Maintaining Mental Health in High Pressure Professions with Dr. Brian Russell

Transcript

Narrator: 0:01

This podcast is for educational purposes only, does not constitute legal advice and does not create an attorney-client relationship. If you need legal assistance about a legal problem, contact an attorney.

Cimone Murphree: 0:15

Well, good morning, Dr. Russell. Thank you so much for being with us here today. How are you doing?

Dr. Brian Russell: 0:20

I’m great. Thank you very much for having me.

Cimone Murphree: 0:24

Absolutely. We are very excited to have you join us today and share your unique perspective on the importance of mental health for professional license holders. For our viewers who don’t know, Dr Brian Russell is a licensed psychologist and attorney in four different states four different states. In addition to the mental health services that he provides to attorneys, he also defends professionally licensed psychologists. Dr Russell, can you give us a little bit of background on yourself and your journey to becoming a licensed attorney and psychologist?

Dr. Brian Russell: 0:59

Sure, I started out in a JD MBA program after undergraduate, getting an undergraduate degree, and I did that and about halfway through that I decided that I wasn’t sure I wanted to just practice law. I had kind of two dads in my life my actual dad, who was great, he’s a law, he’s passed away now but he was a law enforcement officer First. Well, first he was in the Navy and but he was a law enforcement officer First he was in the Navy and then he was a Capitol Hill policeman and then he became a federal law enforcement agent for the remainder of his career. So I grew up listening to his stories and getting very interested because of him and the law and how we try to work within the law and the rule of law and society to get the right things to happen as often as we could. And so I grew up, you know, interested in that and wanting to go to law school and study that.

Dr. Brian Russell: 1:52

But in the course of all that I had sort of a second dad figure in my life who is still here.

Dr. Brian Russell: 2:01

He’s a clinical psychologist and so that had me also very interested in just sort of human behavior. More generally, I was already interested in how we use the law to try to sort of regulate human behavior. But that knowing this guy got me really interested also in just human behavior more generally. And so as I was about halfway through that JD MBA program, I thought, well, maybe I can stay and get a PhD in clinical psychology and then maybe I could find ways to combine the two, so maybe I could do expert witness work in cases, which I had a chance to do, and maybe I could do therapy with lawyers, which I do because it’s a stressful profession, and maybe I could do legal defense for psychologists when they have licensing complaints and so forth, and I’ve done that too. So I’ve always tried to look for ways to kind of to kind of combine these two disciplines of law and psychology that I got so interested in from these two really prominent figures in my life.

Troy Beaulieu: 3:01

That’s such an interesting background and how you kind of arrived at your chosen profession. I’m curious, since you know you got a license in two different professions. I’m sure you’re familiar with some of the stressors kind of the anxieties and the pressures that license holders can face in their careers. Could you tell us a little bit about how you’ve seen this manifested in different situations?

Dr. Brian Russell: 3:34

Well, I think if you look at health care professions broadly, it’s not just psychology, but I would include medicine and other allied health professions, and law and lawyers we’re all helpers. They’re all sort of helping professions if you think about it. And when people are in those professions for the right reasons, you know a big part of it is you know the intrinsic reward that they get from helping people. But when you put yourself in situations all the time where you are having clients in crises of various types lawyers having clients in legal crises, healthcare professionals having clients who are struggling with symptoms of illnesses and so forth it can get really taxing on a person.

Dr. Brian Russell: 4:20

There’s just a tremendous sense of duty that a lot of helping professionals have to do everything humanly possible for their clients and then some and there’s some real caregiver fatigue that can come from that, and so I think it’s really important for folks to realize that they have to take care of themselves, and certainly there are good and bad ways to do that. You know healthy and unhealthy ways to try to do that and so you really want to try to take care of yourself in healthy ways so that you actually can be your best professional self for your clients that actually take care of yourself. In other words, it actually is the way to be the best, whatever it is psychologist, physician, attorney for your clients. Putting yourself last all the time, to the point where you’re just running yourself ragged or you’re trying to take care of yourself in unhealthy ways, really ultimately doesn’t serve the clients or patients or yourself the best.

Troy Beaulieu: 5:28

Yeah, I couldn’t agree more. Self-care is such an important thing. I see that with so many of my professional and occupational license defense clients who are having those challenges, maybe impacting their career, their performance at work, their license with their regulator. And speaking of that self-care, I know you touched on kind of healthy and unhealthy ways. I mean we know that substance abuse obviously has a connection to mental health. Tell us a little bit about that connection and how you see substance abuse issues arising in these contexts and impacting licensed professionals.

Dr. Brian Russell: 6:11

That’s a great question. I think there’s a sort of a complex relationship between substance abuse and other kinds of mental health conditions that people try to self-medicate other kinds of mental health conditions with substances. They sort of try to self-prescribe sometimes and that is obviously not the recommended, healthy way to go about it. If somebody feels they’re struggling with anxiety, for example, alcohol would not be the self-medication with alcohol would not be the method of choice to go about trying to address that. I would recommend that the person does try to address it, especially if it’s causing them trouble, or at least get an opinion of a learned person on whether or not there’s actually something there in the way of a disorder, whether or not they’re actually normal limits, and if they are outside of normal limits, then what kind of things would be healthy for them to do to try to get themselves back into normal limits. And that might involve some medication maybe in some cases, but not self-medication and not with substances of abuse that can end up causing, you know, reasonably be expected to cause more trouble than good for people.

Dr. Brian Russell: 7:28

Interestingly, among our profession as lawyers, we actually see an unfortunately high rate of substance abuse in our profession and I think it has to do not typically usually with the fact that lawyers are more susceptible to other kinds of mental health conditions.

Dr. Brian Russell: 7:49

I think it has to do a lot with some of the vagaries and peculiarities of the legal profession, the pressure that a lot of lawyers have to bill hours, sort of a high pressure financial incentive structure for a lot of folks in the law. And there are other reasons as well. But so, like lawyers, there are physicians who feel a lot of pressure, as you can imagine, to try to save everybody and cure everybody and help everybody. Save everybody and cure everybody and help everybody. And some of the folks who are the most highly motivated to do that also get the most disappointed in themselves and the circumstances and everything when they’re not able to be as successful with it as they want to be and it’s hard for them to sort of turn that off, and so sometimes they too try to do that in an unhealthy way, where a much better thing would be to talk to somebody and learn how to do that healthily.

Troy Beaulieu: 8:52

Yeah, yeah, definitely see a lot of connection between all the challenges that people face. I mean even some of our first responder type clients that maybe go through a traumatic experience and are trying to deal with that trauma or anxiety stemming from that. Sometimes we’ve seen situations where they say they need some help because they’re struggling with substance abuse. So, yeah, it really can have a wide ranging impact on just a variety of different professions a wide ranging impact on just a variety of different professions Absolutely, absolutely.

Dr. Brian Russell: 9:34

And it’s really important that we show our appreciation for those folks, in part by making sure that they have good resources available if they are struggling, so that they don’t end up, you know, having to disengage, at least for a long time or permanently, from the profession they got into. That they’re now trying to deal with and maybe don’t know the healthy ways to do. It was one that was for our benefit. They took themselves out of safety and put themselves in harm’s way for us and got injured physically and or mentally doing that. I feel like we owe them a lot. And I feel similarly with our cops and our first responders. I’ve got a brother who’s a firefighter.

Dr. Brian Russell: 10:33

They do see really difficult things and you can’t sort of erase that from your mind. You sort of carry that with you and you have to figure out how to do that healthily. And you know same with some lawyers. They have clients that are in the throes of really awful stuff a lot and they hear all about it and you know they’re carrying that around with them as they try to go home and have their own home life and or try to disengage from work and enjoy themselves, and sleep at night is a sleep is a big one. Uh, that gets disrupted when people’s minds are just sort of racing and and going around and around on on. Uh, you know, the other people’s uh problems are really really difficult things that you came across in your work yes, that’s so true yeah, it can be really hard to separate that.

Dr. Brian Russell: 11:30

Yes.

Cimone Murphree: 11:32

If someone is looking for help, what are some resources that either license holders or, you know, just the general public may be able to take advantage of if they’re struggling with their mental health or substance abuse?

Dr. Brian Russell: 11:49

Well, so when we’re talking about licensed professionals, there are some that are really pretty good, like, for example, lawyers. Typically, in every state that I know of, there is a lawyer’s assistance program that is there to help protect and rehabilitate lawyers who have gotten themselves into a situation where they need some help, whether it be substance abuse or just depression, debilitating anxiety, whatever it may be. The lawyer’s assistance programs are actually, I think, really a very nice resource because they’ve got not only some free services available to help folks but also a referral network that they typically have to get folks connected up with services that are beyond what the LAP or Lawyers Assistance Program itself provides. And in addition to that, because lawyers can be in trouble professionally if they practice while impaired, the lawyer’s assistance programs also can provide some help if the lawyer does have to disengage from practice, for example, maybe to go to a rehab program to have other lawyers who are available to sort of step in and make sure that deadlines get postponed or met and contacts get made with clients so that clients aren’t thinking that their attorney just went AWOL, and just some really nice wraparound services for lawyers from lawyers’ assistance programs Physicians very similar, in my experience, every state that I’m aware of, there is a physician’s assistance program that exists to help physicians in many of those same ways and to help the physician stay in practice to get through the storm through which the physician is going in his or her life and be able to return back to safe practice. And those people at the physician assistance programs in my experience really are advocates for the participants in their programs where the licensing board is not. Those of us who do licensing board defense for professionals know that the licensing board is not your friend in the same way that a lawyer’s assistance program or a physician’s assistance program could be your friend where they’re advocating for you, they’re rooting for you, they’re trying to help you. The licensing board is, you know, it’s not that they’re trying to be an enemy to you, but they’re looking out for the public and they’re trying to make sure that you’re not practicing impaired or doing anything that would pose a risk to the patient, client, public. So it’s a different. They’re coming at it with a different agenda For the professions other than law and psychology and for the general public. I think it’s unfortunate that there’s not a resource that I could tell you that is sort of akin to lawyers assistance programs and physician assistance programs. In my second profession of psychology I don’t know of anything really like that a psychologist assistance program but I do think that hopefully we’re getting better.

Dr. Brian Russell: 15:03

Our mental health system in our country is kind of fragmented. There’s not really a one-stop shop for most folks like there is, or at least a one-stop shop to start out with, like there would be, for physicians and lawyers with the assistance programs. But I do think that the resources are out there and people have to advocate for themselves and you can start if somebody felt like they needed that. I think a good place to start. Most people do have a primary physician that they go to and those folks I think are really good.

Dr. Brian Russell: 15:38

A lot of times it’s sort of knowing who in the community other patients of theirs have gone to for mental health kind of specific assistance and substance abuse kind of specific assistance. So I think that’s a good place to start. I think we’re starting to have a lot more accessibility for more people across our country, even the folks that live in the more rural parts of our country, thanks to telehealth for everything. But it can be for many things an excellent enhancer of access to folks and so I hope for the majority of our population and other professions that don’t have quite as much infrastructure support with the assistance programs yet. I hope we’re getting better at having resources out there and accessible.

Troy Beaulieu: 16:33

Yeah, and piggyback on what Brian’s saying, I definitely agree. I think things are growing and improving. You know, in Texas we have the TLAP, the Texas Lawyers Assistance Program, just as Brian described. Texas has the Physician Health Program and in Texas that covers other allied health professions, so your physician’s assistants, your radiologic technologists, all the different license holders of the Texas Medical Board. Overseas there is a program for nurses with the Texas Nursing Board. Even the accountancy board, the Board of Public Accountancy, has an accountant’s confidential assistance network. They call it ACAN. So I think it’s definitely growing. You know, I having those programs available because I definitely did, during my time as a regulator, see instances where, oh, it looks like maybe there’s some kind of mental health or substance abuse component to this. And it’s just nice to have those additional tools and options Because not everybody needs to go through the disciplinary process when they, you know, when they have a problem, you know, with their mental health that can be addressed in a different way, in a confidential way.

Dr. Brian Russell: 18:03

Absolutely. I’m so glad to hear that the Texas Physician Health Program actually does address folks in other professions allied health professions that’s great to hear, I didn’t know that. Folks in other professions, allied health professions that’s great to hear, I didn’t know that. Another thing that I would suggest people to maybe look into is, even if their profession doesn’t have something like that, many employers are, you know, kind of getting, are aware, or getting more aware, of the value of helping their staff take care of themselves mentally and emotionally, that there’s a real return on that investment in terms of keeping people not just healthy in general, but keeping people on the job, keeping people productive and keeping people around, not having a turnover as much, and so there’s a real ROI, a real return on that investment for people. And so increasingly employers do have EAP employee assistance programs that they set up and contract with.

Dr. Brian Russell: 19:08

There’s some really big national providers and I’ve worked with one or two of those over the years as a contractor here and there and still do that sometimes, and then there are all kinds of levels and iterations of that, but that would be a place for folks to maybe look to see if their employer does offer something like that and one of the big benefits of a program like that oftentimes, as you said with the accountants, is the confidentiality that if somebody is struggling in a profession where they know that if they were to be sort of caught by the licensing board practicing impaired, or if somebody were to complain to the licensing board practicing impaired, or if somebody were to complain to the licensing board that the licensee did that and it was true that they would run a significant risk of losing their livelihood, you know, temporarily or permanently, if the board felt that they needed to be suspended or have their license revoked.

Dr. Brian Russell: 20:07

So the ability of a licensed professional to go someplace where they can ask for help confidentially and it doesn’t have to turn into then a disciplinary proceeding, is a really really nice sort of safety valve or sort of escape hatch for folks who would otherwise feel really trapped, where they know they need some help but they feel like seeking out the help is going to ruin their financial life. And so I think the physician health program for physicians, the lawyer’s assistance program for lawyers and maybe this accountancy program you’re talking about and others that is one of the really nice components is that oftentimes they do provide folks a way to seek help confidentially and still maintain their professional reputations and licenses.

Troy Beaulieu: 20:54

Yeah, and that’s so true because, like you mentioned earlier, the job of these licensing boards is to protect the public. Their job isn’t to protect the license holder, so it’s often confusing for many of our clients. They think that you know that’s where to go, but a lot of times you do need to go see that confidential assistance and you don’t want to go down the traditional disciplinary path. Thankfully, some agencies do have diversionary tracts where they will spot that as an issue and instead of going down the disciplinary route, the board will put it into a confidential kind of peer assistance. Go get help with what you need for your mental health, your substance abuse. And as long as you kind of peer assistance, go get help with what you need for your mental health, your substance abuse, and as long as you kind of stay on that path and don’t have any issues, then it can actually get resolved confidentially and never become a public issue.

Dr. Brian Russell: 21:49

That’s great. It’s nice to see the boards thinking maybe a little bit outside the traditional box in some of those cases, and I assume those are ones where they feel that the public can be protected while also helping the individual to stay in practice, at least in the long run. And I think that is so important that when we do have chances to do that and it can be done safely, it can be done without exposing the public to risk that people try to do that because we’ve got we certainly don’t have an excessive amount of healthcare professionals in relation to the number of folks who need care in our country right now is the other way.

Troy Beaulieu: 22:34

Exactly yeah.

Cimone Murphree: 22:35

Well, before we go, Dr Russell, do you have any, you know, atypical advice that you would like to share with our viewers? Or maybe, Troy, you might have some atypical advice to just kind of surrounding these resources and you know, and how that might affect a license holder.

Dr. Brian Russell: 22:52

Corey, you want to take that?

Troy Beaulieu: 22:53

first, yeah, sure, I mean. My advice is, you know, if you do think that you have a mental health issue or a substance abuse problem that’s impacting you in the workplace, in your professional setting, be proactive about it. Try and get some help. Talk with you know. Even, like Brian was saying, if you start with your general practitioner, get a referral. Go see a mental health professional, whether it’s a counselor or whether it’s a psychiatrist or a psychologist professionals that can help you look into and see if what you’re experiencing is within the range that’s you know, acceptable under the circumstances, or if there’s something you know you can get therapy and sometimes medication might be appropriate to help treat different issues that you’re experiencing.

Troy Beaulieu: 23:47

But you want to do that before it bleeds over into your professional life and becomes kind of a public issue, whether it’s a client or a patient that’s seeing an issue at work and reporting you or your employer.

Troy Beaulieu: 24:04

I mean, so many of our clients come to us and that’s already kind of bubbled over into a public forum and then it’s a challenge to try and keep that confidential and kind of put it back into a private sphere where you can handle it and get the help that you need. So my biggest recommendation is I know it’s hard to try and struggle with that and have that self-recognition of I think I need help with this. I can’t do this on my own, but if you can get to that point and do that, it’s much better to do that before it gets into the public sphere, where you’re having to deal with your regulator Because, again, as we talked about, their focus is on protecting the public and while there are some diversionary resources, you don’t want to run that risk of going down that path and perhaps the board deciding no, you’re not suitable for this alternative resolution, so we’re going to temporarily suspend your license until you demonstrate that you’re fit to practice. So that would be. My biggest thing is just kind of be proactive.

Dr. Brian Russell: 25:11

Yeah, I think I would second all of that. I think people in licensed professions have obviously gone through typically pretty extensive education. They’ve gone through testing, having to test and do supervised practice and all kinds of things to get qualified for their profession that they do. And typically the kind of person who does that is a person who is pretty self-reliant and has a pretty strong sense of sort of initiative and follow through and also a pretty strong sense a lot of them do of personal responsibility and self-efficacy and so forth, and so that’s a great thing because you need that to get into the licensed professions. But sometimes it can come back to bite folks a little bit when they do find themselves in a situation, and it doesn’t have to be substance abuse, it could be professional burnout, which also can cause a risk of them potentially making an error that could hurt somebody. It could be the depression, anxiety. Maybe they’re going through something in their life outside of their profession a divorce or something like that and it’s taking a heavy toll on them. Maybe they’re not sleeping and then they’re trying to go and do the job and there’s a risk there too. So sometimes I think that even though, even though people sort of have a real bias towards, towards can do and self-efficacy and and and sort of rugged individualism and all that in our licensed professions it’s sometimes the case, kind of paradoxically, that the strongest person is the person who does recognize that they need some help and is willing to avail themselves of the help that’s out there, whether it’s from an EAP or a professional assistance program or just their own psychologist or their own doctor, at least as a place to start. I think sometimes the person who recognizes that it’s a long game that you’re playing, and even if you could continue to sort of white knuckle it which is a common thing, people struggling tend to kind of tell themselves well, it’s going to get better, if I just go on a little bit longer, then I’ll get a breather and I’ll be able to sort of reset and retool and really that’s sort of reset and retool and really that’s sort of some denial talking there. So I think the folks who actually are strong enough to say you know, what I want is a sustainable practice. I don’t want to help you know relatively small number of folks over the next little while and then burn out or wash out or get kicked out of the profession. I want to help a relatively large number of people over a period of years or decades going forward, and the best way to do that is to figure out how to calibrate myself back to where I’m in a really good, sustainable state of mind, a really good, sustainable way of taking care of myself in healthy ways, not the unhealthy kinds of ways like with substance abuse and so forth.

Dr. Brian Russell: 28:16

I think it’s important and in my professional psychology practice with lawyers, I don’t do primary substance abuse treatment, I don’t try to be a rehab. I’m seeing them around the country via video conference, just like we’re talking now, and I don’t personally believe that that is a great way to do primary substance abuse treatment. I have some clients who have had issues with that in the past and they don’t currently it’s not active but folks who would need like a rehab kind of situation, something intensive. I wouldn’t try to do that with them. I wouldn’t. Some people might. I wouldn’t try to do that with them via Zoom. But I do talk to folks sometimes who are sort of in that stage of some of that denial where they’re trying to tell themselves a story about is this temporary no-transcript? And maybe their family, maybe their clients, et cetera. And I really do believe, as you said, that sometimes the better part of valor and really the greater show of valor and really the greater show of strength, is to do that.

Troy Beaulieu: 29:55

Sometimes it’s the hardest thing to do when you’re a very self-reliant person is to kind of recognize and ask for help, because you’re just so used to being able to take care of stuff on your own. But everybody needs help at some point in their life.

Dr. Brian Russell: 30:09

Yes, and you know our professions typically do require continuing education. Lawyers certainly have to do it, physicians and every allied health professional that I know has to do it. I imagine the accountants probably have to do it, and I think there are some good continuing educations out there that people could. If they have to pick something to study as part of their continuing education requirements for the year, maybe one thing they could do that’s really easy to start with, to explore these topics that we’ve talked about today a little bit more is look for a good continuing education about it, one about if you think substance abuse could be an issue for you. Maybe look for a good continuing education specific to your profession, ideally maybe even specific to your profession in your state, because hopefully then it would have some coverage of what the resources are that are out there specific to you. Maybe add that to your queue of the CLE or CME or whatever the profession is courses that you’re going to do in the coming months, and maybe that will give you a place to start.

Dr. Brian Russell: 31:22

If it’s burnout that you’re dealing with or you think you might be, maybe that’s what you do. If you’re a supervisor of other licensed professionals, maybe you do something that would give you a greater ability to spot if somebody whom you supervise is dealing with something like that, and how you a greater ability to spot if somebody that somebody whom you supervise is dealing with something like that, and how you would start those conversations maybe, or even even just colleagues, even if maybe you don’t think you have any of these issues that we’ve talked about today, but you work with colleagues and you care about them. Maybe you still do something to help in this realm when you’re doing your continuing educations, as a way to help you be better able to spot it and maybe help intervene and help somebody else to kind of get out of that denial before they get themselves in a real tight spot.

Troy Beaulieu: 32:06

Well, that’s a great recommendation. I recently had the privilege of going through a mental health first responder course as a manager and a supervisor and that is really insightful. It has a lot of great resources, so there are programs out there for you to look at this in the context of a workplace, particularly if you’re overseeing or managing or supervising others, so that you can see some of those warning signs, to offer help and how to reach out to people and point them in the right direction to professionals or to resources.

Dr. Brian Russell: 32:41

Absolutely, absolutely. I’ve done some of those. I’ve got not to self-promote, but I’ve got some of those kinds of courses that I mentioned on ALM’s CLE Center that are available and I think you could just people could just search my name on there and find those. And we’re about to do a couple more this fall so that people who liked what they saw already could come back and find, you know, kind of some continued offerings there and I’m trying to make myself available as many hours as I can to work not just with individual psychologists but with firms if they want to do something, a training, or if they want to even do kind of an in-house psychologist kind of program. Maybe it’s a smaller firm and maybe they don’t really have it in the budget to do an EAP with one of the big EAP providers, but they do have some resources to make a few hours a week available to their lawyers to use, you know, to have somebody at least to touch base with and consult with on these kinds of things we’ve been talking about today.

Dr. Brian Russell: 33:49

So I do think there are a myriad of creative things going on out there that if somebody is feeling I just don’t know what to do, I just don’t know quite where to turn. Hopefully we’re coming up with increasing answers to that, but they have to sort of start looking. It’s one of those things where probably nobody’s going to necessarily come and and just just lay it right in front of you. But hopefully if, if you start to look a little bit, we’re making it increasingly easy to find stuff and then as you find that first thing, hopefully you know the next thing and the next thing until you’ve got what you need.

Cimone Murphree: 34:29

Yeah, no, those were some amazing takeaways, some really good ideas and tips. Again, thank you so much for being with us today and sharing your knowledge. It’s so important to talk about mental health, especially when it pertains to license holders and licensed professions professions and hopefully this can reach someone who needs some resources. There were a ton of great takeaways from this episode, so again, thank you so much, brian, for being with us this afternoon.

Dr. Brian Russell: 35:00

Thank you so much for having me. It’s been a real pleasure.

Troy Beaulieu: 35:04

Thanks, Brian. We really appreciate all of your insights and feedback today.

Dr. Brian Russell: 35:08

All right. Well, maybe we’ll do it again sometime. Look forward to it.

Narrator: 35:12

Know your Regulator. The podcast that inspires you to engage.