Law Students and Depression

The Problem

There is an increasing body of literature suggesting that Australian law students experience high rates of depression. Studies confirm international research findings to the effect that law students and lawyers exhibit higher levels of psychological distress and risk of depression compared with Australian community norms and other tertiary student groups. Evidence is less strong for other disorders including anxiety.

What we also know from national studies is that:

• Law students are less likely to seek professional help.
• Law students have less expectation of recovery through professional help.
• Law students are more likely to fear discrimination because of mental ill-health.
• Law students are less likely to recognise their own psychological distress and symptoms of depression.

Now it is unclear why such a problem exists in law students, but posited factors include:

• Workload.
• High levels of pessimism and perfectionism, and the way these traits are rewarded in the study of law.
• The adversarial nature of the law which encourages suspiciousness, hostility and aggression.
• Highly competitive institutional environments which exacerbate fears of failure and break social bonds.
• Disillusionment and loss of personal purpose.

My own thinking on this groups these factors and draws on the demand-control theory of workplace stress. This is based on well credentialed research such as the Whitehall Studies of British public servants over several decades. In this theory, health outcomes are associated with the two factors: demand, and control/autonomy. These factors are mediated by social support at work. So people are at most at risk when they have high work demands, and little control over their work, within the context of the nature of their social relationships at work.

Applying this to the particular context of law school, there are high work demands placed on students, and little “control” in the sense of room for personal autonomy, choice, empowerment and individual expressiveness. The mediating factor of social support (provided by peers and teachers) is complicated by the competitive environment and the potential difficulties in creating meaningful interactions between students and staff.

Another angle to come at this is that law students have an exquisite combination of attitudes and experiences in law school, where aspirational prestige meets overwhelming drudgery. For some the resolution of this dilemma is in depression, which can be characterised as a kind of shutting down. Unfortunately this exquisite combination also makes it less likely to recognise one has a problem (or more specifically symptoms of depression), because of both keeping “face”, and the distraction of multiple tasks,

The Brain and Mind Institute in its study of depression in legal practitioners and law students in Australia concluded that it is not merely a problem for individuals, it is a problem for institutions. They suggest institutions (law schools) need to take on the mental health of their members as an essential institutional goal.

Of course, There are some elements that mitigate against this:

Denial – we don’t want to acknowledge there are any problems.

Rationalisation – That’s the way the Law is.

So what can be done?

Normally preventive and proactive interventions are the first line of recommendation. This would take the form of teaching wellbeing, balance and resilience, and encouraging academic and social connectedness. There are wellbeing skills that can be taught and learned, and whilst they can be regarded as “soft skills’ they can also be life saving in the long run. However there are some caveats in the current context with promulgation of interventions aimed solely at individuals.

To understand this, consider a straightforward but well regarded model of population level health interventions maps population against level of risk, as in the following diagram:

Where possible, effective proactive universal interventions cover the most ground. Targeted intervention focus on early intervention and at risk groups. Indicated treatment responds to those clearly identified as in need of response now, and who recognise their ill-health and think that help will be useful.

The dificulty is that universal interventions are often expensive, or ineffective. One reason for the latter can be that the sorts of forces that contribute to ill-health (in this case mental distress) are systemic and well beyond the individual. This is certainly the case with training for the profession of law. Many of the elements of these systems are not amenable to modification through training delivered to individuals, and impacts are highly influential, beyond what individual action can ameliorate. The scale of the challenge is depicted in the following diagram reflecting the way in which the experience of the study of law is nested within various systems:

I draw two conclusions from this:

(1) We need to be realistic that universal interventions aimed at improvements in individuals will only ever have limited impact, and need to be focused and law-specific to have any chance of being effective.

(2) Consideration needs to be given to complementing any such universal responses with targeted interventions.

These are the two areas I will now briefly sketch.

Promising Universal Interventions

From the preceding, any such across the board response needs to have some degree of precision in focus, in both rationale and intended outcomes for law students. Mindfulness training is suited to this purpose.

Mindfulness is a form of self-awareness training adapted from the Buddhist tradition of mindfulness meditation. It has been adapted for use in the treatment of depression, especially preventing relapse and for assisting with mood regulation. It has also been found to have considerable health benefits among normal populations.

Mindfulness is about being aware of what is happening in the present on a moment by moment basis, while not making judgements about whether we like or don’t like what we find. We all have the capacity to be mindful. It simply involves cultivating our ability to pay attention in the present moment and allows us to disengage from mental “clutter” and to have a clear mind. It makes it possible for us to respond rather than react to situations, thus improving our decision-making and potential for physical and mental relaxation.

The application of mindfulness training to law students is not without precedent, in recognition of the benefits of bringing balance into lives and enhancing well-being and performance (see here and here). When people incorporate mindfulness practices, they are better equipped to deal with the unexpected, however it presents itself. In addition, they develop and enhance their capacity to deal with high demands, and social interactions. They are also able to focus with greater clarity on assignments and work. The result is a shift in wellbeing and efficacy as students respond to stressful and uncomfortable events with greater ease.

To make this effective, there may need to be a focused element whereby students become aware of predominant styles of thinking in the law, and where the process of mindfulness training incorporates this and facilitates the capacity to develop relevant complementary skills. What goes with this is being open about the predominant styles of thinking that are encouraged in the structure of the curriculum and the system of law. This requires some interaction between the promotion of the “mindful law student” and all other elements of legal training.

Indeed, the exact form in which such training might be introduced into the pedagogical structure of law is not yet determined. There is no obvious fit as with the teaching of mindfulness within mind-body study in medicine. Obviously balances must be struck that allow the intervention to have the greatest chance of effectiveness and avoid misdirected or token effort, without disrupting the intensive teaching load and the academic integrity of the degree.

Targeted Interventions

In a university context, targeted responses are aimed at early identification of, and response to, students at academic and/or personal risk. This commonly involves pre-enrolment questionnaires, self report, and use of results from attendance records and early assessment tasks, to identify students who appear to be at risk.

Responses generally fall into two categories, depending on the assessed level of risk: For low to moderate risk, information is provided to the student including details of relevant resources and support services. For moderate to high risk, students are invited to a meeting with a staff member to directly discuss support that may be provided.

Whilst this system requires some resourcing, the argument is that the outcomes are better, and the net resourcing is less than having to manage crisis, and emergency situations that are left until too late.

Such a model is complemented by mental health training (including “mental health first aid”) for students and staff which is aimed at increasing awareness and ‘literacy’ in self and others of mental ill-health and how to respond.

Balancing Competitiveness

The Australian Learning and Teaching Council report on the teaching of law addresses the issue of the mental wellbeing of Australian law students. One area focused on is to balance the competitive ethos that is a significant element in legal education by recognising that there are significant aspects of legal practice and legal education where the encouragement of cooperation and the building of relationships of trust are highly desirable. The report includes reference to encouraging connectedness rather than isolation, and autonomy rather than individualism.

This remains a very challenging area when amongst other dynamics, a large pool of students are competing for a limited number of places at major law firms. Nonetheless, peer mentoring programs, and supportive (group cohesion) mechanisms to complement necessary competitive elements need to be considered. The opposition to group work by students is often strong in areas such as Law on the basis of the perceived “lowest common denominator” principle which runs counter to a prevailing aspiration for the highest marks. But this should not be sufficient cause not to pursue collaborative activity within legal training.

Conclusion

There is sufficient evidence now to regard the study (and practice) of law as systemically and inherently dangerous to the health and wellbeing of students and practitioners. There has been some recent recognition by the Law Institute and the Bar Council of this reality, although the general level of acceptance by those working in the legal professional remains limited. In the professional educational tradition, developing the skills to respond to and manage the demands of practice, and bring about systematic change, begins with training – in this case, in what is taught and practiced in Law Schools. Finding innovative and effective means to do this is the challenge facing legal educators.