Chicago Med: When Mental Illness and Law collide

Chicago Med: When Mental Illness and Law collide

Marta Lopera Mármol

Vice President of ISMA

Director of Communications

Introduction

In the 10th episode of season 3 of Chicago Med (NBC, 2015-) the medical drama spin-off of the somewhat successful but not-so-good Chicago Fire (NBC, 2012-), medicine takes on a new turn when its juggled within legalities and mental illness. Before revealing any spoiler, I invite you to watch the clip which narrates the story I am going to analyze.

Synopsis  (*Spoiler Alert*)

In this Chicago Med episode, psychiatrist Dr. Charles is convinced something is off when Dr.Sara treats a man, Mr. Dietrick, that seems to have at first sight a minor injury due to a car hit. His particular assertion in the case is both unsettling and worrisome. As the episode goes on, Dr. Charles becomes convinced that the injured is not a mere accident but a suicide attempt, forcing him to hold Mr. Dietrick in the psychiatric ward against his will and despite his insistence that it was all an accident. By the end, Dr. Charles reveals that Mr.Dietrick suffers from endogenous depression and provokes Mr. Dietrick to reveal he stopped taking his anti-depressants meds.

Pros +

The episode effectively portrayals depression as a mental illness that can affect anyone, even the “perfect picture” person with a successful but also extremely demanding job which in this case and far from being a casualty turns out to be a lawyer. The fact, that the diagnosis is made by a character that has the legitimacy to do so since he is a psychiatrist allows to break in a sense the “stigma wall.” Doctors tend to be more “credible characters” and knowing the effects TV series can have on people, this type of diagnosis made by someone that “has the power to do so” might evoke those spectators that are suffering from depression or have similar symptoms to seek actual help. Therefore, turning this audiovisual piece into an edutainment[1] audiovisual product.

Furthermore, the diagnosis is concrete, showing the broad spectrum of particular mental illness such as depression. Also, it shows how mental illness is as important as physical. Dr. Charles quotes: “It is caused by your brain chemistry,” this is particularly relevant since hints not only a genetic predisposition but also a biological origin. The fact that the patient covers up his feelings as said in the TV series: “You become a Master of disguise” allows a realistic representation of patients affected by depression; the fear of stigma, the defensive attitude as said in the clip: “Englight me Dr. Freud”,  is a common attitude that is often a struggle psychiatrist suffer, and the guilt of the patient as Mr. Dietrick says: “ I have absolutely no excuse to be sad” and the great answer by Dr. Charles: “You don’t need an excuse man you are a human being” creates the imagery that mental illness is not something people choose to have or something to justify an act but instead is a clinical reality like any other.

In conclusion, the episode does one of the best declarations they can do that “depression is not a weakness,” and that it can be presented as many forms, leaving behind the stereotype of the depressed patient constantly crying and being sad. 

Cons –

Despite its reasonable efforts, the episode fails in three main aspects. Firstly, on representing a broader range of gender, class, and race. Is yet again presented by a white male of an upper-high class. Secondly, while depression does have a medication treatment that can be effective, usually selective serotonin reuptake inhibitors, Mr. Dietrick is experiencing suicide thoughts due to the fact that he stopped taking his anti-depressant medication which leads to the idea of what Stephen Harper (2009: 103) defines as “equilibrium-breakdown-recovery” and forgetting other aspects of recovery such as one on one therapy, group support, etc. and lastly, while depression is closely linked to suicide so are other illnesses such as bipolar disorder, PSTD, substance consumption i.e. drugs or alcohol, etc. (Estrada 2016). Suicide is a more complex and multifactorial phenomenon that the show represents.

References

Estrada-Rangil, Oriol. 2016. “Olive Kitteridge y la depresión”. In La medicina en las series de televisión edited by Toni de la Torre,  111-118. Barcelona:Cuadernos de la Fundación Dr. Antonio Esteve.

Harper, Stephen. 2009. Madness, Power and the Media. Class Gender and Race in Popular Representations of Mental Distress. UK: Palgrave Macmillan.

[1] Edutainment can be defined as the process of entertaining people at the same time as you are teaching them something through different mediums such as television series.

I wish you a speedy recovery

I wish you a speedy recovery

Dear Paul Rawlinson, Global Chair of Baker McKenzie:

After knowing your temporary medical leave, I would like to tell you several things:

First of all, I wish you a speedy recovery. Your health must be your priority as of now. It is essential that you take a rest. You are the captain of this big law firm, and employees and clients need you to be okay. Above all, your family.

Secondly, I want to congratulate you on your bravery and humanity to make this history public. According to Baker Mckenzie’s official statement, which has been spread by different British and American legal media, exhaustion has been the cause of your temporary medical leave.

Considering that there is a substantial social stigma about mental health, the fact of recognizing your problem can help many lawyers not to be afraid of talking about mental health issues.

Thirdly, although you already have doctors who take care of you, I encourage you to follow LawCare’s activities. This non-profit organization, which is chaired by Mrs. Elizabeth Rimmer, provides many useful tools with British legal professionals who need help.

Lastly, if I were a CEO of a big company, I could assure that you would be my lawyer. You deserve my respect, loyalty, admiration, and trust.

Best regards,

Manel Atserias Luque

President of the “Instituto de Salud Mental de la Abogacía – Mental Health Institute of Legal Professions (ISMA-MHILP)

The importance of lawyers well-being

The importance of lawyers well-being

Mckenzie Cross

Staff

Note: The author makes reference to the American legal market

Over the past few months, professionals have become more aware of the mental health issues within the legal profession. A rise in depression, anxiety, and stress is leading to worry among the community of lawyers. A worldwide leader, Paul Rawlinson, took a leave of absence in early October this year. Rawlinson was the chairman of the successful Baker McKenzie Firm. He has been chair for two years now and during that period he has witnessed a growth within the firm. Baker McKenzie announced an eight percent gross revenue increase from 2017-2018. Not only gross revenue raised, they reported a significant fourteen percent increase in profits per equity partner (1). Seemingly successful, Rawlinson’s announcement to take a leave surprised people among the community,however, with success comes stress. The firm issued a statement stating, “ Baker McKenzie Global Chair Paul Rawlinson has announced that he will be stepping back from his day-to-day responsibilities and taking temporary leave to focus on a personal medical issue.Based on the advice of his doctor, in response to medical issues caused by exhaustion, Paul has decided to take a step back from Firm leadership and client responsibilities to make his health and recovery his immediate priority.” (2) A leave of exhaustion might not seem like a dying need to take mental illness seriously, however, put it together with someone as important and successful as Rawlinson and other cases of mental illness among lawyers and it becomes a larger issue.

October 14th, 2018 in Los Angeles, California, well known lawyer Gabriel MacConaill was found in his car dead from a self inflicted gunshot wound to the head. Same as Rawlinson, MacConaill was very successful in his career. In 2009 McConaill, joined Sidley Austin’s Los Angeles practice. By 2014, he had made partner and was building an impressive client base. Seemingly happy and successful it came as a shock again to see just how much he was struggling with inside his mind. Mental illness is not something recognized very often among the legal profession yet it is an increasingly large problem.

August of this year another suicide among a partner was committed by Bruce Wickersham. He was a partner at DLA Piper’s Boston office. Suicides are happening all over the country among lawyers. In Chicago Stewart Dolin, an M&A partner at Reed Smith, jumped in front of a moving train taking his own life. These are only a few cases among many that happen around the world. The question is, why is this issue not more widely known? The answer, fear of stigma.

Study shows that twenty-eight percent of lawyers reported that they struggled with some type of depression in the past 12 months. That is four times higher than the national average. Even more concerning is that sixty-one percent admitted to feeling depressed at some point in their career. That is ten times the national average (3). Considering these numbers we have to come to the conclusion that within the legal profession there is an epidemic. However, that epidemic spreads to law students as well. The Survey of Law Student Well-Being and the Reluctance of Law Students to Seek Help for Substance Use and Mental Health Concerns reported outstanding numbers in not only mental health issues but in substance abuse as well. However, one of the most interesting points of focus in the study is the reason that students did not report having a problem. Sixty -three percent of students reported fear that they would not be admitted to the Bar if they reported a substance abuse problem; forty- three percent shared that same fear if they reported having a mental health issue (4).

The report clearly shows the stigma around mental health, however, that is not a reason to let it go unsolved. The easiest way to help those suffering is to let them know that they are not alone. There are websites and hotlines that can help them deal with the pressure and stress that they may be facing at their jobs. Mental illness is an issue that will never fully go away but with help from the community, loved ones, and acknowledgment from the law firms we can find better ways to cope with it.


(1) Walker, Rose. “Baker McKenzie Leader to Temporarily Step Down Due to Exhaustion.” The Legal Intelligencer. October 22, 2018. Accessed December 03, 2018. https://www.law.com/international/2018/10/22/baker-mckenzie-chairman-paul-rawlinson-to-temporarily-step-down-from-role-396-8258/.

(2) Rubino, Kathryn. “Global Chair Of Biglaw Firm Taking Temporary Leave Due To Exhaustion.” Above the Law. October 22, 2018. Accessed December 03, 2018. https://abovethelaw.com/2018/10/global-chair-of-biglaw-firm-taking-temporary-leave-due-to-exhaustion/.

(3)Dan. “Why We Need to Talk About Lawyers’ Mental Health Now.” Lawyers With Depression. September 23, 2018. Accessed December 03, 2018. http://www.lawyerswithdepression.com/articles/why-we-need-to-talk-about-lawyers-mental-health-now/.

(4) Organ, Jerome M., David B. Jaffe, and Katherine M. Bender. “Suffering in Silence: The Survey of Law Student Well-Being and the Reluctance of Law Students to Seek Help for Substance Use and Mental Health Concerns.” Journal of Legal Education. Accessed December 03, 2018. https://jle.aals.org/home/vol66/iss1/13/ .

Elizabeth Rimmer & LawCare

Elizabeth Rimmer & LawCare

Mckenzie Cross

Staff

Elizabeth Rimmer is the Chief Executive Officer for the company LawCare. She joined the organization in 2014 and has worked hard with them ever since. She graduated in 1997 from Kings College in London majoring in medical law and ethics. Before she worked at LawCare, Rimmer had been working as a solicitor specializing in clinical negligence. She has had over fifteen years of experience operating and organizing mental health charities. Currently at Lawcare, she has been working hard to create a strong support system for professionals within the legal field and their families.

LawCare was founded in 1997, and since then they have helped thousands of people within the legal profession with mental health issues. The organization has grown and now serves the people throughout the United Kingdom, Republic of Ireland, Isle of Man, and Jersey. LawCare is focused to not let any lawyer feel alone. Feeling like they are the only one suffering is one of the biggest reasons that they do not seek out help. LawCare has a helpline that you can call where you will be paired with an employee or volunteer that also have experience working within the law sector.

Their helpline is their main support program. It is available to call 365 days a year. The hotline is confidential, impartial, and independent from the United Kingdom’s law system. One of the most unique qualities about the LawCare helpline is that if you feel as though you are struggling more than the person can help you, you will be sent through to a LawCare supporter. A LawCare supporter is an employee who has also gone through a large struggle. They are there for you one on one for as long as you may need. The company also keeps a list of counselors and psychiatrists on hand. These mental health professionals have had special experience working with lawyers in the past, so that they may know the best treatment route for you. These lists are kept on hand so that whenever the need arises they are ready to refer you.

The hotline was created on the basis that sometimes a human just needs to talk to another human. Seventy-five percent of the calls that came through last year reported stress as the reason that they were calling. Sometimes, being able to call a stranger and talk about your problems actually helps you to work through them on your own. LawCare says that most of their callers report that they do not feel as though they need any follow up support.

Another unique aspect to the organization is that they also provide support to families and friends of Lawyers. Not only do the legal professionals need help dealing with stress and anxiety, but sometimes their families need help knowing what to do to help their loved one. LawCare provides this information to families to help them grow together. This is very important because working with stress and anxiety, as well as other mental health illnesses, is already hard enough without having to worry about your family. Lawcare takes this worry away and even turns it around so that your family may help you become even more successful.

Elizabeth Rimmer’s work with LawCare has helped the United Kingdom greatly. Not only has she been helping to create a support system throughout the legal field, she is bringing awareness to an issue that usually does not like to be talked about. By breaking down the stigma walls and showing legal professionals and other professionals that mental health is a very real issue, we can provide support and resources to make the working community a healthier place.        

David Jaffe: a role model for us

David Jaffe: a role model for us

From left to right: Mckenzie Cross (staff), Manel Atserias Luque (president), Ferran Garcia de Palau Garcia-Faria (Well-Being Committee), David Jaffe (Associate Dean of Student Affairs of the American University Washington College of Law), Gabriela Boldó Prats (Well-Being Committee) y Albert Ruda (Dean of University of Girona Law School).

Mckenzie  Cross

Staff

In 2014, David Jaffe was one of three professionals to set in motion a change in how we look at mental health among legal professionals. He graduated in 1993 from American University, Washington College of Law with his Law degree. He has been Dean of Student Affairs since 1997. Anyone who has the honor to meet him can immediately appreciate the love and dedication he has to not only his job but the students that he encounters. I could listen to him speak at a conference in Girona, Spain and to learn about the study that he was apart of.

The article, “Suffering in Silence: The Survey of Law Student Well-Being and the Reluctance of Law Students to Seek Help for Substance Use and Mental Health Concerns,” was the results of the Survey of Law Student Well-Being (SLSWB). The study included 3,300 students from fifteen different law schools. It was the first multischool study on law student use of alcohol and street drugs in twenty years, and the first-ever study to address the use of prescription drugs. The study is allowing society to acknowledge that the mental health within law students is an issue that needs to be addressed and worked through.

The results of the study showed an astounding number of students struggling with mental illness. However, the study also showed how those students believed their mental illness would be perceived by the staff of their college as well as the American Bar Association. The study reported that fifty-three percent of law students drank enough to get drunk in the past thirty days. Seventeen percent of students were screened positive for depression, and thirty-seven percent screened positive for anxiety. With numbers being so high, it is incredible that it is not considered a better know problem; however, Universities cannot help students if they are not coming forward. The study showed that only four percent of respondents sought professional help with drug and alcohol abuse. Sixty-three percent of students reported that they feared there would be a threat to their bar admission if they sought help for alcohol and drug abuse. However, the percentage is only slightly smaller with forty-five percent fearing the same repercussions if they stepped forward with a mental illness. The study shows many different issues among law students; however, the most impressive part of Jaffe’s work was not the study, but rather his dedication to finding solutions.

Suffering in silence identifies a few actions that could be put in place to help students. One of the most important activities was for faculty to have strict attendance policies. This will help faculty look for warning signs, such as a missing student class unexpectedly or coming in late with no notice — also the policy that faculty should attend regular training on how to identify the warning signs of mental health issues. A faculty member that can recognize strange behavior and approach the student with nonjudgmental looks and listening ears will get a better response then students seeking help on their own. Another action that David Jaffe spoke of at the conference was to make a drug and alcohol course mandatory for incoming law students. This could help students to know the risks of their behavior as well as opening them up to understand that the college cares about their safety and health.

Mental health among law students is a growing issue. With help from people like David Jaffe and others, we can help put into place policies and actions to help them. Students need to know that they are not alone and that how they are feeling is not their fault, being compassionate and working to make them feel comfortable and not judged will help to turn this epidemic around.