By Natalie Rodriguez

Law360 (May 7, 2020, 4:05 PM EDT) -- Across the U.S., lawyer assistance programs have taken the bulk of their operations virtual in light of the coronavirus pandemic's lockdowns and social distancing measures. Support groups are meeting on video group platforms, seminars are being conducted online, and clinical assessments are being done by video calls.

Many programs in some of the hardest-hit states and cities — such as California, Illinois and New York City — were able to get their operations virtual within a week of the crisis coming to their doorsteps. Call volumes for these groups have been mixed so far, but across the board, the programs have been working to meet some of the unique challenges the COVID-19 crisis is posing for attorneys.

"There is a significant population of people who don't have a lot of social support," said Diana Uchiyama, executive director of the Illinois bar's lawyer assistance program. This in turn is fueling more substance abuse issues, anxiety and depression among lawyers, she added.

For the most part, the move toward virtual assistance for lawyer assistance programs has been relatively seamless, with little disruption to care, several heads of such programs told Law360.

"We are able to do everything basically now we were able to do before. We've just changed how we are doing it," said Michelle Harmon, the State Bar of California's lawyers assistance program supervisor.

But there have been some hiccups along the way — and concerns about following up with those in need.

"The monitoring is a little more difficult," said Harmon, referring to both substance abuse monitoring and mental health monitoring. For substance abuse testing, which is usually done to meet requirements imposed by an employer or local lawyer oversight authority, attorneys don't necessarily want to go to an urgent care facility for urine testing amid a pandemic.

Doing assessments and keeping track of the state of lawyers' mental health can also be difficult when the attorneys are no longer being seen in person. The video component has been crucial, experts say. It's not perfect, but it allows for clinicians to look for signs that something is amiss.

"There is a lot as a clinician you learn in training about body language. That's definitely something that gets tremendously lost when you're doing it over the phone," said Eileen Travis, director of the New York City bar's LAP.

There can be assumptions that everybody is somehow socially connected to someone at this time, even if it's virtually. But that's not always the case, Uchiyama said.

She noted an elderly widowed attorney who reached out to the program with fears he could die amid the social distancing measures without anyone knowing.

Now, Uchiyama checks in with him weekly, and he has a case manager who regularly checks in as well. Another lawyer, a divorced man living alone, noted his virtual therapy session was the first time he had talked to someone outside of going to the grocery store or having a business call.

In New York, Travis says many solo practitioners are concerned about the future, and some attorneys are struggling with the transition to a more sedentary practice that doesn't involve running to the office and court. Many are also dealing with loneliness and anxiety, she said.

The increase in these kinds of issues, however, has not necessarily resulted in an increase in calls to the programs. In fact, the California LAP saw a decrease in all its areas in March and April.

"It's hard to tell really what the cause of that is. I think, of course, some of it is that people are turning inward. Taking care of yourself can feel like a luxury when you're trying to feed your family," said Harmon.

Additionally, with the state courts on lockdown and the bar exam postponed, the referrals the group would have normally received from those avenues have evaporated.

New York City's LAP was expecting an increase in calls after the pandemic started, but it hasn't materialized, according to Travis.

"For some reason, we're not getting the calls we thought we would, and no one is really sure why that is happening," Travis said.

In Illinois, there were fewer calls than usual in the first week the assistance program went virtual. By the beginning of the next week, though, the calls started increasing, from people dealing with isolation, substance abuse, depression and more. 

"A lot of people have been really struggling with managing themselves at home. I would say the amount of people reaching out increases each week, and the problems are escalating," said Uchiyama, noting that the surges mirror similar trends in the general population. In Illinois, alcohol sales have increased by 50% and marijuana sales have also increased, she noted.

The statistics on increasing alcohol purchases across the country are worrying LAP experts, given that the legal community tends to be at higher risk for alcohol abuse.

In New York City, while there hasn't been an increase in general calls, the virtual Alcoholics Anonymous meeting has seen its population of attendees significantly increase in recent weeks, Travis said.

Another major concern among most of the lawyer assistance programs is keeping attorneys socially connected at a time when some who live alone no longer see others in the office or at court.

"Addiction waits for opportunities like this, and the way to combat that is connection," Uchiyama said.

Harmon has been working with the California Lawyers Association on its development of a new wellness committee. "They had been talking about this before COVID-19, but it just so happened we starting doing the frequent meetings with them when all this happened," she said.

Next week, the NYC LAP is set to launch its first general support group for individuals who have mental health issues, including anxiety and depression — two issues that seem to be rising amid the pandemic. Modeled after the Alcoholics Anonymous meeting, Travis hopes this virtual, confidential support group will give lawyers in need a new outlet and support network.

She also hopes to be able to do a similar support group for young lawyers, especially recent graduates who are now facing an extremely unsure job market, and for law students.

In the Chicago-based Illinois lawyer assistance program, Uchiyama hopes to create several new support groups, given the rising interest in telehealth services.

"People have hopped on board, and they love it. The other good thing that comes out of this is it gives us opportunity to reach people downstate, too," she said.

In the background, though, Uchiyama has some concerns about the LAP's finances, given the increased demand and loss of traditional fundraising dinners that had been planned.

"We hope people will continue to be generous, because we think everybody deserves treatment," she said. 

--Editing by Philip Shea and Jill Coffey.

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