ICLR 2017 – Panel: “Overcoming Stigma”

A synopsis of panel session 4, which takes place on 5 October at ICLR Singapore, kindly provided by the session’s moderator, Tracy Kepler. Conference materials will be made available to ICLR.net members after the conference.

Moderator: Tracy L. Kepler, Director, ABA Center for Professional Responsibility

Kuah Boon Theng – Vice-President of the Law Society of Singapore
Dr. Munidasa Winslow, MBBS, M.Med. (Psych), CMAC, CCS, FAMS – Executive Director of Promise Heathcare Pte, Ltd. Singapore
James C. Coyle, Attorney Regulation Counsel of the Colorado Supreme Court
Marian DeSouza, Executive Director of the Alberta Lawyers’ Assistance Society

Substance abuse and mental illness can affect any attorney regardless of gender, culture, ethnicity, age or socioeconomic status. But no matter what their background, attorneys dealing with these issues seem to suffer in silence. Why? Stigma – cultural prejudice and discrimination that labels an individual suffering from such illnesses as defective, or weak, oft-times have more damaging consequences than the illness itself and create a barrier to treatment. Through our discussion, the panelists will define the stigma, explain the reasons why stigma is so pervasive in the legal profession, and why it is critical to overcome these beliefs and identify effective means to ameliorate stigma and replace its effects with affirming attitudes for recovery. The discussion will focus on several different “life stages” of an attorney – law students, practicing attorneys, and judges, as well as unique challenges faced by under-represented minorities, and how stigma affects each group. The panelists will also identify practical and applicable ways to conquer stigma in the legal community as well as during the regulatory process, and discuss various regulatory efforts and objectives centered on increasing the wellbeing of our profession.

Why is this session of particular interest and to whom?

Everyone is effected by this issue – whether they recognize it openly or not.  One challenge for this session (and others) will be how to ensure the session resonates with both western and non-western regulators who have different cultural and societal backgrounds.  Attorney wellness cuts across all countries, but the nature and intensity of the problems likely differ, and stigma is an even larger issue in more traditional cultures.  We hope to engage all participants in the dialogue to learn the different and cultural differences in the way mental illness and substance abuse is perceived in the legal community.

One reason this is a hot topic at the moment is that globally, organizations are realizing that attorneys are suffering in silence, statistics reflect higher rates of alcohol/substance abuse/mental health problems among the attorney population, and these high rates are not sustainable or conducive to a spirit of wellbeing.  Research has shown that the two most common barriers to seeking treatment that lawyers reported were not wanting others to find out they needed help and concerns regarding privacy or confidentiality.

What particularly do you hope to explore in this session?

We hope to start at the beginning with a definition – The Oxford English dictionary defines stigma as “a mark of disgrace associated with a particular circumstance, quality, or person”.  But it is really more pervasive and goes deeper – it sets a person apart, makes them part of “the other.”
When people are labelled by their illness, they then are seen by others as part of a stereotyped group.

  • Stigma is about beliefs and attitudes – often derived from the media or those around us.
  • Stigma is based on negative views of people simply because they are seen as belonging to a particular group.
  • Stigma often results in fear of members of the stigmatised group (often based on ignorance and lack of understanding).

Negative attitudes also create prejudice which then leads to negative actions and often discrimination.  We hope to explore the various components of stigma such as Labelling, Discriminating, Prejudice, Ignorance, Stereotyping, and Devaluing.  And stigma brings with it experiences and feelings of shame, blame, hopelessness, distress, and most importantly for our purpose at this conference – reluctance to seek and/or accept necessary help.

What do you hope to achieve with this session?

  • To discuss and provide concrete examples of ways of combatting stigma that are nuanced, will be geographically and culturally sensitive so that they are effective.
  • To discuss and determine the effectiveness of certain resources, such as support groups, education, sharing stories, amelioration not reduction, a focus on wellness, outreach, finding ways to combat stigma by creating opportunities for open dialogue
  • To share and educate that language/semantics matter – substance use disorder v. substance abuse, i.e., when someone has bulimia, we speak about an “eating disorder,” not a “food abuse” problem – and start to dispel the lingering belief that addiction is a moral failure rather than an illness.

Useful documents/background reading for context

Online articles:

‘A culture of fear’: Legal Futures

‘JLD resilience and wellbeing report’: Law Society of England and Wales

‘Solving the Stigma of Lawyer Mental Health’: 2Civility

‘A Lawyer Breaks the Silence About Depression Among Lawyers’: Everyday Health

‘What We Can Learn About The Stigma Of Mental Illness From Susan Hawk’: Texas Monthly

‘Some Law Firms Try To ‘Eliminate Stigma’ From Attorneys Struggling With Mental-Health Issues’: Above the Law

Further reading:

  1. W. Britt, T. M. Greene-Shortridge, S. Brink, Q. B. Nguyen, J. Rath, A. L. Cox, C. W. Hoge, C. A. Castro, Perceived Stigma and Barriers to Care for Psychological Treatment: Implications for Reactions to Stressors in Different Contexts, 27 J. Soc. & Clinical Psychol. 317 (2008);
  2. Ey, K. R. Henning, & D. L. Shaw, Attitudes and Factors Related to Seeking Mental Health Treatment among Medical and Dental Students, 14 J. C. Student Psychotherapy 23 (2000);
  3. S. E. Hanisch, C. D. Twomey, A. H. Szeto, U. W. Birner, D. Nowak, & C. Sabariego, The Effectiveness of Interventions Targeting the Stigma of Mental Illness at the Workplace: A Systematic Review, 16 BMC Psychiatry 1 (2016);
  4. K. S. Jennings, J. H. Cheung, T. W. Britt, K. N. Goguen, S. M. Jeffirs, A. L. Peasley, & A. C. Lee, How Are Perceived Stigma, Self-Stigma, and Self-Reliance Related to Treatment-Seeking? A Three-Path Model, 38 Psychiatric Rehabilitation J. 109 (2015);
  5. N. G. Wade, D. L. Vogel, P. Armistead-Jehle, S. S. Meit, P. J. Heath, H. A. Strass, Modeling Stigma, Help-Seeking Attitudes, and Intentions to Seek Behavioral Healthcare in a Clinical Military Sample, 38 Psychiatric Rehabilitation J. 135 (2015).
  6. P. W. Corrigan, S. B. Morris, P. J. Michaels, J. D. Rafacz, & N. Rüsch, Challenging the Public Stigma of Mental Illness: a Meta-Analysis of Outcome Studies, 63 Psychiatric Serv. 963 (2012).


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