FOCUS Continuing education: professionals' mental health
Several high-stress professional sectors facing rising rates of depression, anxiety and suicide are addressing mental health through continuing education courses and other initiatives to improve employee wellness.
Attorneys are among the professionals on the high-stress list, and the American Bar Association has launched a national initiative to address and improve wellness within the legal profession. The ABA Commission on Lawyer Assistance Programs partnered with the Hazelden Betty Ford Foundation to conduct a study on lawyer mental health and impairment. The study included surveys of 12,825 licensed, employed attorneys and found that 28% experienced symptoms of depression, 19% struggled with anxiety and 23% felt stressed.
Among the steps Oregon has already taken to improve well-being among legal professionals is the Oregon Supreme Court's recent approval of an MCLE (Minimum Continuing Legal Education) rule requiring one hour per reporting period on the subjects of mental health, substance use and cognitive impairment. Workshops and other programs are being developed all across the state. Earlier this year, the Oregon New Lawyers Division partnered with the Lane County Bar Association to host a CLE (Continuing Legal Education) focusing on lawyer well-being. Additional sessions were held in Washington County, Pendleton, Bend and Ontario.
Sarah Radcliffe, managing attorney for Disability Rights Oregon's Mental Health Rights Project, became president of the Multnomah Bar Association in June and says she is focusing her year in office on lawyer caregivers and work-life balance.
"Work-life balance is important for everyone, but it is especially urgent for people who have caregiving obligations at home. Mostly I'm thinking about parents, but it's also people who don't have children and are caring for an aging parent or a loved one with a disability," she says.
Radcliffe has spent her career working for nonprofit legal organizations where the expectation is a 35-hour workweek. As she has talked with lawyers who work in private firms, she has learned more about a toxic culture that demands longer work hours per week and leaves less time for family, friends or other interests outside of the office.
"From the perspective of my bubble, it seems really hard to manage," she says. "Some of the rhetoric around lawyer wellness puts the onus on the individual and their self-care practices when, if our workplaces are built on a culture of overwork and intense stress and that structure doesn't allow permission for self-care, that doesn't reduce conditions for depression, addiction or stress. It also pushes women out of the practice when they're put in this position of having to choose because it's too difficult to balance work and family life."
Michelle Ryan, chair of the bar's Quality of Life Committee, says the committee works with other legal organizations to provide speakers for the new mental health MCLE, the Oregon Women's Wellness Retreat and the Opportunities for Law in Oregon. It partners with law schools to promote wellness, and participates in Lewis & Clark Law School's Bar Prowl, which is not a pub crawl but an opportunity for students to get to know practicing attorneys and potential mentors.
The Quality of Life Committee also helped organize last January's Summit on Lawyer Well-Being at the bar's center, and members of the committee facilitated small group discussions on topics such as law firm/organizational support; substance abuse, addiction and mental health issues; special populations such as sole practitioners, rural lawyers and lawyers from non-dominant cultures; and healthy habits. The summit was free and featured information about professional support and resources, and a panel who shared their personal experiences, Ryan says.
Like several Portland law firms, Samuels Yoelin Kantor encourages employees to not only learn more about mental health and wellness through continuing education, but also through group activities such as participating in charity events.
In addition to attorneys, health care providers are among the high-stress professions. Medscape's 2019 National Physician Burnout, Depression & Suicide Report, which surveyed more than 15,000 physicians across about 30 specialties, shows that 14% of physicians reported suicidal thoughts. While half of them had talked with somebody about it, 42% said they had not told anyone.
A 2017 study published in Academic Medicine found that suicide is the second-leading cause of death for medical residents. It was the 2004 death of a resident that led Oregon Health & Science University to establish its Residents and Faculty Wellness Program, a springboard for several initiatives aimed at improving physician wellness starting when they are medical students.
"We take this problem very seriously because of the tremendous losses we experience as a profession," said George Keepers, MD, professor and chair of OHSU's Department of Psychiatry. "The number of physician suicides each year totals an entire class size. Those are huge risks and a huge loss to our profession and society in general, not to mention the devastating personal loss to that person's friends and loved ones."
Starting last year, all health professional licensing boards in Oregon began reporting on whether licensees are taking continuing education on suicide risk assessment, treatment and management. The 2017 passage of Senate Bill 48 requires licensees to report this continuing education when renewing their state license to practice, with the goal of supporting health care providers' mental health.
Dentists, financial professionals, teachers and professional caregivers — also on the high-stress professions list — are implementing mandatory continuing education about mental health and wellness both nationally and locally as well.
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