Treatment for attorneys with substance related and co-occurring psychiatric disorders: demographics and outcomes

The following paper is the result of a retrospective study of clinical case files of legal professionals treated for substance-related and co-occurring psychiatric disorders at a recovery center specializing in the care of impaired professionals. Attorneys traditionally differ from healthcare professionals in two important ways: first, they prematurely leave treatment in greater numbers, and second, they suffer a higher incidence of co-occurring psychiatric disorders. Sixty percent of the attorneys presented with concurrent psychiatric conditions (Axis I and Axis II), compared to 46% of their healthcare colleagues. More than half of the lawyers treated had a prior history of criminal arrest. Sixty-four percent completed treatment compared to an 86% completion rate for medical professionals. The completion rate for lawyers improved significantly following institution of a dedicated impaired attorneys' program under the direction of an attorney/clinician in October of 1999. Prospective studies are needed to determine if attorneys are at greater risk of developing substance related and/or psychiatric disorders than are other professionals of similar demographic backgrounds and what specialized intervention, treatment, and case management services might be necessary to assure equivalent outcomes.