Just What The Doctor Ordered: A Review of “The Right Not To Remain Silent: The Truth About Mental Health in the Legal Profession”
Available now through LexisNexis
I have become somewhat obsessed with the issue of mental health in legal workplaces. Prior to 2020, I did not think of the issue often. I was occasionally moved when reading stories or hearing speeches about the tolls the practice of law could take, and the challenges of being a lawyer while struggle, but it did not hit me personally to any significant extent until late 2020 and early 2021. That is when my world came crashing down and everything changed.
I now read pretty much anything published related to the issue. I do this to keep myself informed of the illnesses which knocked me off my game and, more recently, as the owner of a law firm who is steadfastly committed to not inflicting the same pain on others that I experienced. I will do everything I can to protect my staff and I from ever going through that darkness.
The “Right Not To Remain Silent: The Truth About Mental Health in the Legal Profession” is edited by Beth Beattie, Carole Dagher & Thomas G. W. Telfer and is published by LexisNexis. It is the best and most comprehensive book on the topic of mental health in the legal profession on the market (I say this as the author of a book that is also on the market). I was not asked to write this review and have no involvement with the book project.
The book features a series of essays from practicing lawyers who have struggled with various different mental health conditions. There is extensive coverage of the two most common mental illnesses plaguing lawyers - the tandem beasts which are anxiety and depression. However, this book offers far more. Chapters cover the myriad of conditions that impact lawyers, as well as other members of society, and receive far less productive attention: bipolar disorder, grief and loss, PTSD, postpartum depression, panic attacks, suicide, addiction, obsessive compulsive disorder, eating disorders, and more.
This book offers something for everyone: those currently experiencing a mental health crisis, those worried that a friend or colleague may be experiencing a crisis and managers of workplaces looking to prevent crisis and create a healthy environment. In this review, I will touch on this book and what it has to offer for each of these audiences.
How do we better support friends, family and colleagues who are struggling?
It can be very lonely struggling with mental illness. Despite openly writing about my experiences and not hiding it publicly or in my workplace, I received very little in the form of support. The support I did receive, and the people who gave it, will never be forgotten. While I was ill, I had relatives dealing with physical illnesses. The differences in our experiences were striking. While they received flowers, prepared meals, offers of household assistance, words of support, and understanding for missing events and milestones from their colleagues, I saw no such grace. The mentally ill get no such assistance. We are expected to show up with a smile on our faces and carry on despite our invisible and deep pain. People are afraid of us and most just do not know what to do and choose to do nothing.
I was reminded of this loneliness while reading some of opening remarks in “The Right Not To Remain Silent.” Dr. David Goldbloom is a retired psychiatrist and a professor of psychiatry. He has a long history working with lawyers and now has two lawyer sons. He wrote the following in his Foreword:
The act of human connection is important not only at the outset but also throughout someone’s journey through mental illness. When I speak about workplace mental health, I ask audiences to describe to me what they do if a colleague has been hit by a bus and is hospitalized on the orthopaedic unit of a hospital. They quickly describe visits, get-well cards, etc. And when that person is discharged home for further recovery, they talk about further visits, bringing food over, and even bringing work to their home when it is appropriate. Finally, when this colleague is ready to come back to the office, albeit still in a wheelchair, issues of physical accessibility and graduated return to work are quickly addressed and the office may be festooned with welcome back messages.
What happens if a colleague jumped in front of a bus, and while not seriously physically injured, was hospitalized on a psychiatric unit? Silence.
Dr. Goldbloom shares far more useful insights in his contribution but his overall message was geared to individuals who are looking to better support others to “acknowledge, respect and support your colleagues who are dealing with mental illness.”
The book will generally assist people who do not have lived experience with mental illness understand the perspective and lives of those who are struggling. Various chapters also provide helpful advice, feedback and lessons learned through the failures of others. The chapter by Katherine Cooligan titled “Life Lessons Through Lawyers and Grief” provides helpful insight into the life of a mother who lost a young child while balancing a busy legal practice. What was helpful to her at the time? What was hurtful? What is the long-term impact and trauma? She shares all of it. Similarly, the chapter by Thomas G.W. Telfer titled “Crisis? What Crisis? Encounters with the Mental Health Care System” should be required reading for anyone trying to understand the burden that the mentally ill have to receive adequate healthcare (it also should be required reading in medical school and for nurses and hospital administrators - but that’s an article for another time).
Exposing yourself to stories of mental illness may also alter the perspective of the world around you. When I returned from my leave of absence after dealing with my breakdown, I returned to the same law firm but saw absolutely everything through a different lens. While colleagues would discuss how great it was that everyone was so busy, I would be concerned that we were burning everyone out. I would attend meetings and it would feel like I was speaking a different language than everyone else and that their explanations and plans sounded like unhelpful gibberish to me. Perhaps this book can assist us in all speaking the same language.
If you know someone struggling or want to be prepared to be a useful support person in the event that someone in your life does struggle, this book is for you.
Lessons for Legal Managers and Legal Workplaces
A significant motivating factor in my work writing and occasionally speaking about mental health in the legal profession is my view that legal workplaces are not well educated or motivated to fix problems in their workplaces that result in poor mental health outcomes for their workers. The practice of law is, by definition, a difficult way to earn a living. There is much we can’t control. However, our places of work do not need to make the problem worse. They should be our refuge. A place to regroup, be supported, and heal before we put back on our warrior faces and tackle the outside pressures of difficult clients, opposing counsel and judges. The battles we are fighting should not be for survival in our work environments. Leaders of legal work places would be negligent not to read this book.
The book features lawyers from various work environments - from the largest of law firms in big cities, large in-house departments, to small practices in small towns and government departments. If there are law firm leaders out there who believes they are too busy to read the whole book, read these chapters:
Carole Dagher “Reconciling the Visible and Invisible Me: My Prefessional Journey to Living My Authentic Self” which includes a very helpful call to action and her “do’s and don’ts” when communicating with a colleagues experiencing mental illness.
Beth Beattie’s chapter “To Tell or Not to Tell? That is the Question: Revealing Mental Health Issues at Work”. While this chapter is written primarily for individuals considering disclosing mental health issues, it is also helpful for management to read to understand just how challenging making this disclosure can be so that they are more prepared and trauma informed in their responses.
Katherine Cooligan, “Life Lessons Through Lawyering and Grief” which talks about her experience losing her son Justin. How she managed the grief at the time and the long-term impacts of grief. Her story will help you better respond to and comfort grieving colleagues so that these words are never written about you: “When I told the organizer that I would have to make an exception on that important day to me [a day used to honour Justin], he said nothing, as if I had not spoken. Every time someone else cannot cope with the sensitivity of the loss, I am left to feel empty inside, even all these years later.”
Thomas G. W. Telfer, “Crisis? What Crisis? Encounters with the Mental Health Care System”. Professor Telfer tells both the story of how challenging it can be to recover from mental illness due to the difficulties in accessing proper treatment, medication and services. His story is also one of a very understanding and supportive workplace.
Courtney A. Wilson, “Eating Disorders and the Legal Profession: Harsh Realities and Complexities.” In this article, Courtney discusses an issue that certainly exists but which I have not ever seen discussed either at a conference or in print: the beauty expectations placed on women lawyers and the experience of practicing law while struggling with an eating disorder.
Michael Herman, “Depression: My Journey Through Darkness.” Michael’s experience with leaves of absences, attempted and failed return to work and return to work plans is essential reading for the law firm manager.
The Hon. George Strathy, “It’s time to change the culture of legal practice.” This is the recently retired Chief Justice of Ontario’s third recent article about this subject. He makes the best case yet on why the profession finally needs to change and makes suggestions on how it can be done. I expect his views will be deeply respected by senior members of the bar who are the readers who must drive this change. I thank him for his continued leadership on this issue.
In my view, law firm and business leaders should make time to read all of the chapters as there is no more valuable resource than your people. But, if you truly can’t manage it, the above is a good place to start.
When I published my book in late 2021, I had hoped that it was law firm leadership and legal workplace managers who would pick it up and read it given the widespread mental health issues in the profession during the pandemic. Unfortunately, that did not materialize. We all need to do what we can to make sure law firm owners and managers read this one. If you know someone who needs to read this book, and is not likely to buy it themselves, feel free to nominate them to receive a copy here. Myself and some of the book contributors will be paying out of our own pockets to get this book into the right hands.
For the Individual Lawyer
As I shared on LinkedIn, I was not sure how I would personally react to this book as someone who has made it to the other side of a mental health crisis but who still struggles with depression and anxiety in various intensities on an ongoing basis. I have come to learn that my health is particularly vulnerable from the second week of January until after the May long weekend, due to past trauma in that time period.
When the book arrived on it’s release day, I spent some time thinking about if I should even read it. Some of you may know that I recently had three deaths in my family plus the shocking death of an old friend at the age of 37. My health has not been at it’s best but I have been far better able to manage thanks to better coping strategies, medication and ongoing therapy. I am still very careful about triggers that could set me off. A book about depression, anxiety and suicide certainly could have a negative impact at times - depending on the content.
As a result, I tip-toed into the book. Most of this review comes from journaling I did while reading it.
I started by reading Dr. Goldbloom’s foreword which set the right tone with the words “It is also a book about hope. As the authors take you through their sometimes harrowing journeys, they also show routes back to meaningful engagement with family, colleagues and work.” The focus on hope reminded me of the feeling I had when I did discuss my mental health openly first on social media and then in my book. I received emails and calls and held zoom meetings and coffee date requests from people who had been where I was, who made it through, and who wished to help me. Many of the people who took those actions are authors in this book.
I read the familiar stories first. Although the written word has the ability to dive deeper and disclose more detail than many could muster in oral conversation or a convention speech, I found comfort in stories that I generally already had heard and wished to explore deeper. The chapters by Beth Beattie, Orlando Da Silva, Leslie Anne St. Amour, Katherine Cooligan and Leena Yousefi were my gateway into the rest of the book. While they were certainly sad stories in many ways, I was left with a feeling of hope about the incredible tragedy and personal pain that we are capable of overcoming - even in an unsupportive world. I can certainly related to Orlando’s words when he states:
I also learned that, for me, “hope” and not “success” was the cure to depression.
Those stories each gave me hope and I am so proud of each of these authors for sharing their stories - especially my former associate lawyer Leslie Anne St. Amour. I read her chapter “I’m really glad you’re still here” for the first time when I helped edit it. I was still deeply in the midst of my recovery journey when Leslie Anne was my associate. Her draft chapter was my first introduction to the concept of a “third space”. Third spaces are a sociological concept which refers to a place separate from home or work/school - the first and second spaces - where you can spend time, socialize and where you achieve a sense of belonging. After retiring from competitive softball and coaching in 2019, I was largely without a third space. I have since found one in the form of birding and the nature-loving community in Ottawa. Getting outdoors, finding a community and feeling like I have something beyond a work and home life has been very helpful to my mental health. I think Leslie Anne, who is an environmentalist, will support my third place choice.
I then browsed the stories of other people who I have also met and felt familiar with. I do not believe I have met Carole Dagher in person, but I was familiar with her and her mental health advocacy work. I read her chapter next. I related to so much of what she had to say despite us having very different backgrounds and experiences. I relate to her words considerably when she writes about the difficulty with accepting the reality that “I have not been merely worried or stressed; I have been unwell.” That realization certainly took too long for me to figure out, despite the sleepless nights, endless rumination and frequent crying. Carole’s story is one many will relate to as she chronicles the efforts she made to conceal her illness and her experiences since revealing it. She first revealed her mental illness in a job interview and “insisted that I could only join the legal team if I could bring my authentic self to work.” Despite this disclosure, she was hired and her boss insisted on working with the “real” Carole. That gave me hope.
I read Professor Telfer’s chapter next. I had seen his writing on social media and was somewhat familiar with his story. His chapter provides a very detailed and intimate account of what it was like for him trying to access mental health support. I related to his experience significantly as getting care is not as easy as making an appointment and taking a prescription. It may take a while, sometimes a long while, but that does not mean that help is not possible and recovery will never come. Professor’s Telfer’s article would also be great to share with treatment providers, educators in the healthcare space and hospital administrators. Some (or most?) of his experiences were not terribly therapeutic and the story of the cinderblock room is particularly troubling. At times I have been very frustrated in my own efforts to get proper care, especially since I do not have a family doctor. Reading that it was not just me who is stuck in an ineffective system makes me feel less useless in my abilities to manage my care.
I then ventured into Michael Herman’s chapter. Michael was one of the many people who had reached out to me when I was at rock bottom. As a fellow “big law” lawyer, his outreach meant a lot to me at the time. I perhaps relate most directly with Michael’s story. As a fellow Big Law, very busy, highly motivated, type-A individual, my story is nearly identical to Michael’s other than my crisis hit me earlier in my career. Michael’s story will help people who are trying to come to terms with whether or not they have a mental illness and will provide insights on how to manage and build a proper return to work plan with your workplace. His is also a story of hope. In that regard, he eloquently writes:
I believe that without hope, we are lost. Before I had my moment on the balcony, I was hopeless, clueless as to how I was ever going to get better. Once I had that moment, a sliver of light broke through into the deep dark hole. I felt the first stirrings of hope. Having hope propelled me forward. Even in dire circumstances, holding on to hope can sustain us.
Michael’s chapter gives all of us the gift of hope.
Ryan Middleton’s story similarly resonated with me. I did not know of Ryan’s struggles with his mental health (I think he may have “come out” with those struggles through this book). I was delighted to see in his biography that Ryan has a national management role at a national law firm. He starts his chapter with “For far too long, I have been afraid to tell my story of living with a mental illness.” Those words alone will make all the difference in the world to young lawyers at Ryan’s firm (and across Bay Street) who are struggling. It gives me a significant amount of hope that the practice of law can be a better place when he writes:
The success of a law firm is 100% completely dependent on the performance of its people. Law firms espouse this but often fail to create an infrastructure that enables its people to live a healthier life.
I could not agree more. I also agree with his suggestion that law firm leaders need to be more open about their own mental health struggles so that there are high level discussions within these firms about making improvements. It is difficult to fix a problem that everyone is hiding. Now, as the leader of my own law firm, our number one goal is to create a workplace that is a safe, healthy place for our lawyers and staff so that we can weather all other challenges that this profession throws at us. Michael understands that. We need more law firm leaders like Michael.
Yadesha Satheaswaran is one of the younger lawyers who shared her experience through this book. Like others in this book, she is a first-generation Canadian. She shares her experience with three mental health conditions as well as her interactions with the mental health care system. Her comments about the elimination of any work-life boundary during the pandemic will certainly be relatable to many, while her description of dermatillomania (a type of OCD) will likely be new to most readers. It is impossible to finish her chapter without feeling hopeful when she writes: “I remain optimistic about my potential to not just survive but thrive.” I love that line as it reminds me of my own journey. I recall that in my very first meeting with my therapist, they asked how work was going. My response was “I can tolerate it.” Clearly, I needed to aim far higher than that. We should all feel like we are able to thrive or at least have hope that it will one day be possible.
I pause here to note that this is where the first version of my review ended and I hit “publish”, thinking I had read and reviewed all of the chapters. Due to the disjointed and non-chronological way in which I wrote this review, I had thought the task was done. Later, I was somewhat horrified that I had missed several chapters. Their exclusion was not an indication of the quality of the chapters, but rather a result of the way in which I consumed the book - somewhat chaotically.
I read Aidan Johnson and Dan Stein’s stories next. I was not previously familiar with either of these individuals or their stories but the book had earned my trust and I continued reading. Aidan provided an intersectional approach to the topic out of his own lived experience. This chapter tells the story of their life, focusing in on mental health challenges at various times, from different places and in different circumstances and what they learned along the way. Through this story we learn that we must never presume that we know what is happening in the emotional and private lives of other individuals. They are entirely correct when they write: “If we presume, we risk not noticing trauma, thus making matters worse.” Dan’s article comes from the perspective of a criminal defence lawyer - a segment of the bar particularly exposed to regular and unrelenting trauma. Dan’s message is clear: the practice if law is “tailor-made to stress you out” and we all need to have strategies to protectively and proactively fight against this. Some of Dan’s suggestions seem simple, but they are very practical, achievable steps one can take to make time for their own mental health and build up capacity to handle the inevitable difficult day.
It would not be a complete book about mental health in the legal profession without some time spent on the monster that is addiction. Imran Kamal provides an intimate first-hand account on living life as a lawyer, and as a human, with a drug addiction. He discusses his path to recovery, the 12-step program and provides helpful insights for anyone struggling to come to terms with and move forward towards recovery. I expect an entire book could be dedicated to addiction in the legal profession.
The last chapters written by a members of the legal profession were by Justice Michele H. Hollins and Michael R. Ferguson. Justice Hollins piece reminds us that judges are people too and people are not perfect. Justice Hollins practiced for 25 years until her appointment in 2017. She provides her life story coming to terms with and healing from depression and also shares four practical lessons: Don’t wait, The Reason Doesn’t Matter, Be Vigilant and Work Towards Solution. Michael R. Ferguson’s article is also an important read and provides the unique perspective of what it is like dealing with mental health struggles in a small community where everyone knows everyone. His article discusses the importance of the Law Society of Ontario’s Mental Health Summit in his own mental health journey. He also discusses the advantages and disadvantages of disclosing mental health issues in a small firm and small community. Michael’s personal experience with being open to his boss and legal support staff demonstrates how law firms can be better supportive of lawyers with mental health conditions once they are aware of your triggers. Michael faced greater risk than most by contributing to this book as a lawyer in a small community but he, nonetheless, concludes his chapter with words that may motivate others to do the same:
The first people to put themselves out there, particularly in those small towns, and small firms, risk a lot in their personal and professional lives by doing so, but if enough people practice openness we can begin to challenge the culture of suffering.
I couldn’t agree more.
The final chapter of the book was an academic look at emerging treatments for depression written by Brett Jones, Shayan Imran and M. Ishrat Husain - doctors and researchers in the field of psychiatry. This is a much more helpful read for those struggling with depression than the crap we find on the internet when googling about the condition (something other authors of the book admitted to doing and a practice which I am guilty employing far too often). It was a concise and helpful summary of the treatments, therapies, medications and lifestyle changes that may have positive impacts on treating depression. Again, the chapter leaves one with hope.
Concluding Remarks
I would like to congratulate each of the authors who contributed to this book as well as the editors. This book will make a difference in the legal profession at the individual and organizational level. Thank you for exposing yourself to your own pain and trauma for our benefit. We all owe a debt to you.
Buy the book and order one for your workplace today: https://store.lexisnexis.ca/en/products/the-right-not-to-remain-silent-the-truth-about-mental-health-in-the-legal-profession-lexisnexis-canada-skusku-cad-6975/details