Mental Health Archives - The National Law Forum

Incorporating AI to Address Mental Health Challenges in K-12 Students

The National Institute of Mental Health reported that 16.32% of youth (aged 12-17) in the District of Columbia (DC) experience at least one major depressive episode (MDE).
Although the prevalence of youth with MDE in DC is lower compared to some states, such as Oregon (where it reached 21.13%), it is important to address mental health challenges in youth early, as untreated mental health challenges can persist into adulthood. Further, the number of youths with MDE climbs nationally each year, including last year when it rose by almost 2% to approximately 300,000 youth.

It is important to note that there are programs specifically designed to help and treat youth that have experienced trauma and are living with mental health challenges. In DC, several mental health services and professional counseling services are available to residents. Most importantly, there is a broad reaching school-based mental health program that aims to provide a behavioral health expert in every school building. Additionally, on the DC government’s website, there is a list of mental health services programs available, which can be found here.

In conjunction with the mental health programs, early identification of students at risk for suicide, self-harm, and behavioral issues can help states, including DC, ensure access to mental health care and support for these young individuals. In response to the widespread youth mental health crisis, K-12 schools are employing the use of artificial intelligence (AI)-based tools to identify students at risk for suicide and self-harm. Through AI-based suicide risk monitoring, natural language processing, sentiment analysis, predictive models, early intervention, and surveillance and evaluation, AI is playing a crucial role in addressing the mental challenges faced by youth.

AI systems, developed by companies like Bark, Gaggle, and GoGuardian, aim to monitor students’ digital footprint through various data inputs, such as online interactions and behavioral patterns, for signs of distress or risk. These programs identify students who may be at risk for self-harm or suicide and alert the school and parents accordingly.

Proposals for using AI models to enhance mental health surveillance in school settings by implementing chat boxes to interact with students are being introduced. The chat box conversation logs serve as the source of raw data for the machine learning. According to Using AI for Mental Health Analysis and Prediction in School Surveys, existing survey results evaluated by health experts can be used to create a test dataset to validate the machine learning models. Supervised learning can then be deployed to classify specific behaviors and mental health patterns. However, there are concerns about how these programs work and what safeguards the companies have in place to protect youths’ data from being sold to other platforms. Additionally, there are concerns about whether these companies are complying with relevant laws (e.g., the Family Educational Rights and Privacy Act [FERPA]).

The University of Michigan identified AI technologies, such as natural language processing (NLP) and sentiment analysis, that can analyze user interactions, such as posts and comments, to identify signs of distress, anxiety, or depression. For example, Breathhh is an AI-powered Chrome extension designed to automatically deliver mental health exercises based on an individual’s web activity and online behaviors. By monitoring and analyzing the user’s interactions, the application can determine appropriate moments to present stress-relieving practices and strategies. Applications, like Breathhh, are just one example of personalized interventions designed by monitoring user interaction.

When using AI to address mental health concerns among K-12 students, policy implications must be carefully considered.

First, developers must obtain informed consent from students, parents, guardians, and all stakeholders before deploying such AI models. The use of AI models is always a topic of concern for policymakers because of the privacy concerns that come with it. To safely deploy AI models, there needs to be privacy protection policies in place to safeguard sensitive information from being improperly used. There is no comprehensive legislation that addresses those concerns either nationally or locally.
Second, developers also need to consider and factor in any bias engrained in their algorithm through data testing and regular monitoring of data output before it reaches the user. AI has the ability to detect early signs of mental health challenges. However, without such proper safeguards in place, we risk failing to protect students from being disproportionately impacted. When collected data reflects biases, it can lead to unfair treatment of certain groups. For youth, this can result in feelings of marginalization and adversely affect their mental health.
Effective policy considerations should encourage the use of AI models that will provide interpretable results, and policymakers need to understand how these decisions are made. Policies should outline how schools will respond to alerts generated by the system. A standard of care needs to be universally recognized, whether it be through policy or the companies’ internal safeguards. This standard of care should outline guidelines that address situations in which AI data output conflicts with human judgment.

Responsible AI implementation can enhance student well-being, but it requires careful evaluation to ensure students’ data is protected from potential harm. Moving forward, school leaders, policymakers, and technology developers need to consider the benefits and risks of AI-based mental health monitoring programs. Balancing the intended benefits while mitigating potential harms is crucial for student well-being.

For more news on Artificial Intelligence and Mental Health, visit the NLR Communications, Media & Internet section.

Minimizing National Labor Relations Act Liability for Employers with Non-Unionized Workforces

This post continues our consideration of comments submitted in response to proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA).

Under current law, if a plan provides any mental health or substance use disorder (MH/SUD) benefits in any classification of benefits, benefits for that condition or use disorder must be provided in every classification in which medical/surgical (M/S) benefits are provided. Classifications for this purpose include inpatient, in-network; inpatient, out-of-network; outpatient, in-network; outpatient, out-of-network; emergency care; and prescription drugs. The proposed regulations modify this standard by providing that a plan does not provide benefits for MH/SUD benefits in every classification in which M/S benefits are provided unless the plan provides meaningful benefits for treatment for the condition or disorder in each such classification “as determined in comparison to the benefits provided for medical/surgical conditions in the classification.”

The term “meaningful benefits” is nowhere defined. The regulators nevertheless “recognize that the proposal to require meaningful benefits [ ] is related to scope of services.” “Scope of services” for this purpose generally refers to the types of treatments and treatment settings that are covered by a group health plan or health insurance issuer. The preamble to the proposed regulation invites comments on how the meaningful benefits requirement “would interact with the approach related to scope of services adopted under the 2013 final regulations.” The preamble of the 2013 final regulations addressed an issue characterized as ‘‘scope of services’’ or ‘‘continuum of care’’ but otherwise failed to provide any substance. Two examples from the proposed regulations do, however, give us a sense of what the regulators have in mind.

A plan that generally covers treatment for autism spectrum disorder (ASD), a mental health condition, and covers outpatient, out-of-network developmental evaluations for ASD but excludes all other benefits for outpatient treatment for ASD, including applied behavior analysis (ABA) therapy, when provided on an out-of-network basis. (ABA therapy is one of the primary treatments for ASD in children.) The plan generally covers the full range of outpatient treatments and treatment settings for M/S conditions and procedures when provided on an out-of-network basis. The plan in this example violates the applicable parity standards.
In another example, a plan generally covers diagnosis and treatment for eating disorders, a mental health condition, but specifically excludes coverage for nutrition counseling to treat eating disorders, including in the outpatient, in-network classification. Nutrition counseling is one of the primary treatments for eating disorders. The plan generally provides benefits for the primary treatments for medical conditions and surgical procedures in the outpatient, in-network classification. The exclusion of coverage for nutrition counseling for eating disorders results in the plan failing to provide meaningful benefits for the treatment of eating disorders in the outpatient, in-network classification, as determined in comparison to the benefits provided for M/S conditions in the classification. Therefore, the plan violates the proposed rules.

Notably, the newly proposed meaningful benefits requirement is separate from, and in addition to, the newly prescribed nonquantitative treatment limitation (NQTL) testing standards. These latter standards include a “no more restrictive” requirement, a “design and application” requirement and an “outcomes data and network composition” requirement. A handful of comments nevertheless urge the regulators to add scope of services to its non-exhaustive list of NQTLs. As a result, a plan’s scope of services would be subject to comprehensive NQTL testing. Or, put another way, they would be fed back into the NQTL testing loop. Using the first of the examples above, this would require that ABA therapy to be first compared to the treatment limitations imposed on some M/S benefits in each classification. But what benefits, exactly? The problem is that a plan’s scope of services – what types of treatments a plan will pay for and in what settings – is a high-level plan design feature and not an NQTL.

While reasonable minds can and do differ on much of the substance of the proposed regulations, we doubt that anyone would claim that they streamline or simplify compliance. Compliance with these rules is already complicated and expensive; if the final rule looks anything like the proposed regulations, compliance will only get more complicated and more expensive. The proposed meaningful benefits requirement is intended to prevent plans, as a matter of plan design, from satisfying the parity rules by offering nominal or insubstantial MH/SUD benefits when compared to similar M/S benefits in each classification. Treating a plan’s scope of services as itself a separate NQTL does not advance this goal.

EEOC Takes Action to Address Mental Health Discrimination in the Workplace

Employers must take notice that the United State Equal Opportunity Commission (EEOC) is cracking down on companies that discriminate against workers because they have a mental health condition. Mental health conditions, such as major depressive disorder, bipolar disorder, and schizophrenia, substantially limit brain function. The EEOC determined these disorders constitute disabilities under the American with Disabilities Act (ADA).

The EEOC has significantly increased charges against employers for alleged ADA violations premised upon mental health issues.

In September, the EEOC released its Strategic Enforcement Plan (SEP). A review of the SEP reveals that the EEOC will focus on harassment, retaliation, job segregation, labor trafficking, discriminatory pay, disparate working conditions, and other policies and practices that impact particularly vulnerable workers and persons from underserved communities, including workers with mental health related disabilities.

Hence, employers must be extremely careful when dealing with employees or prospective employees who suffer from mental health conditions.

Under the ADA and other nondiscrimination laws, employers must provide “reasonable accommodations” to qualified employees with disabilities. These accommodations are adjustments to the workplace that allow these employees to perform their job duties. These accommodations are usually not costly and can be beneficial in allowing employees to return to work, avoiding productivity losses, and promoting the recruitment and retention of qualified employees.

However, not all employees with mental health conditions require accommodations to perform their job duties. For those who do, accommodations should be individualized and developed with the input of the employee. Below is a list of examples of accommodations that have helped employees with mental health conditions to better perform their job duties. These are not all possible accommodations but provide a starting point to help employers promote an inclusive and supportive work environment. These include:

Flexible workplace arrangements
Scheduling adjustments
Sick leave or flexible use of vacation time
Individualized breaks
Modification of non-essential job duties
Additional training or support
Positive reinforcement and flexible supervision
Accommodations to the work environment, equipment, and technology
Regular meetings between employees and supervisors to discuss workplace issues.

It is important for all employees to be aware of their rights and provide relevant training to co-workers and supervisors. Effective implementation of these accommodations will help create a more inclusive work environment and benefit both employees and employers.

Erasing the Stigma—Michael Kasdan [PODCAST]

Men often hide their mental health struggles deeming it not manly for them to acknowledge weakness. Michael Kasdan was there at one point in his career, but he’s long since learned better. Today, Michael is an active member of the Good Men Project, sharing his personal struggles with depression with others in the legal profession and beyond. Now, he shares his story and perspective on the state of men’s mental health with Mark Yacano in this episode of Erasing the Stigma.

Michael Kasdan is a partner in Wiggin & Dana’s Intellectual Property Group. He focuses on all areas of intellectual property law, providing his clients with full- service IP expertise that ranges from patent, trademark, copyright and trade secret litigation to IP-related transactions – including licensing and monetization – to helping companies to protect and reap maximum value from their own innovations and brands.

Michael was listed as one of the world’s-leading IP Strategists in the 2103 and 2017 – 2021 editions of IAM Strategy 300 – The World’s Leading IP Strategists and has regularly been listed in Super Lawyers. Clients describe him as creative, energetic, and easy to work with and seek his insight into the business, technology, and legal facets of their IP issues.

Michael writes and speaks extensively. His articles have appeared in Intellectual Asset Management (IAM) Magazine, LEXIS, Thomson/Reuters, Practical Law Company, IP Law360, Bloomberg/BNA, Managing IP Magazine, The National Law Review, and elsewhere. Michael is the sole author of Practical Law Company’s Practice Note on Patent Law and the Lexis Practice Advisor on Patent Licensing and is a co-author of Practical Law Company’s Practice Notes on Global Patent Litigation and Licensing and on Tracking and Privacy.

A member of the firm’s Inclusion, Diversity and Equity Committee, Michael has been the keynote speaker at conferences addressing topics such as diversity and mentorship. He is also a passionate advocate for mental health and wellness in the legal profession and the world at large and serves on the Communications Committee of The Institute for Well-Being in Law.

Michael serves as on the Board and as Director of Communications and Development of the nonprofit MyChild’sCancer and on the Board of the SouthNextFestival. He was formerly Chairman of the Board of the nonprofit CityScience, which focuses on improving STEM education in cities. He is also the Director of Special Projects and Sr. Sports Editor for The Good Men Project.

Michael received his J.D. magna cum laude from New York University School of Law. He was a member of the NYU Law Review and the Order of the Coif, was Fish & Neave Fellow for the Engelberg Center on Innovation Law and Policy, and served as President of the Intellectual Property and Entertainment Law Society. After law school, he clerked for the Honorable Judge Roderick R. McKelvie in the U.S. District Court for the District of Delaware. Michael received a B.S.E. in electrical engineering magna cum laude from the University of Pennsylvania, with a minor in mathematics. He was a member of Eta Kappa Nu, Tau Beta Pi, and the Penn Parliamentary Debate Team.

Erasing the Stigma · Erasing The Stigma–Michael Kasdan

Article By Mark Yacano of Major Lindsey & Africa

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IMS Insights Podcast: Episode 9- Rudhir Krishtel On Mindfulness And Wellness For Attorneys Amid COVID-19

In this episode, Rudhir Krishtel joins us to share guidance on mindfulness and wellness for attorneys. He also provides tips and strategies to help with adjustments for those balancing the intense demands of a legal career during the uncertainties of the COVID-19 pandemic.

In his lawyer days, Rudhir practiced law for fifteen years as a federal clerk, patent litigation partner at Fish & Richardson, and later as senior patent counsel at Apple.

Today, he is a certified Co-Active Coach and facilitator, focusing on workplace wellness and intensity for law firms and attorneys. Many lawyers struggle with stress and lack of purpose in their practice. As a former lawyer, Rudhir coaches clients and hosts workshops to identify the issues that hold lawyers back from advancing in their career with clarity and fulfillment.

His work during his lawyer days led Rudhir to train as a yoga teacher through the Baptiste Institute and on mindfulness meditation through Warrior One. He also a Professional Certified Coach through the Coaches Training Institute & International Coaching Federation, and uses this training along with his experience as a practitioner to deliver much-needed support for the legal community. Details on Rudhir’s consulting and mindfulness workshops for attorneys can be found at www.krishtel.com.

Transcript

Teresa Barber: Rudhir, hello, thank you. I really appreciate you joining us today. Could you tell me just a little bit for our listeners… Tell us a little bit about your background as an attorney and a little bit about your consulting practice.

Rudhir Krishtel: Yeah, Teresa, thank you so much, and thanks IMS for having me here. I was practicing law for 15 years. I started at my practice as a federal clerk. I was ultimately a partner at Fish & Richardson in their patent litigation team in the DC office. Then for the last five years of my practice, I was senior in-house counsel at Apple out here in the Bay area where I moved to seven, eight years ago.

Rudhir: After 15 years of practice, I started to notice… What I started to see were cycles of behavior in the practice over 15 years, just ways that we all behave at work that I felt like were somewhat compromising to our practice. I started to notice that we accept that stress is a part, a natural part, of our work life. We wouldn’t get paid as lawyers at the rates that we charge, and we wouldn’t be able to do the work that we do if it wasn’t something that was challenging or stressful, so I totally understood that.

Rudhir: But there’s this interesting relationship where work caused stress, but then stress actually started to impact the quality of our relationships and ultimately the work product. It is this weird cycle where work causes stress but then stress impacts the work. I think everyone just accepted that as the norm, and I felt like this was a dialogue that we needed to have and a cycle in the system that we needed to improve.

Rudhir: It’s when I decided to leave the practice. Three years back I left the practice. I retrained first as a mindfulness instructor and yoga instructor. And not wanting lawyers on their yoga mats all the time, I ultimately trained as an executive coach. Now, I coach attorneys. I have a coaching business that’s Krishtel Coaching. I coach attorneys in their practice one on one, and we identify some of the most challenging aspects of your practice and try to move them out of the way so that attorneys have a more fulfilling practice. I also host workshops. I visit law firms and legal departments and host dialogue on ways that we can start shifting our culture, build a greater resilience, incorporate emotional intelligence and mindfulness practices. I also host online coaching programs and webinars on these topics.

Rudhir: The consulting and the coaching practice has evolved over the last many years. I’ve now coached over 100 attorneys, managing partners at law firms, general counsel at companies, a wide range of attorneys on really how they can be better for themselves and others in their practice and really trying to shift and improve our culture in the legal workplace.

Teresa: Rudhir, it sounds like you identified the need while you were in the boiling pan yourself and didn’t really see anyone meeting those needs. As you’ve worked now for a number of years with clients, especially at big law firms and at corporations in house, what have you seen as the return on it? It sounds like you also had a theory that if we start to apply this, it’s not only going to improve quality of life and wellness and balance, but will also impact work product. I would be interested in some antidotes from clients you’ve worked with so far.

Rudhir: Teresa, what you said first is what I want to tap into a little bit, which is what I did notice during my time at Apple. You make this switch from a partner in law firm to go in house, and we think about it as sort of this greener pasture switch, attorneys going in house. What I notice is I got more senior in the practice. With every level up, growing of the team, salary bump, promotion, whatever it was, every time the further I got up, the lonelier I felt.

Rudhir: It’s very interesting that here we are achieving this so-called dream, and yet I felt somewhat more isolated, and I’m a pretty social person. I’m the person at Fish that was head of recruiting for our office. I’m definitely the person that planned all of the March Madness pools and getting everybody back together outside of work. I’m that person. For me to feel somewhat isolated was really fascinating, to be naturally connected and connecting and yet feel lonely at the same time was a very odd experience.

Rudhir: But I felt it more and more as I got more senior. I started to realize, “Well, if I’m experiencing this, how many other people are experiencing this?” There’s this unique thing that happens in legal practices that we are shrouded in confidentiality and in adversity in this adversarial experience. There’s a lack of trust that we have oftentimes with our colleagues. The thing that’s most challenging for me at work, I’m not sure I’d be comfortable talking to my colleagues about, whether it be a difficulty with a technical issue or a difficulty with building business or a challenge with how I’m managing my team. Sometimes we’re not comfortable being necessarily open about that with our colleagues just because of the legal work environment.

Rudhir: I started to notice this, and I realized I’m so senior in this practice I wish I had my own set of advisors. I’m at this point where I’m generating enough revenue. I’m generating enough revenue for myself that small businesses generate. We’re in the hundreds of thousands now. Some lawyers are in the low seven figures in terms of their business generation and their income. Yet, I don’t know who my closest advisors necessarily are that I just deeply trust.

Teresa: Right.

Rudhir: I started realizing, “Well, if I’m having that issue, there must be other attorneys that are having this issue.” And it becomes even that much more compounded with intersectionality. Now we’re talking about women that might be having these challenges, attorneys of color that might be having these challenges, really everybody. When I started to notice this, I thought, “Here’s a space that I feel like we need someone to step into.” That’s the decision that I made. It’s very interesting. I work with a wide range of clients, and to sort of address your second question, the second part of your question, is it’s just been deeply valuable this work for the clients that I’ve worked with, and it shows up in many ways.

Rudhir: People don’t often think about connecting with… Well, let me say that differently, Teresa. When we have somebody in our corner that is willing to champion us, that is willing to hear us out, that is willing to co-strategize with us, that is sort of a peer in the practice and that has real confidentiality, so much is possible. I’ve sort of seen that with my clients. I’ve seen a lot of growth and evolution on people having much better relationships with their teams, managing their groups in healthier ways, finding ways to solve problems with some of the challenges they face in their teams, interacting with people in a healthier way, becoming that much more adapt at generating business and for people that are looking for some sort of a transition and feeling stuck really having place where they can start to dialogue and strategize and brainstorm on that, and we come up with just incredible directional shifts for people in their life and their business. This practice I feel like has been a huge benefit to the clients that I work with.

Teresa: You touched on something that was interesting to you a minute ago, Rudhir. You were talking about this feeling of isolation, social isolation. We’re talking today and it’s later in March 2020. Back on December 31, 2019, the World Health Organization first identified an epidemic in China. Today, we’re looking at shelter in place orders not only around the San Francisco Bay area but throughout that entire state possibly with more coming in other markets and many people now working in a brand new environment, work from home environment where those lines between family and work are blurred a little bit.

Teresa: Looking at the 2019 novel Coronavirus pandemic, this is unprecedented territory, with you and your work with clients, what are you seeing right now?

Rudhir: It’s very interesting because I tend to think that lawyers as I mentioned despite us working with each other and connecting tend to have somewhat more of a natural isolation and loneliness already. This is just me saying this. There have actually been studies. The ABA has put out studies. There are psychologists that have put out studies that identify and indicate that lawyers have less sort of a lower social tendency than others than most.

Rudhir: And so at a time when we’re now even doubling down on the isolation, I’ve seen a lot of challenge. I see lawyers that are expressing concerns over a lot of things. Here we have a group of people that are natural problem solvers, lawyers are natural problem solvers. We are always thinking ahead. As we think ahead, we’re thinking ahead to how long is this going to last. There’s an uncertainty.

Teresa: Right.

Rudhir: We’re thinking to how is this going to impact my business? For in-house attorneys the business that they’re in and corporation that they’re in, but for outside counsel attorneys, how is this affecting my business development and business generation? What does this mean for my income? What does this mean for my team? What might this mean for the health of my family and the people around me? What might this mean for others? There’s just a lot of concern layered on top of a business and a practice that already has us sort of in a position where we’re “constantly putting out fires.”

Rudhir: I think that what I’m seeing is a higher level of anxiety in some than what might usually be the case. I think when anxiety comes up, we are not at our best self. We are not behaving in a way that is sort of rooted in our best self. We’re being reactive. We are thinking about we’re in sort of a flight or fight mode. We’re thinking about ways that we can run and save things or we’re thinking about ways that we can sort of fix things right away. I think there’s a deep discomfort that’s happening in this moment.

Teresa: With the questions that you’re seeing from clients right now, I know you’ve set up a webinar right now. You’re providing some guidance to people who are looking for it. What can people do right now? With the sense of what do I have control over, there is so much certainty. What are you telling people right now?

Rudhir: Yeah. I set up a free webinar Wednesdays mornings at 9:00 a.m. Pacific, noon Eastern on mindfulness tools for managing uncertainty. I find that mindfulness practices, resilience practices, emotional intelligence practices are very much relevant in this time. I think that even just paying attention to the news has me at a slightly higher level of anxiety. I’m waking up a bit more tired than usual this week. It’s just very interesting. Not much has changed because we work from home my wife and I, and so for us to practice social distancing and kind of put a barrier around our house is actually not too different than what we’re usually doing.

Teresa: Right.

Rudhir: I’m slightly more on edge and slightly more tired. These practices of mindfulness and resilience and emotional intelligence, I think, are just really valuable in this moment. I’ve started to offer them out on a weekly webinar, just simple tools. For example, you asked what might be something that we can do. Lawyers, we tend to be very head heavy. I didn’t even understand what that meant a few years ago because I didn’t know what the difference was between that and anything else.

Rudhir: We tend to be thinking people. We’re valued for our knowledge. People want us for our advice, and we want to offer our advice. We’re problem solving. We always respect and value the attorney that “knows more.” So much of our work is in our head. Settling the body and settling ourselves in these times actually happens in the body. What percentage of our livelihood is our mind physically, and what percentage is our body? That’s an interesting question to ask. So much of us is our body. In fact, most, if not all of us, is our body.

Rudhir: One of the first tools that we talked about in this webinar was a body scan technique. A body scan is a meditation technique that allows us to just pay attention to what else is happening right now in our body. There’s just a lot of information there. Lawyers are great at gathering information. We’re incredible at intake. I think in this moment one of the tools is just actually take intake for yourself. We’re always asking someone else, “So what’s your problem? What happened? Who are the people involved?” Et cetera. The questions that I offer are, “What’s happening in my body right now? What’s happening in my breath? What am I noticing in my chest? Is it tighter? What am I noticing in my stomach? Am I at unease? Are my feet grounded? What happens? What’s the difference between grounding my feet versus sitting them elsewhere? What’s the quality of my breath? What’s my body temperature?”

Rudhir: I think when we scan our bodies… And on my website I have mindfulness audio recordings and guided meditations, and these are available all over the place. There’s apps like Calm and Insight Timer and Headspace. UCLA has an incredible meditation center, and they have some great guided meditations. I offer a few on my website at Krishtel.com. Basically, what we’re inviting people to do is actually just pay attention to what’s happening for them in a moment.

Rudhir: This isn’t something that we need to do all day. A body scan meditation can be 10 minutes of your day, five minutes of your day. Pay attention to your breath. Even right now is one of those podcasts, Teresa, if you just sort of take a breath and pay attention to what’s going on in your lungs and what’s going on in your throat and just breathe. You just notice sort of a different quality show up. We kind of exist in this on edge slightly underlying nervosa, and it’s normalized in our practice. I think we can in this moment because it’s even exacerbated, it’s slightly more acute because of all the information coming in and everything that’s changing, I think is an incredible time to pay attention to breath, pay attention to body and just what’s going on for us.

Teresa: That’s really helping in hearing you talk about almost an inventory of awareness. Rudhir, for those, wellness has been a buzzword that’s been around and gaining increasing traction and attention in recent years. Can you break down mindfulness for those that may not be familiar with that term and just help us understand when we say mindfulness, when you say mindfulness, what do you mean?

Rudhir: I’d love to. I’d start by actually just saying that when I started regularly meditating, it was the beginning of an incredible shift in my life both professionally and personally. It’s for those who are exploring meditation and dabbling, the commitment to a practice of 20 minutes a day, 20 minutes twice a day or even 10 minutes a day of mindfulness practices I think can be the beginning of a huge evolution and even revolution in your life in terms of how you feel and just fulfillment.

Rudhir: When I was at Apple about a year or two in, I started a daily practice of 20 minutes twice a day of meditating. I’ll tell you a little bit more about what is mindfulness and different ways of practicing. Just to kind of get people in tune with the benefits, I started practicing, and so much changing. Three months of regular practice, I committed to 20 minutes twice a day, and I did it because actually I paid for a class. When you pay for a class for some reason, it’s just like a gym membership. Something happens, and you’re like, “All right, I’m paying the money. I’m going to make a commitment.”

Rudhir: I make the commitment of 20 minutes twice a day. I’m a coffee drinker. It’s not the morning coffee. It’s the 2:00 p.m. coffee for all my friends at Fish and Apple. At 2:00 p.m. it was clockwork. I’d come around the halls and say, “All right, let’s just go get coffee.” I noticed after two or three months of practicing… It’s not like it has an alarm set, it’s just at that time of the day you start feeling a little bit tired. My morning energy is I’m ready to go. Around 2:00 p.m. it starts to wither.

Rudhir: I started to notice three weeks had gone by and I hadn’t asked anyone for coffee. I’m an engineer by trade. Trained as an electrical engineer, studied, became an IP attorney, so I need a logical underpinning for a mental practice. At least I did at that time. I don’t anymore. I’m all in now. But back then I sort of needed some evidence. The evidence was just clear. I have so much more energy that I don’t need coffee. I don’t drink coffee from 7:00 a.m. until midnight, and I’m just fully functioning.

Rudhir: I couldn’t believe the shift that happened for me in that moment that I was getting a physical benefit to a mental practice. That’s when I decided I was all in. I started to have healthier interactions professionally. I started to notice that things were slowing down. People talk about time is going by fast. That’s not a thing for me anymore. Time actually does not go by fast. I started to worry less about all the things that were coming and about what was happening. I just started to feel more present.

Rudhir: There’s so much energy there. The energy is because… And this is for the people that are just looking for the logic. If your mind is moving less, and it’s sort of moving at a less rapid pace, it’s triggering less emotions. If you think about when you pay attention to what your thoughts are in a two minute period, “What am I going to eat for lunch?” It’s the basic thoughts. “What am I doing this week? What’s my schedule? What am I going to eat for lunch? What’s for dinner? What’s happening with that meeting?”

Rudhir: Each of those thoughts… And you notice in a two minute period they just keep spinning. Each of those thoughts may trigger and may bring out an emotion. When emotions come up in our body that is a moment where your energy starts to get drained because an emotion can trigger you to hunch your shoulders, and you don’t even realize. It may start reducing… slowing down your breath. You don’t even know. When that email comes in from that challenging client or from that colleague, you sort of hold your breath.

Rudhir: Those little moments add up in the course of the day. In our jobs you can work from 8:00 a.m. until midnight, not leave your desk, and feel like you ran a marathon that day. Mindfulness and meditation practices start to slow that down. They start to slow down the rapidity of the thoughts. They start to readjust how reactive you are to these things. They relax your body in these moments when you might naturally be tense or stressed. You’re gaining back 5% to 10% energy.

Rudhir: There’s this book Ten Percent Happier. I relate to almost everything that’s in that book because you really are. Ten percent more energy in this moment can be huge. How much more energy do you have at the end of the day for your colleagues, your clients, your family? You just have so much more energy. Just 10% can make such a difference. You were asking about what is mindfulness, but before I go into that, I’m curious if any questions are coming up for you based on what I’m saying?

Teresa: Well, I’m just anticipating questions. I think seeing the email come in or thinking about the email, it’s not saying that email is not important or that client’s need isn’t important, it’s putting it into a place where we’re not maybe as reactive to it, where it’s kind of processed in a way that is a little more centered. Right?

Rudhir: Yeah. This is a great dovetail into what is mindfulness because I think there’s a lot there. When I think about mindfulness you’ll see a range of definitions. But I consider if we’re paying attention to ourselves, our thoughts, our emotions and our body, and noticing what’s happening with those things, without judgment. And the without judgment piece is actually really important because oftentimes what’s happening for us we might think is wrong or something’s not great about it or amazing about it. Mindfulness is actually just let’s just pay attention to what’s happening.

Rudhir: I talked about this body scan technique as sort of one way which is paying attention to what’s happening with your feet and your legs and your stomach and your lungs and your shoulders. When that email comes in as an example. We all know that email, that alert, that case alert. That colleague, that person we don’t like, all of it. It happens at least 10 times a day. Ten times a day, 20 times a day, 100 times a day you tense up when that message comes in, and just sort of noticing what’s happening in your body in that moment rather than necessarily solving the email. Because our first reaction is what am I going to say? You might notice the quality of your breath in that moment that you’re actually not breathing. It’s fascinating just taking a deep breath in that moment rather than reacting right away and just noticing what happens to your body that it settles.

Rudhir: Noticing what happens to your shoulders, they tighten up, that you sort of take a forward learning approach, that you might get uneasy in your stomach. All these things are happening. As we pay attention to that, when we’re responding to that email from that place, it’s actually fight or flight. We’re responding from a place of fight or flight. Fight or flight is sort of an old… It’s an old system. It comes from an old brain of ours. It’s the amygdala. It’s an old brain. It’s a lizard brain that we have. It basically really comes from this era and this time of evolutionarily when we were sort of fighting bears and lions. You’re sort of out in the wild and you’re worried about fight or flight. Either I attack this thing that’s in front of me or I’ve got to leave.

Teresa: Base survival.

Rudhir: It’s survival. Yeah. By and large in our legal office, outside of that scary partner in the corner, there’s no bears around. There’s no tigers. For us to be experiencing fight or flight as much as we do in the course of our day is really a ratio that it happens versus the actual need is way out of proportion. The other thing is that creativity, centeredness, true leadership, aren’t happening when we’re in fight or flight. We’re not coming from a collected and a gathered place. We’re coming from a reactive place.

Rudhir: When we write a brief in a case, we don’t write a react, we write a response. I use these two words differently. There’s reacting, and there’s responding. I think responding comes from a place when we gather data and information, we use our wise lawyer selves, we are using wisdom, and we are responding in a gathered and a collected way. We’re reviewing. We’re able to come back to people from a centered place. That’s what we want in our briefing. That’s what we want in our responses to our colleagues, in our communications. We end up feeling in a reactive place, and so it’s fight or flight. It’s like, “If they say something, I can defend myself,” or “I’m going to avoid this email for a few hours because I’m nervous about what’s going to happen.”

Rudhir: So all these things come up. But when we take a breath we notice what’s happening in our shoulders, we notice what’s happening in ourselves, we notice the thinking and the nervousness that might be happening in our head. Maybe we can respond in a healthier way. Maybe we can slow down some of that movement and gain some energy back.

Teresa: Interesting using the word creativity. We’re in a transformative moment. Whether it’s a temporary transformation or whether we’re going to see lasting effects. We have the White House signing the Defense Production Act. Many people working from home. I’m sure for many there’s a lot of scary elements to what we’re seeing with the public health crisis around COVID-19. You and I we’ve had some earlier conversations about possibilities out there, but what do you see, Rudhir, right now as possible in this moment?

Rudhir: We have to be very thoughtful about many people whose health is being compromised in this moment, and we have to really be thoughtful about many people whose lives have shifted and are challenged by access to resources and hourly workers and wage workers whose jobs are being eliminated in the short term. There’s a lot of challenge and compromise that’s happening at this moment. We want to make sure that we keep our awareness on that.

Teresa: Right.

Rudhir: I actually feel like interestingly enough a lot is possible in this moment. I think there are new ways that we’ll be able to connect with people and we’ll be testing out. For example, this webinar that I’m doing or the greater number of video calls and group calls that I’m having online where people are finding healthier ways to interact. I actually think it’s an incredible time to call that colleague or that contact that you haven’t been in touch with for a while and just say, “Hey, how are you doing?” And just get on the phone or get on a video call and just listen and be with somebody and connect in a way that you might not have otherwise.

Rudhir: I do feel like people might have a little bit more time now, and if you think it’s a time where, for example, business development dies down, I think actually it’s the exact opposite. People are looking to connect in this moment, so fill that void. Finding new ways to connect right now, to reach out, to interact, to connect with your families and yourselves, I think that’s huge in this moment.

Rudhir: I think time alone can be an incredible time for coming up with new solutions and to be creative. I think about Isaac Newton came up with some of his most valuable theories, the roots of calculus, and the basic understandings that we have on gravity, some of the most critical theories that he came up with were during the Plague when he had to leave Cambridge and isolate during that moment.

Rudhir: Social distancing, this isn’t the first era of social distancing. This has been going on with every pandemic that we’ve experienced in the history of time. Even in that moment he came up with some of the most valuable scientific principles and mathematic principles that we lean on today. There’s this huge opportunity in this moment to be creative, to think about what’s possible.

Rudhir: And as lawyers we are in this service industry, and so there’s this incredible opportunity to think about what are the new ways and the different ways in which we can serve others and add value? When we are reactive and in fight or flight, we aren’t thinking from that place. We’re wondering how to protect ourselves or wondering how… what’s going to happen to us. But when we start slowing down and rooting in, we remember that there’s so much possible in this moment for all of us, so many systems that we can build to serve our clients and to support our colleagues.

Rudhir: I’m going to be offering team building webinars in the next few weeks. Here’s an opportunity. Your entire team is isolated. How do we stay connected in this moment? So maybe we jump on an hour and a half Zoom call, and we actually do a team building exercise, facilitated exercise, in this moment. For me, I just feel like so much is possible, and it’s time to really start thinking about creative ways that we can connect with others, which we all need as humans and in our professions, and so what are the ways that we can do that now?

Teresa: That’s really interesting. We’ve been hearing talk about… We’ve all been hearing the guidelines around social distancing, but moving to the term physical distancing to recognize that we need… We still as humans we still need a little bit of that connectivity that you’re talking about. Interesting. Rudhir, some of the resources we’ve been monitoring and sharing with our clients have been resources you have been sharing with broader audiences. Can you talk to us about what’s out there right now? What resources are there? You’ve really been pouring a lot of your focus to provide some guidance and help right now in the recent days and weeks. What’s out there right now? What are you working on, and what could you suggest as resources for people?
Rudhir: Well, we mentioned it once already, but I’m doing this weekly webinar on mindfulness tools for handling uncertainty, and I’m doing this every Wednesday morning through my relationship on the co-chair of the wellness committee for the National Asian Pacific American Bar Association. We’re doing a similar webinar on Thursdays every week right now, myself and a mentor of mine, Angela O., are doing this webinar every week for that community.
Rudhir: I’m talking with the Association of Corporate Counsel on putting out a webinar on what tools we can use to manage the challenge. There’s a couple of bar associations that I’m working with on how we can exhibit our leadership in this moment. How can we show leadership in this moment of challenge and difficulty? From my perspective, there’s a lot of offering that’s happening in this moment, and I think what’s really beautiful and really nice about the community is actually seeing all the things that are being offered up in this moment and ways that we can support each other.

Rudhir: I think it’s a great time to pay attention and listen and get online and see what’s being offered by others. There’s a lot of opportunities to interact in workshops and dialogues and ways to connect from home right now that I think people should be tapping into. I think it’s also just a time to connect for people that have the luxury of doing that with family in their home or even with nature. There’s no restriction on necessarily going out in some areas and actually just taking a walk and connecting in that way.

Rudhir: I do workshops on building resilience. Part of those dialogues we talk about, “What’s restorative for you?” What’s restorative for you? The answers that people typically come up with are things that are just very accessible to us even in this moment, which is time with my family and my friends, connecting with my pets, eating a really good meal, watching a good show, taking a walk in nature. All of these things people find restorative are by and large free and still very accessible to us in this moment.

Rudhir: This might just be a nice healthy hibernating moment for all of us. I think that another thing is this is actually a great opportunity for skills building. I work with a range of clients. For some of them, presentations and stand up are something that they like working on. There’s nothing stopping people from being at home and recording a presentation and seeing how they are. When we start thinking about what’s possible in this moment, I feel like there is so much opportunity.

Teresa: One of the other areas, we were discussing earlier, Rudhir, related to the new work at home scenario. Looking at the normal heavy workload that an attorney deals with, at least having that separation between work and home, without being blurred now, which not the case for you necessarily. You’re accustomed to it. What guidance are you providing right now for how to handle that new blurred line and how to handle what is really a novel situation for many professionals and especially for attorneys?

Rudhir: I think that it’s very interesting seeing this transition that people are making to being at home. Luckily, I’ve been working at home for a few years now, and so this transition wasn’t so difficult. I definitely feel like there are things that we can do to make this that much more comfortable. First, I think for people that don’t work from home a lot, it’s actually setting up a comfortable situation for sitting.

Rudhir: Some people might think this is the time to just work at the dining table or in that uncomfortable chair, but we might be here for a while. Maybe it’s time to get a nicer chair, a nicer desk at home. Maybe it’s time to invest in that, a standup desk or something, a chair that’s got good support for you. So actually just sit in a place that’s comfortable and not necessarily in the thing that you might default to when you do a little bit of work from home.

Rudhir: Second, I think that things that are really helpful are really when we’re working from home the boundaries really start to fade between work and home literally. There’s really no boundary anymore. You might have this urge to almost work all the time. There’s really no limit to it. I think there’s this mentality around clocking in and clocking out that I think can be a really welcome shift in this moment.
Rudhir: If you’re putting in certain hours, actually when does the pen go down? When does the laptop get shut? What are the few hours during the day where you’re actually just doing the thing that you need to do to take care of yourself or center? For some people, they’re not commuting anymore. They use that commute time as the period to transition from work to home. Create that transition period for yourself. Sit for five or ten minutes and do nothing and allow the mind to settle and shift. Let’s not just use all of our time now or fill all of that time with work because doing that along with all the information that’s coming in and the way that the world is changing can really start draining you further.

Rudhir: I think healthy boundaries with work right now are imperative and actually maybe just creating some mental shifts. When I go down to the living room, when I’m in my next room, that’s when I put the laptop… The laptop stays in this area of the house. I don’t let it carry everywhere. Just trying to think about physical and mental barriers that you can start to create between work and home even when you’re in one place so that it’s not all bleeding together. We work effectively when we are restored. We need to reenergize. So think about the things that reenergize you and try to build in systems at home that allow you to keep that energy.

Teresa: That’s helpful. Rudhir, you mentioned one mentor a few minutes ago in our conversation. Can you talk to me about any mentors that you’ve had throughout your career who’ve especially shaped your thinking, shaped your own career?

Rudhir: There’s so many. It’s a difficult question. I remember when you emailed me in advance about some of the things you might ask, I said let’s do this at the end. I was hoping it wouldn’t even get to these. I have so many mentors. There’s so many people that have been valuable. In the work that I do I always feel like I stand on the shoulders of so many people that came before, and so there’s just so many experiences that I have that are learning.

Rudhir: I think the place to start is that I just feel like every opportunity and every interaction is a moment of learning. I feel like I’m learning from people all the time. Mentors is a really higher elevated state for somebody I feel to hold that space. I learned so much from my clients. I learned so much on calls like this. I learned so much from every interaction. I think the first thing that comes to me is actually just not losing sight of the learning opportunities in every interaction. What can you learn about this person across from you and the rich experience that they have? What value might you be able to get in that possibility of that conversation?

Rudhir: The person that made this entire next chapter of my life that much more possible for me was my wife. When I was in my last few years at Apple, I started to feel this itch, and it was… I’m not sure, but I can’t say that I’m as happy as I’d like to be in my life professionally. I think there’s something else. I don’t know exactly what I want to do. I’d sort of come home every few days with this dialogue with her.

Rudhir: I’d sort of talk about different things that I want to do. I’d tell her, I’d say, “You know, I think I need a month or two off. I need a month or two off. I’m going to ask my manager and team if I can combine my four weeks of vacation with one other month off. It could be unpaid. I don’t care. I just need a couple of months to sit.” She said, “You don’t need two months. You need a year.”

Rudhir: I just thought, ” A year?” Apple doesn’t have a year long sabbatical program. How are we going to do that? She said, “I’m giving you a year.” She said, “For one year you don’t need to do a thing. You don’t have to generate any income. You don’t have to do anything around the house. You don’t have to do anything for a year, and whatever you do after that I don’t care. But for one year just take a break.”

Rudhir: I have never had that kind of permission before or just being met by somebody that was saying, “Look, you’re good as you are. You don’t need to do anything.” I think that that’s amazing. I just felt like to get that type of support from somebody… My wife runs a nonprofit. My mind was, “How are we going to manage the finances and everything?” She’s like, “We’ll budget. We’ll plan the way that organizations plan when they go through a transition.”

Rudhir: So we made the plan. As soon as the plan came into place, and I saw that it was possible, everything that was happening was leading to signs of leaving and taking this time off. I think she has a way of thinking and a being that’s very different from what I’m used to in my environment. It’s very refreshing. She really values people taking the time to restore because we don’t know what’s possible. She’s really at the sort of root of this transition, which is allowing me the time and space to think and see some of the challenges in our workplace.

Rudhir: What I did during that time off is I just wrote a lot and investigated and understood a lot about our work, and that’s what allowed me to see this opportunity for stepping into this whole new career path for me. When I think about people that I look up to or I look to, I think about right now in this moment of my life I think about my wife first.

Teresa: Rudhir, that’s really wonderful to hear you say it, and I appreciate you sharing too on such a personal level that story.

Rudhir: Well, I just want to offer that in this moment I feel like we’re experiencing challenging times. I feel like we’re part of an amazing profession that can actually offer a lot. If anyone could use any support or has any questions, please feel free to reach out. My website is Krishtel.com. My email is simple. It’s my first name Rudhir@Krishtel.com, and I’m sure you’ll be providing it, Teresa.

Rudhir: But feel free to reach out in this moment because I just feel like it’s an incredible opportunity for making sure that all of us are feeling good in a way that allows us to support our community in the way that lawyers do. We are very important center, I feel like fabric, of the world. I feel like we are really the center of a lot of leadership in the world. I feel like we’re in this position to offer a lot, and for anyone that needs support through that process I just welcome people to reach out and connect.

Teresa: Thank you, Rudhir. It’s been really wonderful speaking with you learning more about what you’ve been doing. We’ve enjoyed seeing it and really are happy to be able to share it with our audience too. We will be in touch for sure. We’ll definitely have your resources available on the podcast.

Rudhir: All right. Fantastic. Thank you, Teresa. Talk soon.

Teresa: Thanks, Rudhir. You too. Bye-bye.

Rudhir: Bye.

ARTICLE BY Teresa Barber of IMS ExpertServices.

For more on Law Office Management, see the National Law Review.

Attorney Wellness and Mindfulness Part 2: What does Mindfulness Practice Look Like?

In Part I of our series on wellness in the legal industry, Elena Rand, a former litigator and legal executive coach with a Master’s degree in Clinical Social Work and current CMO of Wiggin and Dana identified why the legal industry needs to understand chronic stress and how it impacts the body, and how mindfulness, even at a basic level, can help improve both individual attorney’s performance and the often stressful law firm environment.

Today, Ms. Rand goes over the basics of a mindfulness practice, as well as addressing some common barriers to practicing mindfulness and how to overcome these barriers.

What are some simple practices that a novice or even a skeptic might be able to take on to start feeling some small benefit? And along those lines, do you need to devote a lot of time to mindfulness practices to begin to see a difference? What kind of commitment level do you need to show?

There is no right or wrong way to do mindfulness practice. There are no absolute time requirements or limits and there is no Olympic medal for “ great mindfulness”. There’s no level of perfection, there is nothing to “achieve” or “strive for” and that’s a key part of the practice. In fact, if we go back to what mindfulness is, it asks us to be accepting of whatever comes up and sometimes whatever comes up is “I only have five minutes to breathe and guess what? In those five minutes, I’m obsessing about that conversation that just happened down the hall,” but mindfulness is being aware of exactly that, and accepting of that. That is the work. It’s saying, “you know what, I just spent five minutes inhaling and exhaling and trying very hard not to think about that conversation, and all I did was think about that conversation.” If you brought your attention to that in the moment and then proceeded to pay attention to the next moment, and the next moment… well, then that is mindfulness meditating. You were just meditating. I want to debunk the idea that mindfulness is this sort of clear-minded perfection that will alleviate all your worries, obsessions, preoccupations etc.

You can do it for five minutes, you can do it for 10 minutes, you can do it for three minutes, you can do it in any number of ways. But again, it’s intentionally bringing your attention to what’s arising and accepting it.

As to how do you actually do it—well, definitely one way that we’ve all heard of is breathing techniques. And there’s a lot that’s been written about just focusing on your breath.

Inhale, exhale, inhaling and exhaling for any number of minutes is a start. And during that time what will invariably happen is what’s been called monkey mind, which is a flurry of thoughts. Everything from your clients, a brief for the meeting you have a four o’clock as well as an argument you had with your spouse and your conversation with a firm partner. All of that’s going to be going through your mind while you’re just trying to inhale and exhale. And that’s the practice. And the idea is to gently bring your attention back to the singularity of your breath over and over and over and over again. So that’s one modality, but some people I’ve worked with really aren’t into the breathing thing, and they ask for another way.

Another way is intentional activity. Select something that you know you do every day. Eat lunch, go for a walk, drive home and bring your attention to that action. What does it feel like? What does it feel to actually taste my food? What is it? How many times do I chew? What does it feel like to actually swallow that food? Am I hungry still? Am I not? This is a mindfulness practice that focuses on taking an action.

A third of mindfulness practice is what I call sort of a body scan. This is just sitting, not focusing necessarily on your breath, but focusing on your body, which we don’t always do. I mean, some people joke that our bodies are there to help us carry our heads from meeting to meeting. The reality is that many of us are not in touch with our bodies. The body scan is another opportunity to kind of pause, and bring explicit attention to your body. Start with your feet. What do your feet feel like? Are they grounded? Can you feel your feet? Can you feel your ankle? And then sort of work your way through your body and what the sensation is. You’re really looking for that sensory attention. So there are three examples of ways that you can introduce mindfulness in a practical way, you don’t need to go to an Ashram experience.

Let’s talk about identifying barriers. With wellness there’s a lot of mindfulness, there’s a lot of talk about self-compassion, patience, relaxing and will practicing all of this mindfulness take away from your competitive edge? Will mindfulness make it harder to win for my clients and my firm? It’s a tough world and I need to be strong and win. Is mindfulness going to weaken my competitive and adversarial instincts?

For anyone who really believes that genuinely I would recommend they read The Art of War by Sun Tzu. In that book, there’s a lot of wisdom about the power of self-compassion and compassion for your opponent that strengthens your ability to have real strategic clarity about what needs to get done next. So that’s from a philosophical perspective.

From a purely personal perspective, at the end of the day anyone who is going to be fiercely competitive and adversarial also needs clarity and strategy. That takes us back to what the purpose of mindfulness is, to improve your executive functioning by addressing your body and strengthening your ability so that you can endure. I think that that if you put it in that framework, you can actually sell it a little bit more to people who want to be more competitive and more adversarial.

This is the quiet backstage work that competitive attorneys have to be doing on themselves in order to go into battle and be as effective a warrior as they can be. I don’t see it as at odds. I see this as adding to their repertoire of, strategic skill-building so that they can be as effective and as competitive as they want. It’s working on a muscle that has kind of atrophied, which is self-care, and their wellness and strengthening that so that they can choose to do with that whatever they would like.

The law offices like many business environments, seem to be in a constant state of emergency which can make it difficult to be consistent with a mindfulness practice. How do you maintain a mindful practice in a high-pressure environment? Are there any tips, tricks, life hacks, anything like that to make it more likely to be successful?

What I personally do, which is very simple, is I have a separate space, a different chair. It doesn’t look like a meditation chair. I get to sit in that chair and I have a cup of tea, in-between meetings or right before the end of the day. This chair is away from my desk, and I will intentionally make a cup of tea in my office and I sit in that chair and take some time for myself, measuring time with an app on my FitBit. Then, I know that at least I have incorporated some level of breathing or grounding or intentional action into my day, and that’s separate from my other practices. Some firms have taken to having a mindfulness group that meets together monthly.

I think when you introduce it that way to people it becomes achievable, but obstacles still exist. It takes about a month for an action to turn into a habit. One way to reach that point is to enlist a friend, someone who is like-minded and values achieving mindfulness as much as you do to help keep you on track.

I think one of the biggest obstacles is time and perception. The timepiece is personal. At the end of the day, if it’s important to you, you will find the time to take care of you, which goes back to wellness.

Again, I think a lot of people have a perception of, “Oh, that touchy-feely guru wellness stuff that’s all really kind of hip and important now in law firms.” I really worry and want to make sure that the concern for wellness is not a passing fashion. I want sustained change, and I think that even the perception of those types of wellness activities at law firms is changing as we have more and more millennials who are asking for it or expecting it, who are embarking upon it, who are creating, healthy boundaries around their work and their life and their wellness. The barriers of time, and how it is perceived, are changing, but it’s slow.

My big hope right now is that this doesn’t become a flash in the pan kind of interest, but rather a pivotal moment and a paradigm shift, like what happened 10 years ago with the law firm’s focusing on business development and maternity leave where the industry realized the need for change and there was a shift in industry norms.

I am a big proponent of embarking upon wellness as a lifestyle change and not a quick fix. There was no quick fix to changing maternity policies and flex-time at law firms. There was no quick fix to introduce in the ideas of business development and leadership skills, and there’s going to be no quick fix for really shifting the law firm culture into a wellness culture so that attorneys can be doing all the things that are expected of them. We need to embark on the change mindfully and with intention so that we bring about meaningful culture change to the legal community.

Many thanks to Ms. Rand for her time and expertise on this important topic. Elena Rand and Eilene Spear of the National Law Review will be hosting a panel on this topic at the Momentum Events Employee Wellness Event for Legal and Professional Services Providers at the Riverside Hotel in Fort Lauderdale on February 27- 28.

ARTICLE BY Eilene Spear and William C. P. Thieme of The National Law Review / The National Law Forum LLC.

For more on the topic, please see the National Law Review Law Office Management page.

Attorney Wellness and Mindfulness Part 1: Why is Mindfulness a Benefit to Attorneys and others in the Legal Industry?

Attorney wellness and a focus on all aspects of employee well-being, including mental health, has become an important issue in today’s workplace environment. Law firms, and the legal industry in general, with its competitive reputation, expectation of heavy workloads and high stakes environment is beginning to embrace wellness practices as an anecdote to the chronic stress often faced by attorneys and other individuals who work in law firms.

The problem is so widespread that in 2017, the ABA House of Delegates approved Resolution 106 amended the ABA Model Rule for Minimum Continuing Legal Education (CLE) to include a requirement for lawyers to receive at least one hour of mental health, substance abuse credit every three years. And mental and physical health issues as well as substance abuse CLE courses are mandatory in several states, such as Illinois and Florida or count towards professional responsibility credits in numerous other states.

Elena Rand JD, MSW and Chief Marketing Officer of Wiggin and Dana has been working on this issue for years, putting her experience as a litigator and a legal executive coach along with her Master’s degree in Clinical Social Work to help those in the legal industry understand chronic stress, how it impacts the body, and how mindfulness, even at a basic level, can help improve performance and well-being.

Elena Rand and Eilene Spear of the National Law Review will be hosting a panel at the Momentum Events Employee Wellness Event for Legal and Professional Services Providers at the Riverside Hotel in Fort Lauderdale on February 27- 28, and in preparation for that presentation they sat down and discussed some aspects of mindfulness, identified some barriers to its practice and outlined the need in the legal industry.

I know you have formal training in Clinical Social Work and have dedicated much of your professional life to workplace health and wellness issues, can you take a minute or two and address your background and why wellness at the workplace, specifically in the legal industry is an issue that you care about?

Attorney wellness and wellness and the legal community in general is something that has been sort of a mission and a passion of mine probably for the last 15, maybe even 20 years. It really came to the forefront of my attention when I was working as a legal executive coach. I was doing coaching for a large law firm, really focused on working with attorneys to improve their leadership and business development and networking skills and taking high-performers to the next level. What I invariably discovered is that there is an underbelly of crisis and struggling for many of these enormously successful, high achieving, high performing go-getting attorneys. I found that attorneys were struggling both in terms of managing their baseline day to day life to extreme mental health issues and addiction. That kind of came to full bloom and grabbed my attention.

As a legal executive coach working with high-performing attorneys, I was sort of a first responder in many ways for a lot of the wellness and mental health crises that were being buried for many, many years. Before we could even get to how to focus on getting you to the partnership level, and how do we focus on doubling your book of business, attorneys were coming to me on their own saying, “I don’t think I can take another moment of this,” or “if I add one more thing to my day, you know, I’m going to, I’m going to really lose it.”

I started to see that this was an issue that kept popping up and presenting itself, so I went back to grad school and earned a master’s in clinical social work. I wanted to have a real behavioral toolbox so that I could understand human behavior, understand the spectrum of wellness and the lack of wellness, and really be able to service the legal community in that way.

Additionally, wellness has been a lifelong personal struggle and mission, in my life. I was one of those crazy, high-performing litigators who hit a wall at 90 miles an hour when I had my first child at the age of 27 and suffered from crippling postpartum depression. Suddenly, after years of just pushing and pushing, I one day woke up to realize that I was now severely impaired. It was very scary and humbling and you know, it became sort of my own passion and mission to really bring a level of attention and awareness to wellness in the legal community.

It’s pretty obvious that the legal industry is very competitive and that it can be full of very high-stress situations. What are some symptoms of constant stress that you might come across in the day to day operations of a typical law firm?

That question’s really important. You know, stress is basically a physiological reaction to a perceived threat to you and to your environment, right? So that’s where you get the whole fight or flight physical response. That’s what stress is. From a biological perspective, what ends up happening is your blood pressure goes up, your veins constrict, and you have basic physiological symptoms kicking you into fight or flight mode. From purely a biological perspective, these automatic stress responses can have serious ramifications that can end up impairing an individual’s daily functioning.

Biology impacts our behavior; so chronic, ongoing stress in the body manifest and present some clearly identifiable behavioral dysfunctions. For starters, chronic stress induces a level of constant baseline agitation. Everything and anything can be irritating to the point of explosion. Everyone is a little bit of a powder keg about to explode. Chronic stress will cause sleep deprivation. It has been linked to eating disorders. It can cause imbalances in your metabolism. It’ll cause imbalances in your serotonin level, and the other thing it does is it causes isolation. You have increased isolation with stress because you’re protecting yourself. You’re not talking to anybody, you’re going through all of these things and everything in your body and mind is telling you to isolate.

From an executive functioning point of view, there is so much research to show that people functioning under high levels of stress for a long period of time can demonstrate impaired judgment, impaired ability for conflict resolution, and impaired compassion. These impairments impact interpersonal relationships at work including client relationships. High stress has a whole host of impairments associated with high-level executive functioning that really is being called into play moment to moment. As an attorney, chronic stress can compromise your ability to focus and use good judgment. Your ability to analyze situations correctly and be able to step away and say, “is this a moment for confrontation?” or “is this a moment for cool off?” is now off. Your ability to assess how best to present information appropriately to the client, to the associate, or to the partner is also off. Bottom line is that chronic high stress really impairs many of the operational skills needed to interface and practice effectively as a lawyer. Finally, it also impairs the softer skills that are really needed as you become more of a senior partner and involved in business development.

From a business perspective, both individuals and the institutional law firms are negatively impacted by untreated chronic high stress as an individual’s capacity to handle situations and use good judgment and analysis have basically gone out the window.

How does mindfulness practices help counteract that stress in a typical law office environment?

Basically, mindfulness is bringing your attention to the present moment in an intentional, deliberate and systematic kind of way with an attitude of acceptance of whatever might show up or for whatever you’re experiencing. What mindfulness does, is it forces you to pause, which is, you know, a novel concept for many attorneys. One of the key things that happen when you are in a stress-induced situation is you stop breathing. We hold our breath. When you do that, you essentially jack up all of those sympathetic stress indicators in your body I mentioned before. I really want to make mindfulness super clear and basic, because I want to make mindfulness practice really accessible and strip away any preconceived ideas of what mindfulness is.

So, what is the power of the present moment? If we strip it down, the present moment for any human being at any given moment is made up of a cocktail of their emotions, their sensations, and/or their thoughts. When you’re bringing your attention to that bundle of things that are happening, what you’re feeling, what you’re thinking and what you’re sensing in the world, suddenly you start to breathe and you start to invoke and sort of trigger your parasympathetic nervous system, which is the self-calming, self-soothing embodiment that we all automatically have in our body. What you’re inviting yourself to do is to intentionally focus on the present moment so that you can breathe, so that your body can be able to kick itself into a place of calmness.

We’re not talking about achieving nirvana, you know, we’re talking about creating a tool that is user-friendly so that in the moment you can pause, breathe and be able to ground in the present moment so that your body and your mind can kick into a better and perhaps, more optimal way of functioning.

That’s a simplified way of thinking about it because other levels can be a little off-putting or intimidating. If you read a lot of philosophy on mindfulness and meditation, anyone who claims they’re an “expert” in mindfulness doesn’t get it, in my opinion. We’re all beginners. And the idea that we are all beginning all the time in this process with the “beginner’s mind” is what can make the difference of whether you try mindfulness or not. There is no perfection or achievement award in mindfulness; starting at the beginning and paying attention to the present moment over and over again is the practice.

Many thanks to Ms. Rand for her insights. Monday we will have Part 2, which will address the basics of what mindfulness practice can be, as well as some barriers to practicing mindfulness and how to overcome them.

ARTICLE BY Eilene Spear and William C. P. Thieme of The National Law Review / The National Law Forum LLC.

For more on the topic, see the National Law Review Law Office Management section.

PTSD Compensation for First Responders without Associated Physical Injury Revisited by Ohio Legislature in New House Bill

With the recent proliferation of mass shootings and other deadly incidents, several states have taken on the issue of allowing mental and/or emotional impairments caused by post-traumatic stress disorder (PTSD) to be a compensable workers’ compensation condition for first responders without the requirement of a physical injury.

In June 2019, House Bill 80, the budget bill for the Ohio Bureau of Workers’ Compensation, included such a proposal. After the bill passed the House, the Senate stripped the policy provisions on the mental-only diagnosis issue out of the proposed budget. Senate leaders indicated while there may be a reason for a special circumstance, it should be studied and debated separately from the workers’ compensation budget. In July 2019, leadership vowed to consider the legislation later in the year.

True to their word, the issue was revived in September 2019 by Representative Thomas Patton. House Bill 308 reintroduced the issue of PTSD coverage for first responders exposed to traumatic events in the course and scope of their employment. Two hearings on the bill have already occurred, most recently on Oct. 22, 2019. Proponent testimony was offered by several organizations and individuals. The statements reiterated concerns first responders are not able to pursue avenues for compensation under the law set forth by the Supreme Court of Ohio in Armstrong v. John R. Jurgensen Co. Interestingly, one of the organizations offering proponent testimony was the Ohio State Medical Association.

The business community remains opposed to any legislation that would allow for a “mental-mental” avenue for claimants. Rob Brundrett, director of public policy for the Ohio Manufacturers Association, provided testimony on House Bill 80 earlier this summer. Beyond merely the increased cost to employers, if a mental-only diagnosis were allowed, Mr. Brundrett noted the potential expansion of workers’ compensation beyond first responders could be required.

“If we erode the physical-injury requirement for peace offers, firefighters, and emergency medical workers, it may be difficult to justify not doing the same for other professionals who seek equal treatment,” Mr. Brundrett said in his testimony.

How such a proposal would be funded is also a concern of employers. Mr. Brundrett, who is closely following House Bill 308, has indicated that several discussions in the Senate have occurred in recent weeks on a potential bill that would provide PTSD coverage for first responders outside of the Bureau of Workers’ Compensation system. This proposal would, of course, be the preference of the business community.

While passage of this issue in the past has been unsuccessful, the August 2019 mass shooting in Dayton and its impact on first responders may result in this bill moving through the legislature. Dinsmore’s workers’ compensation group will continue to monitor this bill, as its passage would have a profound impact on employers.

If you wish to see the proponent testimony and follow the bill, you can obtain more information here.

ARTICLE BY Caroline E. Diwik, Anthony “T.J.” Jagoditz and Christopher A. Benintendi of Dinsmore & Shohl LLP.

For more on mental health, see the National Law Review Health Law & Managed Care page.

Mental Illness in Family Law & Divorce

According to the National Institute of Mental Health,

Approximately 1 in 5 adults in the U.S. (46.6 million) experiences mental illness in a given year.
Approximately 1 in 25 adults in the U.S. (11.2 million) experiences a serious mental illness in a given year that substantially interferes with or limits one or more major life activities.
Approximately 1 in 5 youth aged 13–18 (21.4%) experiences a severe mental disorder at some point during their life. For children aged 8–15, the estimate is 13%.

Not surprisingly, mental health issues come up in the context of a divorce in a variety of ways. They arise when mental health issues contribute to the breakdown of the marriage or relationship. For instance, a partner may suffer from a condition which causes him or her to behave in ways that are detrimental to the relationship. This can manifest itself in aggression, narcissism, and self-centered behavior to the detriment of the other partner or children, excessive spending impacting family finances, to engaging in dangerous behavior with a partner, and/or their children.

What happens when someone believes that their partner’s actions are caused by a mental illness? After a complaint for divorce has been filed, or other court process started, attention needs to be focused to the behavior, and steps should be taken to:

Ensure that children are safe;
Assets of the marriage are protected; and
A plan is created to provide treatment options if children are involved.

If a spouse or partner is suffering from mental illness to the extent that he or she cannot make rational decisions, the court has a variety of options to protect that person, both personally and his or her property. The court can appoint a guardian for the person, particularly if the illness is so extreme as to cause a person to be incompetent.

If the litigant is ill, but not to the point of incompetency, the court can appoint a Guardian Ad Litem.

If a partner or spouse’s illness is creating a risk of assets being dissipated, a court can freeze accounts, and limit access to funds. A court may allow a third party to make payments on behalf of a litigant such as rent, etc.

There is little question that difficult issues arise when a parent suffers from mental illness. The courts, acting in the best interests of children, must make sure the child is safe, while at the same time safeguarding a parent’s rights to have a relationship with a child. When custody is an issue and one parent is alleging that the other suffers from a mental illness, the court will typically order an evaluation by a licensed mental health provider with experience in custody cases. The court may enter an order limiting, or prohibiting contact with the children pending the outcome of the evaluation. Then, depending on the outcome of the evaluation, the court may order therapy, medication, or other recommended treatment as a condition to parenting time. While the parent is undergoing treatment, the court can order supervised parenting time to make sure the children see the parent, but also making sure they are safe.

If substance abuse is part of the illness, there are options to make sure a child is not with a parent who is intoxicated. In addition to random drug testing, which the court can order as a condition of parenting time, there are devices, similar to mini breathalyzers to detect alcohol and certain other substances. These can be carried on someone’s person, in a pocket or purse, and they will be sent a random text instructing them to blow into it. A report will then be sent to the custodial parent, who can take steps to protect the children.

Sometimes, a child will suffer from a mental illness and the parents may differ as to the existence of the illness or for its treatment. This often results in a health care provider refusing to treat in the absence of agreement. In that case, either parent can petition the court for assistance, and an order allowing treatment.

This post was written by Jennifer Weisberg Millner of Stark & Stark

Read more about Divorce & Family Law on the National Law Review’s Family Law, Estate Planning and Personal Injury Legal News page

Eating Disorders are Mental Health Conditions Subject to Parity Law

The Departments of Labor, Treasury and Health and Human Services (Departments) continue to issue FAQs addressing the implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act and the 21st Century Cures Act (Cures Act). The MHPAEA prohibits group health plans from imposing financial requirements and treatment limitations on mental health and substance use disorder benefits that are more restrictive than the requirements imposed on medical and surgical benefits. The Cures Act requires the Departments to solicit public feedback regarding how to improve required disclosures under the MHPAEA. The FAQs in Part 38 contain the same request for public comment that was in Implementation Part 34, and provide a draft model form that can be used by participants to request information from a health plan regarding nonquantitative treatment limitations (NQTL) that may affect their mental health and substance use disorder benefits, or to obtain documentation after an adverse benefit determination involving these benefits.

In addition, the FAQs provide guidance regarding eating disorder coverage. If a plan provides these benefits, FAQ-1 in Part 38 confirms that the coverage must comply with the MHPAEA. The guidance indicates that “eating disorders are mental health conditions and therefore treatment of an eating disorder is a ‘mental health benefit’ within the meaning of that term as defined by MHPAEA.” Plans should be reviewed to determine whether financial requirements and treatment limitations placed on eating disorder treatment comply with the parity requirements under the MHPAEA.

This post was written by Sarah Roe Sise of Armstrong Teasdale LLP.

For more legal analysis check out the National Law Review.

Tag: Mental Health

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Attorney Wellness and Mindfulness Part 2: What does Mindfulness Practice Look Like?

What are some simple practices that a novice or even a skeptic might be able to take on to start feeling some small benefit? And along those lines, do you need to devote a lot of time to mindfulness practices to begin to see a difference? What kind of commitment level do you need to show?

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Attorney Wellness and Mindfulness Part 1: Why is Mindfulness a Benefit to Attorneys and others in the Legal Industry?

It’s pretty obvious that the legal industry is very competitive and that it can be full of very high-stress situations. What are some symptoms of constant stress that you might come across in the day to day operations of a typical law firm?

How does mindfulness practices help counteract that stress in a typical law office environment?

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PTSD Compensation for First Responders without Associated Physical Injury Revisited by Ohio Legislature in New House Bill

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Mental Illness in Family Law & Divorce

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Eating Disorders are Mental Health Conditions Subject to Parity Law

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Transcript

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What are some simple practices that a novice or even a skeptic might be able to take on to start feeling some small benefit? And along those lines, do you need to devote a lot of time to mindfulness practices to begin to see a difference? What kind of commitment level do you need to show?

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It’s pretty obvious that the legal industry is very competitive and that it can be full of very high-stress situations. What are some symptoms of constant stress that you might come across in the day to day operations of a typical law firm?

How does mindfulness practices help counteract that stress in a typical law office environment?

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