Measuring Lawyer Mental Illness: Evidence From Two National Surveys

ABSTRACT The American Bar Association has declared a “well‐being crisis” among lawyers, but the empirical basis for this claim has been contested in recent years. This study systematically compares two high‐quality, nationally representative surveys—the National Health Interview Survey (NHIS) and the National Survey on Drug Use and Health (NSDUH)—to measure the prevalence of mental illness and alcohol misuse among lawyers. In both surveys, lawyers report elevated rates of alcohol misuse compared with the general public and similarly educated peers. The NHIS finds that lawyers experience psychological distress at rates lower than the general public and similar to, or moderately higher than, similarly educated peers. In the NSDUH, by contrast, more than 40% of lawyers report moderate or serious psychological distress in the past year. This rate is significantly higher than those reported by the general public, by similarly educated peers, and the rate found in the NHIS. While we cannot fully explain all of the differences between the two national surveys, we resolve some of these differences by studying sensitivity to instrument validation and calibration and closely aligning the measurements used in both surveys. To assess the remaining differences, we identify several advantages of the NSDUH, including the privacy of data‐gathering methods, additional clinically validated mental illness measures, and results that are more consistent with other national surveys. The persistent divergences between the NHIS and NSDUH underscore the challenges of measuring mental illness and the importance of continued work on survey implementation, validation, analysis, and interpretation.