Credit: gualtiero boffi/ Credit: gualtiero boffi/


Starting today, we are going to have a candid conversation about some very personal matters. And by “we,” I mean me and you, the reader. It will be the sort of conversation for which too little in your legal education, training or job has likely prepared you. We’ll be delving into some of the most important yet paradoxically under-addressed matters facing the legal profession—substance use and mental health, and the broad array of issues that tend to go along with them.

To be clear, this column isn’t about continuing legal education (though I hope you will learn a lot), and it’s not about data and statistics (though there will certainly be some of that). This is about your questions, my answers, and making some progress around serious problems that have lingered too long in our profession. To say this is breaking new ground would be the sort of banal understatement that you hopefully will not find in this column moving forward, but it’s true.


As a “mailbag” column, you are invited to send your questions to, and I’ll do my best to provide accessible, useful and frank answers that will advance your understanding of the issues surrounding mental health and substance use and make you more comfortable thinking and talking about them. Our discussion will be informed by my experience—past and present—which has combined to provide me with a uniquely qualified perspective on the intersection between substance use, mental health, and the practice of law. I’ll be sharing that perspective here in this space, and hopefully you’ll enjoy reading it.

Through my prior work as an attorney, licensed alcohol and drug counselor, director of a clinical treatment program at the Hazelden Betty Ford Foundation, and lead author of a landmark study on attorney substance use and mental health problems published last year in the Journal of Addiction Medicine, I am intimately familiar with how lawyers struggle, and why. In my current role as strategic advisor to law firms and other stakeholders in the profession, I help organizations address, prevent, and reduce addiction and mental health problems, while I also continue to advocate for broad change throughout the profession. In short, the issues we’ll be discussing are my professional world.

So why does the legal profession need a resource like this? Because we’re unwell, and we’re not talking about it enough. According to the study I authored—titled “The Prevalence of Substance Use and other Mental Health Concerns Among American Attorneys”—between 21 and 36 percent of practicing attorneys qualify as problem drinkers. At the same time, 28 percent of attorneys struggle with depression, 19 percent suffer from anxiety and 23 percent suffer from stress. Younger lawyers are the most troubled and at-risk group, although no age bracket or experience level within the profession could even remotely be held out as an exemplar of good health.

The bottom line is that all around and often hiding in plain sight, many lawyers are struggling but don’t have the support, awareness, insight, comfort level, motivation, willingness, or even the ability to address the problems and seek help. Many more, while perhaps not struggling with a substance use or mental health problem yet, are engaged in unhealthy behaviors that put them at risk for future problems and, at a minimum, greatly diminished wellbeing.

Culture, fear, stigma and denial are huge factors in the equation, and the profession, meanwhile, has not done enough in helping lawyers get and stay well. Historically and collectively, we’ve missed the target. And considering that we are a licensed profession entrusted with the public confidence and some of the most fundamental responsibilities of keeping our society, government and economy in motion, maybe the better question is why wouldn’t we need a resource like this?

In my work as director of a treatment program for addicted attorneys, judges and law students, I saw firsthand—and in a clinical setting—the wide and indiscriminate path that addiction and mental health problems carve through our field with far greater frequency than the general population. Alcohol, drugs and mental health disorders kill lawyers, derail careers, ruin finances, wreak havoc on entire practice groups and firms, disrupt families and friendships, and harm the public. Regularly. Daily. We must do better. It’s time for us to think more, talk more, and do more about these longstanding problems. For ourselves, the future of our profession, and the clients we serve, it’s time.

So where do we go from here? Well, we start by you sending your questions to the email address below. Though it’s abundantly clear what the subject matter of the column is, I should probably explain that my goals are to educate, motivate, demystify, and destigmatize. If you think your question lends itself to one of those aims, I look forward to hearing from you. Maybe the question is about you, or maybe it’s about a friend or coworker. Maybe it’s more philosophical or theoretical, something that touches on broader themes. Whatever it is, I’ll do my best to select and answer questions that I think will hold the most benefit to readers.

Finally, the disclaimers and details. As a biweekly column, this is not a real-time discussion, and not an appropriate resource for individuals in a state of acute crisis. Furthermore, while I will be sharing my expert and professional opinions, advice to readers does not constitute a therapist-client relationship and should not be relied upon or construed as such. Most important, all reader questions and submissions are viewed and will be treated as strictly confidential. Reader pseudonyms will be used in my column responses, and please rest assured that I consider your submissions privileged and confidential.

With all of that said, start sending your questions to me at and I’ll see you back here in two weeks!


Patrick R. Krill is the founder of Krill Strategies, a behavioral health consulting firm focused exclusively on the legal industry. Go to for more information.