffeine, helps prevent your cup from “running over” with anxiety. If you tend to bottle up your feelings and worry a lot by yourself, it may be helpful to pay more attention to your emotions and become more willing to express them to others. Step 3: Discover The Power of Positive Thinking Another way of tackling panic attacks is to look at the way you talk to yourself, especially during times of stress and pressure. Panic attacks often begin or escalate when you tell yourself scary things, like “I feel light-headed . . . I’m about to faint!” or “I’m trapped in this traffic jam and something terrible is gonna happen!” or “If I go outside, I’ll freak out.” These are called “negative predictions” and they have a strong influence on the way your body feels. If you’re mentally predicting a disaster, your body’s alarm response goes off and the “fight-flight response” kicks in. To combat this, try to focus on calming, positive thoughts, like “I’m learning to deal with feelings of panic and I know that people overcome panic all the time” or “This will pass quickly, and I can help myself by concentrating on my breathing and imagining a relaxing place” or “These feelings are uncomfortable, but they won’t last forever.” If it is too hard for you to think calming thoughts or to concentrate on relaxation strategies when you’re having a panic attack, find ways to distract yourself from the negative thoughts and feelings. Some people do this by talking to other people when they feel the panic coming on. Others prefer to exercise or work on a detailed project (such as gardening, deep cleaning your bathroom, sheep shearing, or reenacting historic naval battles with scale models constructed entirely from paper clips and Junior Mints). Changing scenery can sometimes be helpful, too, but it’s important not to get into a pattern of avoiding necessary daily tasks. If you notice that you are regularly avoiding things like driving, going shopping, going to class, or taking buses, it is probably time to get some professional help. Step 4: Get Help You might find that dealing with panic attacks will be easier if you have a person who can act as a coach as you learn how to cope with the attacks. Meeting with someone who has experience working with panic attacks and anxiety can help you find the right mixture of strategies that will work for you. This might be a therapist, psychiatrist or family doctor. In addition to counseling, sometimes it can be helpful to talk to a psychiatrist or other physician about taking medication to help you cope with panic attacks. This has been a helpful tool for many people, though lots of people also recover from panic problems without medicine. Taking medicine for panic problems is usually temporary. It can provide relief of some symptoms while you focus on learning strategies for managing anxiety in the future. Step 5: Keep the Faith! Above all, have faith that you CAN learn how to handle panic attacks. If you practice the techniques you’ve learned about here, or seek out more information through counseling or the self-help resources below, the chances are EXCELLENT that you’ll be able to overcome the panic problems in your life! (Source: UT Counseling & Mental Health Center by Mark Zentner, Ph.D. and Jeff Kulley, Ph.D; Anxiety & Panic Workbooks) 23

5. Help a Friend Who is Depressed Often you are in the best position to know that a classmate is struggling. While raising the subject can be sensitive and not always easy, you might be pleasantly surprised at the good you can do. - Be supportive. Listen to your friend. Set aside time so that you can talk without being interrupted. Let your friend know that you care and are willing to help. - Introduce your friend to coping techniques such as those suggested above. If these do not seem to help, suggest that your friend seek professional help. Contact your state’s lawyer assistance program (see Seeking Treatment)

“if you would only recognize that life is hard, things would be so much easier for you.” - louis brandeis or visit your law school or university health services, if applicable. - Understand that your friend is suffering from depression, and will not just “snap out of it.” Overcoming depression takes work and time. - Remember to take care of yourself. Being there for your friend should not come at the expense of your own health, physical or mental. If you are overwhelmed, take a step back and consider calling a counselor for advice.

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STUDENT BAR ASSOCIATIONS ...............

Your Role and Why It Matters Student Bar Associations (SBA) at most law schools exert an enormous amount of influence over their student body. SBA leaders can make a significant difference in helping students cope in a healthy way and in assisting with the avoidance of mental health and substance abuse issues. The greatest thing an SBA can do is to create awareness around these issues. What You Can Do As an SBA President -or leader- here is what you can do:

1. Build a Foundation by Raising Awareness. Raise Awareness. Raise awareness of the risk factors and warning

signs that are associated with mental health and substance abuse issues (provided earlier). Make students aware that they are not alone in their struggle with stress, anxiety, depression and substance abuse, in turn creating a supportive environment that educates students on how to best cope with the many stressors of law school. Distribute Information. Serve as a provider of information by directing students to the law school or university counseling services, LAPs, and resources in this toolkit. Provide access to the information through programming, accessible flyers, a wellness day, and/or links on your SBA website or social media page. Be creative; you should know your school and student body better than anyone. Consider also using the Wellness Booster Kit: http:// www.americanbar.org/content/dam/aba/administrative/lawyer_assistance/ls_colap_wellness_booster_kit. authcheckdam.pdf (© 2014 Anne Brafford, Sandra Adkins, Jill Sanford).

2. Creative Programming.

Schedule a panel with mental health professionals, representatives from your local LAP, and alumni to discuss effective ways to cope with stress. Start a dialogue between faculty and students about the stressors of law school and how together they can work to address the issue. Promote Healthy Ways for Students to Cope: If your socials center on drinking, it will be difficult to simultaneously encourage students not to use alcohol to cope with stress. Diversify your socials to include relaxing daytime events, organize a 5K run for charity, and make sure that the socials, if they do center around alcohol, also serve non-alcoholic beverages. Promote a “Wellness Wednesday,” encouraging students to go outside for pick-up recreational sports or have checkers or lawn games available for student use. Know What Times of the Year Students Are at Highest Risk: As students begin their law school career and are managing the transition to law school, an introduction to the risk factors and potential resources during Orientation is a great way to alert students to mental health from day one. As finals near, students are more likely to exhibit signs of stress. Many schools have instituted weeks dedicated to focus on stress by working with their schools to host meditation or quiet rooms, shoulder massages, yoga, and therapy dogs.

3. Implement Continued Participation. Mental health and substance abuse are topics that should be addressed throughout the year. SBAs can take various steps to ensure that wellness initiatives are continually present on campus by implementing some of the following: 25

Talk to Your Administration – As the voice of the students, the SBA is in an ideal position to make their administration and faculty more aware of law student mental health issues. Make sure your SBA is aware of all the resources that are available through the school. If your school does not already provide mental health resources for students, encourage them to do so by communicating to them the seriousness of the problem. Encourage the administration to assist with activities or events that will help relieve law student stress. Create a wellness between the SBA and the administration to reassure students of the support and rehabilitation options available throughout the school.

“the unfortunate thing about this world is that good habits are so much easier to give up than bad ones.” - somerset maugham Create a Student Wellness Committee. Create a student wellness committee that addresses the students’ general well-being (i.e, stress management and nutrition). Involve non-SBA board members, faculty members, and mental health professionals with the committee. Create a Student Lawyer Assistance Liaison Program (LAP) within your SBA. A number of law schools already have student LAP representatives. A LAP representative would: Participate in state LAP events- like conferences or trainings; Serve as the point of contact between the students and the state LAP. This is especially helpful in coordinating events to include state LAPs; Distribute information from the state LAP to students; Forward to professors articles/brochures about substance abuse/depression in the legal community and/or law school; Disseminate information (emails, etc.) to students about speakers at the law school or nearby forums who address mental health issues; Coordinate with local LAPs and/or university counseling programs or services to make presentations to 1Ls during orientation. Many state LAP Directors are eager to have a law school student contact. Contact information for your state’s LAP is available in this Toolkit. NOTE: It is critical for SBA leaders to know that LAP services are absolutely confidential. Although many LAPs are funded by the state bars, they are not otherwise connected with that bar. LAP staff are prohibited by federal law from disclosing to anyone the information provided to them by law students (unless the student indicates that her or his life, or the life of another, is in immediate danger). LAP counselors cannot tell anyone - the law school administration, the bar, etc. - what the law student shares during her or his counseling sessions at the LAP. Help Start a Mental Health Student Organization Many schools have mental health law societies at their school that not only focus on students who want to practice mental health law but also on improving the mental health of law students. Many state LAPs also provide peer26

assisted counseling, although students may initially be reluctant to access those services. Having a student-run organization serve as a liaison to the state bar may be an attractive alternative. Materials reflecting how some student organizations have been created and operate are available in the Law School Resources section below.

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ADMINISTRATION ...............

Your Role and Why It Matters Law school administrators and deans of students play a crucial role in raising awareness of law student mental health issues and helping students to cope effectively with the stressors of law school. These officials are in a position to develop focus groups, organize meetings, and establish or revise policies as necessary to address many of the issues raised in this toolkit. What You Can Do

1. Ensure a Substance abuse Policy Exists. Most student service administrators work for a law school that

is a part of an undergraduate institution that has a comprehensive alcohol policy. However, the university-wide policy may not apply directly to the particular needs of a law school, including the adult population. Student service administrators may be in a position to develop or revise the substance abuse policy for their law school. Developing an alcohol policy may seem like a daunting task if you are not familiar with your institution’s goals, liability issues, and constituent concerns relating to alcohol consumption. However, the process can be straightforward and enlightening if you begin with a few considerations as your guide. Stakeholders. Identify the target groups and be sure to include representatives while developing the policy. If a policy exists, review its strengths and weaknesses in light of current needs. Institutional Mission. Why is the alcohol policy being developed or revised? What are the goals (to control? to educate? something else?) What type of policy contributes to the furtherance of the institution’s mission? Is the purpose of the policy control or education? Enforcement. Is the policy practical enough to enforce? Include training for the individuals responsible for implementation. Monitor the implementation phase to ensure that the policy is effective and to make timely adjustments if needed. Dissemination. Dissemination should be broad and continuous; vehicles for publicity should be strategized with representatives of the targeted audience. Application. The policy should apply to all constituents (faculty, staff, and students) on campus. When and where do you allow possession or consumption? When and where do you advertise the use of alcohol? Violations. Sanctions should be clearly stated within the policy. Violations of the alcohol policy should be treated 28

in the same manner as other institutional policies, and all constituents should be disciplined in the same manner. Consider possible provisions: Requiring a permit to serve alcohol Requiring non-alcoholic beverages to be served Limiting students to a two drink maximum Providing access to designated drivers or cabs Requiring food to be served at events where alcohol is served Requiring that no school funds be used for alcoholic beverages Providing education to servers Providing the resources students with substance abuse problems can access for assistance

2. Address Mental Health Issues During First-Year Orientation. First year orientation is one of the most

important times to address law student mental health issues. Not only are first year students at orientation hanging on to every word, but they are also at an early point where they can take appropriate steps to avoid mental health issues from becoming a problem in their lives. We that each first-year orientation should include a presentation on the following topics: - How to cope effectively with stress and anxiety - The incidence of substance abuse and depression in law school and the legal profession - The questions relating to substance abuse and mental health that the local bar asks on its application - An overview of the mental health services available through the law school, the University, and the local LAP Because as so much information is covered during first-year orientation, mental health issues can get lost. An alternative is to work with each first-year section legal writing professor to set aside time for discussion of these topics during the early portion of the semester. If your school has midterms, the lead-up to them may also prove a good time to raise these issues.

3. Make Students Aware of Available Health Resources. There are two consequences of law schools not

publicizing the mental health resources available to students: students feel that this is not a problem shared by many and therefore feel stigmatized as to seeking help; and students who really want help do not know where to find it. PROBLEM: Students Need Mental Health Help NATURE OF THE PROBLEM: - Stigma - Bar Examiner Questions - Emotional Stoic Law School Culture - Availability of Trusted Resources to Help SOLUTIONS: Make Mental Health a Priority - Provide as many options as possible for assistance, including on-campus and off-campus mental health resources and mental health counselors located at the law school. - Be sure the helping resources are confidential. 29

- Conduct ongoing campaigns to publicize these resources – probably online, as the most effective communication tool with students. - Conduct yearly meetings with Dean’s office, Board of Law Examiners, and state LAP to develop solutions to bar application barriers and encourage law students to seek help. Example: In Washington, D.C., the chair of the D.C. LAP Subcommittee for Outreach to Law Schools hosts semiannual lunches where the local law school deans of students and representatives of the LAP discuss current mental health issues affecting students at their respective law schools and outreach efforts being implemented at the respective law schools. The deans of students use the lunches to exchange ideas (e.g., what outreach efforts were effective that semester, which efforts were not), brainstorm on new outreach ideas, discuss mental health impairments and addictions that appear to be prevalent in their law school communities and what might be done, and also stay connected with the D.C. LAP by learning about their outreach efforts. Nationally, law school deans and deans of students have created similar regional arrangements, in person and via video or phone conference. Provide Additional Resources Provide for a full-time law school counselor to address mental health concerns and issues. Having a counselor available at the law school may lead to de-stigmatizing the idea of seeking help, while bringing this resource closer to students may increase the likelihood that students will seek assistance. Also consider a partnership with your local LAP, where there may be options such as having a counselor on campus occasionally or regularly. Establish a Ground Strategy Those with the most severe mental health issues often are the least likely to seek help, which is why it is crucial to train students and faculty to recognize signs and risk factors associated with common mental health issues. Students are often the first to recognize when their friends are going through a challenging time, yet equally often they do not know how to address the situation: intervene, share the matter with the dean of student, or do nothing. Caring students and faculty must be trained and provided the tools necessary to recognize risk factors in others and to help those suffering address their mental health issues. A kind and loving, non-judgmental response from a caring friend or faculty member can be just what is needed to encourage someone in need to seek assistance. Help Educate Faculty on How to Deal With Law Student Mental Health Issues Faculty members can be in the best position to identify a law student dealing with mental health issues. It is essential that faculty are aware of the mental health issues that law students face and are provided the necessary training and tools to help students address these issues.

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FACULTY

............... Your Role and Why It Matters Faculty play an important role both in understanding and in seeking ways to help students cope with issues that affect them. Faculty are often looked up to by students; moreover, they have the ability to spot potential issues by, for example, noting ongoing class absences. What You Can Do

1. Counsel Students. A significant role that faculty can play without any additional information or education is

to monitor attendance in their courses. The ABA offers a general standard for ensuring attendance; as a practical matter, faculty apply a broad range of means for complying with the standard. Any counselor or expert who has worked with a student in crisis, however, will attest that class absences are more often than not a sign that a student is being adversely affected in a significant way. Some faculty express concern about calling attention to a student’s absence, whether because they are not equipped (or otherwise do not wish) to respond to a student’s issues, or out of fear that the student may feel he is being singled out by the professor. There are certainly ways of bringing to the attention of a dean of students or other relevant official such concerns without being directly involved. One law school conducts random “check-in” email outreach to students, encouraging them to come in for a brief chat; such outreach allows for a student whose concern has been raised by a school official to be folded in without making him feel like he is being singled out. Another school has established a procedure whereby any law school official concerned about a student is told to send an email to a specified address containing only the student’s name; receipt of this email by trained law school individuals allows them to check with one another to see if any red flags have been or should be raised, investigating further, and determining if a meeting with the student is warranted. Counseling Skills for Faculty When Meeting with a Student in Need of Assistance - Nod while the student is speaking to demonstrate that you are listening. - Maintain eye contact to demonstrate that you are listening. - Reflect the student’s feeling. If, for example, the student sounds frustrated while giving facts of a story, responds, “you sound very frustrated, this must be very hard for you...” - Paraphrase what the student is saying. If the student gives details about a situation, respond with “so you became angry with the situation and went out drinking,” even though the student may have provided a 10-minute description of the encounter. It is important to remember both content and feeling when students are speaking. Details are important so the student knows you are listening and have the story straight, but hearing their feelings and then reflecting them back to the student will build rapport. It helps the student feel like they 31

are being understood. - Ask open-ended questions and avoid closed-ended ones. “Tell me how you feel about your law school experience” vs. “Do you like law school?” - Allow for silence. This allows the student to gather thoughts and think about them more deeply before speaking. Also, it prevents the lay counselor from attempting to rush in with a solution, as the student will develop more insight and mastery if encouraged to find solutions on his/her own. - Show Unconditional Positive Regard for the Student. This means that the lay counselor never blames or shames the student. Never use words like “you should have” or “why didn’t you” as these are value-laden. - Reward Positive Behavior. If a student is doing well, in both word and deed, the lay counselor can acknowledge it. Instead of “I am very proud of you”, say, “you can be very proud of yourself for not drinking, but instead dealing with the situation in a more healthy manner and continuing to tell your teacher how you felt.” Finally, consider what some of your faculty colleagues have done in terms of opening up to their students about their issues.

2. Stay Abreast of Current Literature.

Brian Clarke, Law Professors, Law Students and Depression . . . A Story of Coming Out (Parts 1, 2, and 3), 2014: http://www.thefacultylounge.org/2014/03/law-professors-law-students-and-depression-a-story-of-coming-outpart-1.html   http://www.thefacultylounge.org/2014/04/in-part-i-of-this-little-series-i-laid-out-some-of-the-statisticsregarding-the-scope-of-the-problem-of-depression-and-anxie.html   http://www.thefacultylounge.org/2014/04/the-coming-out-trilogy-part-3.html Elyn Saks: A tale of mental illness – from the inside: www.ted.com/talks/elyn_saks_seeing_mental_illness?language=en

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RESOURCES

...............

SEEKING TREATMENT Most law schools are part of an undergraduate institution that has a comprehensive substance abuse and mental health policy. Those schools are also likely to have university counseling centers or other similar counseling options. These resources vary substantially by school. Also, the majority of law schools have a dean of students or a designated individual who is able to offer at least general counseling and provide resources. If your school does not have resources readily available in pamphlet form or on a website, many of the resources below are invaluable. There are high-quality treatment facilities throughout the country. What is best for any one individual requires a thorough knowledge of the disease of addiction, a thorough evaluation of the individual, and a comprehensive knowledge of available treatment resources. Like much of medicine, the availability and quality of treatment services can change rapidly. State Lawyer Assistance Programs (LAP) have an interest in keeping up-to-date on the best treatment resources in their community, inclusive of where scholarships might exist for students (see www.abanet.org/legalservices/ colap/lapdirectory.html). - ABA Commission on Lawyer Assistance Programs (CoLAP) Listserv for Law Students in Recovery (closed and anonymous), e-mail [email protected] - ABA CoLAP Confidential Hotline for Law Students and Lawyers, 1-800-LAW-LAPS (529-5277) - Active Minds, www.activeminds.org, a student-organized support group with chapters at a number of law schools - Addiction Recovery Resources for the Professional: www.lapage.com/arr - Alcoholics Anonymous: www.alcoholics-anonymous.org - American Foundation for Suicide Prevention: www.afsp.org - American Medical Association: www.ama-assn.org - American Psychology Association: www.apa.org

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- Center for Substance Abuse Treatment: www.samhsa.gov - Cocaine Anonymous: www.ca.org; 800-347-8998 - Crystal Meth Anonymous: www.crystalmeth.org - Dave Nee Foundation (addressing depression and suicide among law students): www.daveneefoundation.com - Debtors Anonymous: www.debtorsanonymous.org - Directory of State and Local Lawyer Assistance Programs: www.abanet.org/legalservices/colap/lapdirectory.html

- Florida State University College of Law, Law Student Resources: www.law.fsu.edu/academic_programs/ humanizing_lawschool/studentresources.html - Gamblers Anonymous: www.gamblersanonymous.org - Habit Smart: www.habitsmart.com - International Lawyers in Alcoholics Anonymous: www.ilaa.org - Marijuana Anonymous: www.marijuana-anonymous.org - Mental Health America: www.nmha.org - National Alliance on Mental Illness (NAMI): www.nami.org - Narcotics Anonymous: www.na.org - National Clearinghouse for Alcohol and Drug Information: www.health.org - National Institutes for Mental Health: www.nimh.nih.gov - National Mental Health Awareness Campaign: www.nostigma.org - National Suicide Prevention Hotline: 1-800-SUICIDE (784-2433), www.hopeline.com - Sobriety and Recovery Resources: www.recoveryresources.orgsubstance - Nicotine Anonymous: www.nicotine-anonymous.org 415-750-0328 - The Hidden Sources of Law School Stress: Avoiding the Mistakes that Make Unhappy and Unprofessional Lawyers, Lawrence Krieger: www.law.fsu.edu/academic_programs/humanizing_lawschool/booklet.html - Treatment Improvement Exchange: www.treatment.org - Web of Addictions: www.well.com/user/woa/ - Women for Sobriety: www.womenforsobriety.org 34

SELECTED ARTICLES and MEDIA RESOURCES There are myriad articles seeking to provide assistance to law students and to caring individuals who wish to help those students with mental health, substance abuse, stress and related issues. The link to several articles and other resources that have resonated with readers over the years are provided here. The ABA’s Law Student Division website has a whole host of resources, including organizations, weblinks, blogs, and articles: http://www.americanbar.org/groups/law_students/initiatives_awards/lshealth.html “Law School and Stress”, First Year Orientation Speech by Professor Barbara Glesner Fines: http://law2.umkc.edu/ faculty/profiles/glesnerfines/bgf-strs.htm ‘“I wish I would have called you before . . . . .” Depression and suicide: Make sure you don’t utter those words”’, by Don P. Jones & Michael J. Crowley: http://www.americanbar.org/content/dam/aba/administrative/lawyer_ assistance/ls_colap_depression_and_suicide_jones_and_crowley.authcheckdam.pdf “The Devastation of Depression: Lawyers are at Greater Risk--It’s an Impairment to Take Seriously”, by Michael J. Sweeney: http://www.alabar.org/alap/articles/devastation_of_depression.pdf “Getting Healthy, Staying Healthy”, a video for law student on the importance of getting ahead of their issue while in school, produced by David Jaffe: http://media.wcl.american.edu/Mediasite/Play/acfe55debf3d4910930e8657b1 68983e Lawrence Krieger has produced a student assistance booklet called “The Hidden Sources of Law School Stress” which have been distributed in law schools across the country. Information and ordering instructions are available at: http://www.law.fsu.edu/academic_programs/humanizing_lawschool/booklet.html Free Apps for Relaxation: http://shar.es/Pn5ZD (see “There’s an App for That!”; part of the Lawyer-Coach website)

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LAW SCHOOL RESOURCES ...............

Sample bylaws Article I: Statement of Purpose LAW STUDENTS ANONYMOUS (LSA) is being established in the fall of 2003 at COLLEGE OF LAW in association with the Assistant Dean of Academic Assistance and Student Counseling with the following objectives: (1) To provide a weekly support group for those students who may need to receive the help of a group in dealing with problems such as substance abuse or other stressors. (2) Provide through the use of cooperative agreements with licensed organizations a system of assessment and referral for those students whose problems lie deeper than what a support group can provide. (3) To provide informational programs to the Faculty, Students and Staff on topics appropriate to the goals of the program such as identifying substance abuse or coping with stress. (4) To provide a help line or phone number similar to an EAP. (5) To act as a liaison to the state Lawyers Assistance Program. Article II: Membership Section 1 Any currently enrolled student at College of Law may be a member of LSA entitled to all the privileges and duties of membership herein provided. Section 2 In order to work the help desk for LSA and act as a group leader, or serve on the Board, a student must have completed their first semester and the peer assistance training provided by LSA. Section 3 There will be no membership dues to LSA. Section 4 Any Student who misrepresents the policies or objectives of LSA will be subject to disciplinary action or removal from the membership. Article III: Board of Directors Section 1 The Board of Directors will be elected to a term of one year and their duties shall consist of: a. Director - The Director shall oversee the Board and shall act as LSA’s representative to the College of Law, Student Bar Association, and the State Lawyers Assistance Program. In addition, the Director will preside over meetings, receive all mail addressed to LSA and have signature authority over all bank accounts maintained by LSA. 36

b. Treasurer - The Treasurer shall maintain all accounting records of LSA and is responsible for maintaining the accounts). The Treasurer will have signature authority on all banking accounts maintained by LSA. c. Secretary - The Secretary shall take minutes of all meetings, post notices of meetings and presentations and make any necessary room arrangements for meetings or presentations. The Secretary shall also be responsible for preparing any correspondence relating to any LSA matters. d. Volunteer Coordinator - The Volunteer Coordinator shall be responsible for making all necessary arrangements for the time, room and leader of the weekly meetings and for the staffing of the phone line. The Volunteer Coordinator shall also be responsible for establishing a training schedule for student volunteers. Section 2 Members of the Board will be elected as follows: a. Elections will be held during the Spring Semester for the following academic year at a time to be decided by the current Board, not to be later than the third full week in April or prior to Spring Break. b. The majority of eligible voting members who are present at the election meeting will elect Board Members. c. Nominations will be open and taken from the floor. d. A minimum of one (1) semester of membership is required to be nominated for a position on the board and to be eligible to vote. e. Nominations shall be made at a special meeting to be held no less than one week prior to elections. f. Newly elected officers shall take office on the first meeting of the fall semester. g. Voting shall be by secret ballot and counted by the current Director and Secretary. h. Current officers can be nominated to run, and can be re-elected to the same position for consecutive terms.

Section 3 Any officer who is deemed inactive in the performance of their duties or who misrepresents LSA or who is found guilty of any act that hinders the goals of LSA may be removed by a 2/3 majority of the voting members, provided he/she is afforded an opportunity to provide a defense.

Section 4 The Board of Directors may establish committees and delegate their authority on an as needed basis. Article IV: Amendment Process Section 1 These bylaws may be amended as provided herein.

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Section 2 Before any proposed amendment is acted upon by the membership: a. It must be typewritten, double-spaced. b. It must be signed by at least two voting members. c. It must be read to the members during the meeting previous to the meeting that it is to be voted on. d. A copy must be posted on the LSA bulletin board and notice made to all members at least seven (7) days prior to the meeting at which action is to be taken. Article V: Ratification Section 1 These amendments shall become ratified and shall then become effective upon the approval of a 2/3 vote of the eligible voting members present at the meeting during which voting on the proposed amendment takes place. Article VI: Additional Bylaws Section 1 In the interest of time and academics, meetings shall be limited to one hour, unless the board deems it necessary to extend the time. Section 2 In order to stay within the one-hour limit, no more than five topics will be on each agenda. Section 3 The Board of Directors without membership approval can expend no more than $25.00, unless already budgeted. Section 4 Business records shall be open for membership inspection upon request; however, no record shall contain the name or other identifiers of any student receiving assistance from LSA. Section 5 LSA will adhere to Robert’s Rules of Order, with some added flexibility when conducting meetings. Section 6 LSA officers will have executive meetings prior to every membership meeting. They will have the responsibility of consulting and agreeing upon the time and place of the meeting, how the notices shall be delivered to the membership; who will be presiding; discussion of the objectives of the meeting; and what will be on the agenda for that meeting. Article VII: Office Hours Law Students Anonymous is located in room X, College of Law. Office hours are xxxx.

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WHAT SOME LAW SCHOOLS HAVE DONE/ARE DOING TO PROMOTE WELLNESS Collaborative efforts between the office of student affairs/services with the campus counseling services to offer law student specific programming such as: “Bounce Back Quickly from Dashed Expectations,” a presentation intended to help law students with taking their own road to resilience. We hope to better inform students on strategies of adapting well in the face of adversity and significant sources of stress. One school has branded “Let’s Talk,” a program in which a mental health professional comes to the law school for 1-2 hours a week and serves as a consultant for the law school community. This allows students to raise concerns that they may have about themselves or someone else and to get feedback on an appropriate next step. This is done privately and confidentiality. Designating a specific mental health professional at the campus counseling services to either come to the law school for a designated day each week or to remain in the counseling center but have a specialty in working with law students. Another option that some schools have adopted is to set up special walk-in hours once a week near the law and school. Programming Ideas Wellness Fair. The school can invite businesses/agencies from the community to table in the school lobby for students for a few hours in the middle of the day.  Attendees can include: yoga studios, rock climbing gym, martial arts center, counseling center, chaplains (when applicable), the director of the local LAP or LCL, a massage therapist, dieticians, strategies for time managements, creativity station, etc..  Many businesses will bring brochures and class schedules, and may bring coupons or offer discounts. “Family Fun Day” for students and their families. Include good food, good company, a roving magician or other entertainment for the kids, to create a place where law students and their families can be “normal” for a day. Relaxation/Wellness Week. Perhaps offer these during exam period or midway through the semester. Offer different programs or events each day that center on wellness or relaxation; please see attached flyers for specific ideas. (Vanderbilt and UC Davis flyers here) Some general ideas include but are not limited to: chair massages, therapy dogs, Dave Nee Foundation Uncommon Counsel Presentations (http://daveneefoundation.org/), Sexual health presentations, mindfulness workshops, resiliency training, etc. ABA Law Student Division Mental Health Day. The ABA Law Student division has a Mental Health Initiative Project that designates a day each year as “National Mental Health Day” and provides a mental health day toolkit on the Division website: http://www.americanbar.org/groups/law_students/initiatives_awards/lshealth.html

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RELAXATION WEEK April 1-4

  Tuesday, April 2, 12-1:30 p.m., King Hall Courtyard “Going to the Dogs:  Relieve Stress with Puppy Love!”  All King Hall students, faculty and staff welcome!! Thursday, April 4, Noon-1 p.m., Room 2303 Food for Thought:  A Conversation About Health and Wellness in the Legal Profession.”  Presented by Katherine Bender, MS, NCC, Dave Nee Foundation and Shana Alexander, Psy.D, UC Davis Counseling Services.  Pizza will be served!! Thursday, April 4, 3:20 p.m. Hosted by: the King Hall Health Law Association Group Exercise Session. Come join King Hall’s Health Law Association for a great work out on the grassy field to the west of the track on Russell Blvd. and Howard Way at 3:20 pm this coming Thursday, April 4th. Exercise will include a variety of running, strength training, calisthenics, core work, and ab work. If you are unable to do one type of workout- no worries! All levels of athletes are welcome! The workout will be adjusted based on each individual’s ability.” Sponsored by the Deans’ Office and the King Hall Health Law Association Hope to see you there!! Peer to Peer Some law schools offer mentoring programs in which each 1L is placed with a 2L or 3L mentor. Other law schools train “peer counselors” so that students who may have substance abuse or mental health concerns can talk with a peer as a first step. See for example the Law School Peer Support Network Training Manual developed by the University of Minnesota: http://www.americanbar.org/content/dam/aba/administrative/ lawyer_assistance/ls_colap_law_school_peer_support_network_training_manual.authcheckdam.pdf Some schools have student-initiated wellness groups or mental health awareness groups who can assist in sponsoring some of the programs or workshops mentioned above. Suicide Prevention Programs:

- Q.P.R. (Question, Persuade, Refer - a suicide gatekeeper prevention: www.qprinstitute.com) - The Dave Nee Foundation Uncommon Counsel (http://daveneefoundation.org/)

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INTERVENTION Interventions are a tool for helping a person get help whose condition is such that his/her perception is affected by the disease so that the addicted person cannot readily see that help is needed. Interventions without fail work better with professional assistance. State lawyer assistance programs have people trained in interventions that may be contacted and are glad to help law school administrators either directly or by putting them in touch with a local, trained interventionist. Interventions work best in contexts where the impaired person has something significant at stake and the law school context is an ideal time for a student with addictive disease to get help that will allow him or her to address this issue. Types SIMPLE: One-on-One. Loved one or M.D./Counselor asks the person to stop using and gives education and/or support in the request. CRISIS: Individual ends up in a hospital or jail and stops on their own. CLASSICAL: Vernon Johnson Model. Johnson wrote the book, “I’ll Quit Tomorrow.” This model focuses on the user and uses family/peer support. User will not know about the meeting to intervene until all concerned individuals are gathered. SYSTEMS: Based on works by Virginia Satir, which focuses on family. Does not keep the intervention secret from the user. Uses individuals outside of the family, such as friends, clergy and employer. This approach does not confront in the same way as the Johnson Model. The CRAFT (Community Enforcement and Family Training) program is another way to deal with a friend or family member with a substance abuse/addiction issue, particularly as a student may be in law school while dealing with family member or a friend in addiction, which can also produce extreme stress, anxiety and affect one’s performance. http://motivationandchange.com/outpatient-treatment/for-families/craft-overview/ 

ASSESSMENT TOOLS There are a number of free online self-tests for assessment of possible impairment issues. The important thing is not to panic if the results of a test suggest there is an issue. However, you should seek a resource that you know or believe you can trust to help you find additional answers. http://www.the-alcoholism-guide.org/free-alcohol-asessment.html http://samhi.mimh.edu/sa.asp LawLifeline self evaluator: http://www.lawlifeline.org/self_evaluator

COURSES AND OTHER LAW SCHOOL PROGRAMMING ON MENTAL HEALTH AND SUBSTANCE ABUSE Syllabus I: Silver, Marjorie A. (2004) Substance Abuse, Stress, Mental Health, and the Legal Profession. Touro Law Center for the New York State Lawyer Assistance Trust (2004): http://www.nylat.org/documents/CourseinaBox.pdf Syllabus II: Prepared for the ABA Commission on Lawyer Assistance Programs and for the Canadian Bar 41

Association 1st Year: STRESS AND LIFESTYLE MANAGEMENT -Lecture: Lawyer from Lawyer Assistance Program on topic: Managing Stress as a Practicing Lawyer -Credit Time: 1.0 Hour -Video on Stress Management/ Lifestyle Issues -Credit Time: 1.0 Hour -Seminar Discussion on 3 case examples (class in groups of 20) -Credit Time: 3 x 1.0 Hour= 3.0 hours -Essay assignment (1000 words): Strategy for handling personal problems arising from specific (new) case examples. -Credit Time: 5.0 hours 2d Year: WHEN PERSONAL PROBLEMS BECOME PROFESSIONAL ISSUES -Lecture: Lecture: Lawyer from Lawyer Assistance Program on topic: When a Lawyer faces disciplinary proceedings as a result of personal problems -Credit Time: 1.0 Hour -Video on the Intervention Process -Credit Time: 1.0 Hour -Seminar Discussion on 3 case examples (class in groups of 20) -Credit Time: 3 x 1.0 Hour= 3.0 hours -Essay assignment (1000 words): Strategy for handling personal problems arising from specific (new) case examples. -Credit Time: 5.0 hours 3d Year: ALCOHOLISM AND DRUG ADDICTION -Lecture: Lawyer from Lawyer Assistance Program on topic: Alcoholism, Drug Dependency and other addictions -Credit Time: 1.0 Hour -Video on the Lawyer Assistance Programs -Credit Time: 1.0 Hour -One hour Lecture: set up and presentation of written material in preparation for an all-day retreat. -All-day retreat on Friday, Saturday or Sunday (class in groups of 20) to discuss practice and personal problems arising from addiction, illness, or other distress; -Discussion Topics: alcohol addiction; drug addiction; alcohol/drug use; family pressures; balancing responsibilities to clients and spouse/children; emotional difficulties including depression, physical or emotional illness. -Credit Time: 7.0 hours -NOTE: The Syllabus has been organized for three different formats on the basis of one hour per year, two hours per year, and ten hours per year. -The one hour per year model would provide face to face lecture (#1 in each year). -The two hour model would include both the lecture and the videos (#1 and #2 in each year). -The ten hour model would incorporate all four items for each year. -Further, the law school could choose to devote more than one or two 42

hours in any given year. For example, the law school could choose the ten hour format for the first year and the two hour format for each of the second and third year. “Well-Being and the Practice of Law”: http://law.duke.edu/curriculum/courseinfo/course?id=419 Don Carroll “Law and Addiction Outline” from “Legal Education and Alcohol” presented at the 15th Annual National Workshop for Lawyer Assistance Programs: http://www.americanbar.org/content/dam/ aba/administrative/lawyer_assistance/ls_colap_don_carroll_legal_educ_and_alcohol.authcheckdam.pdf

HISTORY AND SOURCES The history of the ABA’s work with lawyers affected by alcoholism, substance abuse, and mental health issues dates formally to 1988. That history, as well as the support provided to law students by a number of professionals since then, is offered here: http://www.americanbar.org/content/dam/aba/administrative/lawyer_assistance/ls_colap_toolkit_history_and_ sources.authcheckdam.pdf

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Substance Abuse and Mental Health Toolkit for Law Students and

S U B STA N C E A B U S E & M E N TA L H E A LT H TO O L K I T for Law School Students and Those Who Care About Them A collaborative effort of the ...

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