When Kayla Pope, M.D., J.D., entered law school, she found herself in a
pressure cooker. The adversarial environment was fueled by an emphasis on
class ranking and a relative lack of academic guidance for students learning
Kayla Pope, M.D.: "Early intervention holds a great deal of
promise for the patient as well as for society."
"In the beginning I think a lot of people struggle, but the culture
really discourages you from seeking help," she told Psychiatric
Shortly after gaining her law degree, she learned that a fellow student had
committed suicide. His death made an impact on Pope and her classmates and
left her wondering what, if anything, could have been done to prevent the
This question was in part what led Pope to a career in psychiatry and, last
year, to spearhead the Law School Mental Health Initiative, aimed at
addressing the mental health needs of law students.
As an attorney, Pope represented children and adolescents in child abuse
and neglect proceedings, custody disputes, and juvenile criminal proceedings
Her work with children and adolescents, many of whom had endured emotional
trauma, sparked her interest in the mechanisms that trigger juvenile
delinquency and a desire to teach the courts about the impact of child abuse
and neglect on emotional development.
"As an attorney, I saw abused and neglected children coming into
court, yet it was hard to prove [the abuse and neglect]," she told
Psychiatric News. "I wanted to find ways to capture what they'd
experienced and present it as evidence to the court."
Pope pursued a master's degree in experimental neuropsychology at George
Mason University and also began working at the National Institute of Mental
Health's Section on Affective Development and Neuroscience under Daniel Pine,
M.D., where she had the opportunity to participate in studies involving the
psychopathology and neural substrates underlying emotional development.
"The goal of this research was to learn more about how to intervene
at a young age in children with emotional problems," said Pope."
Early intervention holds a great deal of promise for the patient as
well as for society."
Subsequent work at the American Academy of Child and Adolescent Psychiatry
as director of research and training from 1999 to 2001 further ignited her
interest in child psychiatry, she said.
She entered medical school at George Washington University in 2001 with the
goal of becoming a child psychiatrist and noted that her medical education was
vastly different from her law school education because in medical school she
received a great deal of guidance and mentorship. "It was more of a
supportive environment" than was law school, she recalled.
Pope entered the psychiatry residency program at the University of
Maryland/Sheppard Pratt in 2005 and was accepted into the Children's National
Medical Center/NIMH Child and Adolescent Psychiatry Research Fellowship in
July 2008. She is primarily interested in studying early markers for
disruptive behavior in children, she said.
While in residency training, Pope learned about the efforts of Daniel
Suvor, a third-year law student at George Washington University, who with the
American Bar Association (ABA) Law Student Division, helped to establish March
27 as National Mental Health Day for law students.
In a press release from the ABA, Suvor noted that "the stigma of
mental illness and the laws in many states that grant conditional bar
admittance to those who battle these conditions have historically prevented
many from seeking treatment."
To educate law students and bar association administrators about the signs
and symptoms of depression and anxiety and facts about common mental
illnesses, staff with the ABA Law Student Division developed the Toolkit for
Student Bar Associations and Administrators, which included educational
materials on depression and other mental health problems.
According to data gathered by the ABA, the prevalence of depression among
law students and lawyers is higher than that of the general population. As an
example, a study conducted by William Eaton, Ph.D, and colleagues using data
from the Epidemiological Catchment Area study found that lawyers are 3.6 times
as likely as those in the general population to meet criteria for major
depressive disorder. The findings were published in the November 1990
Journal of Occupational Medicine.
Last year, Pope reached out to a variety of experts to initiate the
formation of a work group under APA's Corresponding Committee on Mental Health
on College and University Campuses. The goal is to launch an initiative to
educate law students and law school administrators about the signs and
symptoms of depression and other common mental disorders and how the disorders
At the meeting was APA member Saundra Maass-Robinson, M.D., who agreed that
there is a need to reach out to law students. Maass-Robinson has worked for
more than a decade in Georgia with the Supreme Court Board for Bar Fitness. As
a member of the board, she told Psychiatric News that she helped the
legal community in Georgia gain a deeper appreciation for encouraging full
disclosure by bar applicants as to their past psychiatric and/or substance use
"As a result," she said, "law schools and law students
here in Georgia are advised by the board, early in their law school education,
to get help if needed for any type of mental illness and that this will not in
any way jeopardize their 'fitness' for the bar."
Maass-Robinson added that in her capacity on the board, she has promoted
treatment seeking as advantageous to bar applicants. "Help seeking shows
an awareness of the problem as well as maturity in seeking treatment,"
Additional members of the work group are Melissa Nelken, J.D., a law
professor at the University of California Hastings College, and Hanna
Stotland, J.D., a Chicago attorney.
The work-group members hope to address some of the barriers that keep law
students from accessing mental health treatment. The barriers are significant:
for instance, many health insurance plans that cover law students allow only
two mental health—related visits. "There is also a great deal of
stigma attached to receiving mental health treatment," she said, due to
the competitive nature of law school.
Further, in many states, having a mental illness can prevent students from
being admitted to their state bar associations. Under the ABA's model rule on
conditional admission to practice law, bar applicants with a diagnosed
psychiatric disorder that could interfere with their ability to practice law
are placed on a two-year probation in which they are monitored and required to
receive psychiatric treatment. If the applicants make it through that
probationary period with no undue effects on their legal practice, they gain
full admission to the bar.
Work-group members see this rule as potentially problematic in practice.
For example, it is unclear whether bar applicants need to disclose to their
clients that they are on probationary status while practicing, Maass-Robinson
The work group plans to work with states to iron out these practical issues
and to study the effects of the rule on bar applicants with diagnosed mental
There is a great deal of variability in how state bar associations that
have not adopted the model rule deal with applicants with mental disorders,
Pope said, and she would like to have work-group members collaborate with
states on how applicants in those states fare as well.
Work-group members are also working on creating a position statement for
consideration by APA's Board of Trustees as well as the ABA encouraging early
diagnosis and treatment by psychiatrists and encouraging law schools to aid in
providing access to quality mental health care.
Members of the work group have also been developing programs that foster
collaboration between psychiatry departments and law schools. Nelken has been
working with the UCSF Forensic Psychiatry Program to develop a pilot
educational program for law students at UC Hastings. Similar efforts are under
way to develop a relationship between psychiatry programs and law schools in
the Washington, D.C., area. The work group also plans to work with leaders of
the Association of American Law Schools to educate law school administrators
and professors about the impact of mental illness on law students.
Pope said that she is encouraging participation of interested professionals
in the work group's activities to improve the mental health of law students.
Those who are interested in learning more about the initiative can contact
Pope by e-mail at