The largest study of lawyer mental health and well-being ever conducted has given law firm leaders a lot to think about.
Published in September 2026 by the American Bar Association’s Commission on Lawyer Assistance Programs and Krill Strategies, the study draws on responses from more than 37,000 actively licensed lawyers across 28 jurisdictions.
The headline finding is confronting: nearly half of lawyers, 47.4%, screened positive for high burnout. Around one in five met the threshold for moderate to extremely severe symptoms of depression, anxiety or stress. More than 41% screened positive for risky drinking.
But the numbers that stood out to me were not only about how many lawyers are struggling. They were about the working conditions driving that distress and why people still hesitate to seek help.
Those are things law firm leaders can do something about.
The study found that work-related burnout was the strongest predictor of clinically significant depression, anxiety and stress symptoms.
Hours also mattered. Lawyers working 71 hours or more each week reported substantially higher levels of stress and burnout than those working closer to 40 hours.
Litigation was consistently associated with higher burnout and greater symptoms of depression, anxiety and stress. Litigators working extreme hours were among the most vulnerable people in the study.
Many plaintiff firms sit directly at this intersection. They operate in private practice, manage demanding litigation and experience periods of extreme pressure when trials, deadlines and major matters collide.
The study examined litigation generally. It did not isolate the effects of contingency economics, trial calendars or the emotional weight of working with people affected by catastrophic injury. Even so, the overall risk profile should be familiar to anyone who has led a plaintiff firm through a demanding period.
Over the past decade, the legal profession has invested heavily in mental health education and awareness. That work has made a difference in one respect: people generally know support is available.
The study found that 75.2% of respondents were aware of lawyer assistance programs.
Despite that awareness, many lawyers still did not feel able to use the support available to them.
More than half (53.3%) cited concerns about confidentiality. Almost as many (49.2%) feared that seeking help could damage their professional reputation. Another 34.5% said they did not have the time.
That tells us the problem is no longer simply a lack of awareness.
A firm can circulate information about an employee assistance program, add a wellness page to its intranet and remind people that help is available. None of that matters if lawyers believe using the service could expose them, harm their standing or take time they cannot spare.
Making support available is not the same as making it accessible.
I have spent years talking with employers about workforce health, and this is where many well-intentioned organizations get stuck.
They introduce a benefit and assume the job is done. But the real test is whether someone can use that benefit privately, quickly and without creating another problem for themselves.
For law firms, there are two separate issues to address.
The first is the work itself. Long hours, uneven caseloads, inadequate coverage and repeated pressure on the same people are management issues. No health benefit can fix a 71-hour workweek or redistribute a caseload. Firm leaders must own those decisions.
The second issue is access to support.
Preventative health can help reduce the distance between someone recognizing that something may be wrong and taking action. That could mean giving people faster access to appropriate care, removing unnecessary costs or delays, and making confidentiality part of how the service works.
A lawyer should not have to explain a midweek absence to a supervising partner, search through a provider directory, wait weeks for an appointment, or wonder whether anyone at the firm can see that they asked for help.
Every extra step gives an already busy person another reason to put it off.
Preventative health does not replace health insurance, primary care, emergency support or treatment from a qualified clinician. It sits alongside those services and makes it easier for people to act earlier, before a concern becomes a crisis.
The study gives firm leaders a useful place to start. These are four questions worth asking this quarter.
Firm-wide averages can hide the real problem. Look at how many lawyers cross 70 hours in a week during demanding periods, how often it happens, and whether the same people repeatedly absorb the pressure.
A heavy week may be unavoidable. A pattern of heavy weeks affecting the same people requires attention.
Count the actual steps involved.
Does someone need to find a provider, confirm whether the service is covered, wait for an appointment, take time away from clients and pay a deductible?
A benefit can look generous on paper and still be too difficult to use when someone is already overwhelmed.
Confidentiality was the most commonly reported barrier in the study.
Firms should be able to explain clearly what information they receive, what remains private and whether a person can access support without notifying a manager or changing their schedule in a visible way.
Employees should not have to rely on reassurance alone. Privacy should be built into the service.
More than a third of respondents said time stopped them from seeking help.
Support that requires half a day away from work is unlikely to be used by a trial lawyer in the middle of a demanding matter. Firms should look for services people can access quickly, privately and at a time that works around their professional obligations.
None of this requires firm leaders to assess anyone’s health, and they should not try. Their responsibility is to examine the conditions people are working under and the barriers standing between them and appropriate support.
Plaintiff firms are people-powered businesses in the most literal sense.
The firm’s capacity, client experience and performance depend on the judgment, focus and stamina of a relatively small group of people. When that capacity starts to erode, the effects rarely stay contained.
They show up in slower client communication, missed deadlines, avoidable errors, lower-quality work and unexpected departures. By the time the firm can see those outcomes, the underlying health problem may have been developing for months.
The legal profession now has a decade of comparison data, its first validated national burnout baseline and a clearer understanding of what prevents lawyers from acting early.
Firm leaders do not need to diagnose their people or promise to eliminate the pressures inherent in legal practice. They do need to look honestly at the demands their people are carrying and whether the support they provide can realistically be used.
Firms that treat this as a management question will get further than firms that treat it as a wellness initiative.
Source: Patrick R. Krill and Justin J. Anker, When Demands Equal Distress: An Updated Understanding of Lawyer Mental Health and Well-being, published in the Journal of Affective Disorders, September 2026. The study was conducted by the American Bar Association Commission on Lawyer Assistance Programs and Krill Strategies.
Michael Bux
Vice President | Sanguine Preventative Health
Michael Bux is Vice President of Sanguine Preventative Health, where he works with employers to understand the health pressures affecting their workforce and identify preventative health programs suited to their people and business. He has more than 25 years of experience across consulting, finance and sales.
Sanguine Preventative Health helps employers understand what may already be affecting their workforce, then recommends and supports preventative health programs suited to their people and business.
Sanguine Preventative Health provides advisory and program-support services. It does not provide medical advice, diagnosis or treatment.
