The restaurant industry has a mental health crisis

Servers, line cooks, and dishwashers all over America are struggling to find help in an industry that often exacerbates the problem.

The restaurant industry has a mental health crisis

Servers, line cooks, and dishwashers all over America are struggling to find help in an industry that often exacerbates the problem.

When Rafaa Gonzalez was 20, he was sentenced to two years in prison for smuggling immigrants into the United States. He had become a smuggler in order sneak his mom back into Texas; she had been deported to Mexico when he was six. His plan was to escort her into the Rio Grande Valley, where he, his dad, and three siblings lived, on the trip after the one that got him arrested.

While on parole, Gonzalez moved to Austin with his pregnant girlfriend and landed one of the few jobs available to someone with a criminal record: restaurant dishwasher. He didn’t stay in the dish pit long. He climbed up to line cook and then, at a second restaurant, he waited tables and tended bar. Today, after following his now-ex-girlfriend and son back to the Rio Grande Valley, he works the grill at a Cajun place.

While he was incarcerated, a prison psychologist diagnosed Gonzalez with bipolar disorder and post-traumatic stress disorder, which he said stems from being molested as a boy. “One night [this spring], it all came at me, and I started crying,” Gonzalez told me over the phone. “I cried for two hours thinking about everything I’ve gone through, and I kept thinking: Why do I have to keep going through this? Why do I have to keep struggling?”

That night in early June, he sought advice on how to deal with depression through a post in the Facebook group Server Memes, which has 65,000 members. More than 300 people responded to the post, showing their support. Gonzalez’s ongoing struggle with depression makes him part of burgeoning stereotype in the food and beverage industry — a restaurant worker with mental health issues.

In 2017, the nonprofit Mental Health America (MHA) released a two-year study concluding that the environment in the food and beverage industry correlated with a high level of mental health issues. The organization surveyed more than 17,000 employees in 19 industries, and the food and beverage industry was one of the three worst to work in, along with retail and manufacturing. Anyone who has ever juggled a six-table section can probably guess the contributing factors listed in the report: stress, low wages, long hours, job insecurity, a lack of trust for coworkers (particularly managers), and substance abuse.

A 2015 study by the Substance Abuse and Mental Health Service Administration ranks the restaurant industry highest among 19 industries for illicit drug use and third highest for heavy alcohol consumption, while a 2018 study published in the American Journal of Epidemiology revealed that tipped workers are at greater risk of depression, insomnia, and stress compared to non-tipped workers. And though these studies do not connect sexual harassment to the state of mental health in the industry, it must be acknowledged that women make up roughly 56 percent of the estimated 15 million people in this line of work. Sexual harassment can have an impact on someone’s mental health for years, and in the restaurant industry, it affects income and creates a hostile workplace environment. Some have called the prevalence of sexual harassment in the industry an epidemic.

Theresa Nguyen, vice president of policy and programs at MHA, said the organization’s unreleased 2019 research shows that the food and beverage industry hasn’t improved since its previous study was published.

“We’ve heard anecdotally about this problem for a long time,” Nguyen said. “Our results are consistent with the feelings we have about what might be going on there.”

That means some of the traits that make the American restaurant industry what it is — shouting matches in the kitchen, gossiping about coworkers at the service station, late-night tequila shots in the middle of the week with the person you gossiped about because there’s no one else who’ll drink with you — often facilitate an environment that correlates to mental health issues for many workers.

Some stereotypes, like the bartender who drinks too much or the chef who often loses his temper, seem so ingrained into the industry that it’s hard to imagine a restaurant without them. But while the industry may present unique challenges, it is imperative that restaurant owners and managers address these negative cliches without undermining one of the most positive aspects of the industry’s identity — that of a place where anyone, from ex-cons with a high school education like Gonzalez to struggling writers with an MFA like me, can work.

“It wasn’t great for my well being. I felt a level of anxiety, depression, dread and foreboding every day.”
Marie Billiel

Patrick Mulvaney, owner and chef of Mulvaney’s B&L in Sacramento, says the changes have to start at the top of each restaurant. “By modeling the right behavior for my managers, they will model it for the staff, which improves, not only morale up and down the line, but also responsiveness, which improves performance and retention,” he said.

Mulvaney believes restaurant owners need to create a space in which workers feel comfortable talking about their mental health. Last year, he partnered with five organizations, including Kaiser Permanente and the James Beard Foundation to create I Got Your Back, a peer-to-peer or near-peer counseling program.

Mulvaney launched the program in his restaurant last October after 12 people in Sacramento’s restaurant community died due to mental health complications, including substance abuse and suicide, in the span of a year. Mulvaney and a handful of staff members were trained on how to talk to someone who is anxious, depressed, or suicidal, as well as what resources to offer them. Those who received training were given a purple hand pin to wear to signal that employees could reach out to them for help. The restaurant placed a box next to the computer where workers punched in; and at the start of each shift, employees would place one of three cards in the box: blue for depressed, red for angry, and green for happy. Then, at the pre-shift meeting, managers discussed the mood of the staff.

The program helped Mulvaney and his staff get through a tough winter, during which four people in the Sacramento restaurant community, including three people who had worked for him, died by suicide. But Mulvaney said he’s seen the biggest change in the day-to-day life at the restaurant. “You can feel it when you walk into a room,” he said. The program has also prevented him from turning into the stereotypical angry chef when he sees an employee doing something incorrectly.

“Instead of saying, ‘You’re fucking stupid; let me show you how to do it,’ I move forward and navigate it better than I would have,” he said. “I think there's impatience in the industry, and the toxicity in kitchens may stem from that and our inability to look at ourselves.”

By the end of this summer, I Got Your Back will be piloted in 22 other Sacramento restaurants, and Mulvaney hopes to take the program statewide and then national.

There are other programs dedicated to fixing the mental health crisis in the industry. Fair Kitchens provides training kits across America and Canada with guidelines for chefs and managers on how to talk to employees about depression, anxiety, and substance abuse. Like I Got Your Back, Fair Kitchens’ goal is to create a workplace environment in which workers can talk openly about how they feel. Another organization, Culinary Hospitality Outreach and Wellness, is located in Denver and has weekly meetings like a 12-step group, where service industry employees can meet and talk about their problems.

Marie Billiel, a service trainer at a Boston restaurant, said that anything that normalizes the conversation about mental health will help the industry. But she fears it’s going to take more than one solution to deal with sexual harassment in restaurants. Billiel, who is 30 and has worked in restaurants for 14 years, said she was sexually harassed by customers, coworkers, and managers at her first server job at a diner in western Massachusetts.

“So many days I would feel a sense of dread going into work, wondering how bad it was going to be that night, or if I was going to be put in a situation where I had to make a choice whether or not I was going to suffer through whatever was happening or risk losing tips,” she said. “It wasn’t great for my well being. I felt a level of anxiety, depression, dread and foreboding every day.”

Billiel believes that the best way to combat sexual harassment in the industry is to raise the tipped minimum wage, which is $2.13 an hour for most American servers. This base wage is paid to employees who receive at least $30 a month in tips, and if the worker does not earn the state’s standard minimum wage ($7.25 in most places) when tips and the tipped minimum wage are combined, restaurant owners are supposed to make up the difference. This practice is known as the tip credit, and some employers don’t follow it, cheating workers out of hard-earned money.

Whether to eliminate the tipped minimum wage is probably the most controversial topic in the industry. Those who believe raising it would be a mistake think restaurant owners would cut staff and rush toward automation, which will likely happen regardless. Many also fear that customers would stop tipping, forcing servers who earn more than $20 an hour under the current system to take a significant pay cut. On the other hand, advocates for raising it say the benefits would include a reduction of racial and economic inequality, better mental health, and an improved relationship with customers. Seven states have raised the tipped minimum wage and 10 more have introduced bills to do the same. There’s evidence to support Billiel’s claim. Reported cases of sexual harassment in California have decreased by half since the state raised its minimum wage for restaurant workers.

“I want to help change the environment in the kitchens so people aren’t afraid to speak up about what they’re going through.”
Rafaa Gonzalez

Line cooks deserve a raise, too. Gonzalez earns $11 an hour, which he said is the most he’s ever made, and is higher than most line cooks in the Rio Grande Valley. Still, it’s not enough to survive. He has to live with his sister and he has fallen behind on his child-support payments. He can’t afford health insurance, and he refuses to drive into Mexico to buy cheap generic versions of the medications he needs to treat his bipolar disorder and PTSD. He insists they turn him “into a literal zombie,” and despite his doctor’s recommendations, as well as pleas from his family and friends, Gonzalez hasn’t taken any prescription drugs in three years.

“Everyone’s always like, ‘Go get your meds,’ but I hated taking them,” he said.

Gonzalez self-medicates with marijuana; earlier this summer, he tried to go a week without smoking to save money. Within a couple days, his depression returned. And that’s when he decided to seek advice by posting on a service-industry Facebook group page. Many of the hundreds of replies he received told him to drink more alcohol or do more drugs, speaking to another problem endemic in the restaurant industry: substance abuse.

It’s hard to untangle the substance abuse from the mental health issues the industry faces, but due to the party-friendly atmosphere that hangs over the line of work, it also seems like it deserves its own separate category. Even if restaurants across the country adopted I Got Your Back and workers from coast to coast began opening up about depression and anxiety, the industry would still have to face the fact that it attracts more people with addictive personalities than any other occupation.

Ken Jones (not his real name) was one of the people who advised Gonzalez to seek treatment from a medical professional. Jones worked as a server in Oklahoma for five years and was addicted to oxycodone for most of that time. “It was an easy job to hold down while I was on drugs,” he said. “I had cash every day. It was easy to find drugs through work, and the job gives you an instant friend base to party with.”

Jones got clean in rehab in 2016, but when he returned to work in Oklahoma City, he quickly realized he couldn’t handle the stress of the restaurant sober and found a job in marketing. Jessica Smith, (not her real name) who suggested microdosing magic mushrooms to handle depression in response to Gonzalez’s post, said she’s trying to leave the restaurant industry in order to get sober.

Smith, a 35-year-old bartender in Dallas, said she struggles with a heroin addiction. She started taking mushrooms before work as an alternative to heroin, which she’s used on and off since high school. If the sports bar where she works practiced I Got Your Back, one of her coworkers could talk to her about finding a 12-step meeting or a counselor. But she’s already been through rehab and doesn’t think I Got Your Back would work for her because she doesn’t open up to coworkers about her heroin use.

“For now, I gotta do something just to deal with my shift,” she said. “I think if I changed jobs or went back to school I could get away from all this and stay sober. It’s too easy to fall back into using with this job with the stress and anxiety. And drugs are everywhere at work. Everyone does coke.”

As for Gonzalez, he doesn’t want to leave the industry yet. He said he likes being a line cook, and wants to be a positive influence for his coworkers. “I want to keep working here and help people who have issues like me,” he said. “I want to help change the environment in the kitchens so people aren’t afraid to speak up about what they’re going through.”

More access to health care would certainly help people like Gonzalez. It has been estimated that about 10 million restaurant workers have health insurance through the Affordable Care Act or Medicaid. That still leaves about five million people uninsured in an industry that earns over $700 billion in sales annually.

“I was only able to get treatment because I was young enough to still be on my parents’ health insurance,” Jones said. “Maybe it would help if there was universal health care.”

I can relate to Jones. In 2013, when I was going to grad school full-time and waiting tables a few nights a week, if I hadn’t had health insurance, I wouldn’t have been able to afford my first therapist. Eight months later, he helped me get sober after I finally admitted how much I drank and smoked weed.

I worked as a server and bartender in Pittsburgh for a decade. For all but three of those years, the industry functioned as a side gig that aided in my survival. That lifeline wasn’t purely financial. I have alienated friends and family, and working in restaurants has provided a support group I couldn’t have lived without.

But the restaurant industry is more than just a world where students and young professionals can earn extra cash. In our phone interview, Mulvaney described it as an industry of misfits, and that has definitely been my experience. I worked alongside art-school graduates who refused to work in cubicles, teachers who quit their jobs because they made more money and had more fun behind the bar, and Iraq War veterans who loved the thrill of a dinner rush. To some, the stereotypical restaurant worker might still be a waitress with a high school diploma or an ex-con with nowhere else to go, but this is one of the country’s largest industries, and it’s filled with all sorts of people who are underpaid, lacking healthcare, and in mental distress. They all work hard, and they all deserve better.

Gavin Jenkins is a freelance journalist based in Pittsburgh. His work has appeared in The Washington Post, The Atlantic, Vice, Mel, and Narratively.