Restaurant work has become more stressful than ever. Could a staff therapist help?

Restaurant jobs have always been difficult, but the mental stress has gotten worse during the pandemic as restaurants closed or cut hours — or became a ground zero for the fight over mask-wearing.

"It is totally nerve-wracking sometimes, because all of my tables I'm interacting with aren't wearing their masks," says server Nikki Perri. "I am within six feet of people who are maskless."

Perri works at French 75, a restaurant in downtown Denver. She's 23, a DJ and music producer. And she's not just worrying about her own health.

"I'm more nervous about my partner. He disabled. He doesn't have the greatest immune system," she says.

Perri's not alone when it comes to feeling anxious and stressed about her restaurant work. After the initial shutdown, French 75 was having problems finding employees when it reopened. So were other restaurants.

"We put a Survey Monkey out and pay was number three," said chef and owner Frank Bonanno. "Mental health was number one. Employees wanted security, and mental health, and then pay."

His company, Bonanno Concepts, runs 10 Denver restaurants including French 75, Mizuna and Denver Milk Market. The survey went out to employees of all 10. Bonanno says these jobs offer competitive pay and good health insurance, but the mental health benefits aren't very good.

"Most such psychologists and psychiatrists are out-of-pocket for people to go to. And we were looking for a way to make our employees happy," he says.

That, according to his wife and co-owner, Jacqueline, was when they had a revelation: Let's hire a full-time mental health clinician.

"I know of no other restaurants that are doing this, groups or individual restaurants," she says. "It's a pretty big leap of faith."

It took a little while to figure out what exactly employees wanted and what would be most helpful. Focus groups began in summer of 2021 and they made a hire in October of 2021.

So to their menu of restaurant workers, which already included chef, bartender, and server, they added a new and unusual role: wellness director.

Qiana Torres Flores, a licensed professional counselor, got the job. She'd previously worked one-on-one with clients, and in community mental health, but jumped at the chance to help create a totally new profession inside the restaurant world.

"Especially in the restaurant and hospitality industry, that stress bucket is really full a lot of the time. So I think having someone in this kind of capacity, just accessible and approachable, can be really useful," she says.

Traveling between the 10 restaurants, Flores has led group sessions and mediated conflicts between employees. She's taught the company's 400 employees techniques to cope with stress, and put on Santa's Mental Health Workshop to help with holiday-related sadness and grief. She's done one-on-one counseling and referred a few employees to more specific types of therapy.

"Not only is there help, but it's literally five feet away from you and it's free and it's confidential. And it's only for you," she says.

Bonanno Concepts has also taken other steps to help staffers manage the challenges of the pandemic. Last year, it chose to require customers at all 10 restaurants to show proof of vaccination at the door.

Flores is six months into this new adventure. The owners say her presence gives them a competitive advantage and hope it helps with retention and turnover among their employees.

Restaurant staff often work difficult hours and can be prone to substance use issues — they also approach the job with a grind-it-out mentality. Many workers either don't ask for help or don't always see mental self-care as important; and restaurant culture historically hasn't prioritized it, or has viewed it as something employees should deal with on their own time.

"It has been a really important option and a resource for our team right now," says Abby Hoffman, the general manager of French 75. "I was just overjoyed when I found out that this program was starting."

She gives the effort high marks, and says it builds on earlier efforts to recognize the psychological toll of restaurant jobs .

"I think the conversation really started around the death of Anthony Bourdain, knowing how important mental health and caring for ourselves was," Hoffman says. "And we were able to kind of have that conversation a little bit."

The death by suicide of the charismatic Bourdain, a celebrity chef and TV star who openly struggled with addiction and mental health troubles, resonated with many restaurant workers.

Bourdain died in mid-2018. Then, Hoffman says, came the pandemic, which helped relaunch tough conversations about the psychological impacts of their jobs: "We were, again, able to say, 'this is something, this is so stressful and scary, and we need to be able to talk about this.'"

Voicing these concerns, she speaks for an entire industry. The Colorado Restaurant Association recently conducted a survey, and a spokesperson says more than 80 percent of its members reported an increase in the stress levels of their staff over the past year. A third of the restaurants fielded requests for mental health services or resources from employees in the past year. More than three out of four restaurants reported a rise in customer aggression towards staff members.

By hiring Flores, Bonanno Concepts is offering an innovative solution to help employees manage the wide variety of stressors, says co-owner Jacqueline Bonanno.

Some of those stressors come from the job itself, but others stem from wider societal problems: "We have a generation of people who have been dealing with mass shooter drills, who have now gone through a pandemic, who were fired en masse from their jobs," she says. "And if, as a society, we can't provide those resources, then maybe as an employer we can."

Denise Mickelsen, a spokeswoman for Colorado's restaurant association, says she's unaware of other restaurants or groups hiring a full-time staffer dedicated to health and wellness. She noted Pomegranate Hospitality, which owns Safta, at the Source Hotel in Denver, has a "director of people and culture" who handles health and wellness issues, and the company also offers an employee assistance program for staff who need mental health counseling.

But a full-time therapist is a new development: "It's fair to call what they're doing fairly unique and/or innovative," says Vanessa Sink, director of media relations for the National Restaurant Association. "It's something that some of the larger chains have been trying, but is not widespread."

Other projects in a similar vein are springing up. One is called Fair Kitchens. It describes itself as a "movement fighting for a more resilient and sustainable foodservice and hospitality industry, calling for change by showing that a healthier culture makes for a healthier business."

Its website says the movement was founded in 2018, "amid growing awareness of the serious wellbeing issue at the heart of foodservice and hospitality." It cited research by Britain-based Unilever Food Solutions that found most chefs were "sleep deprived to the point of exhaustion" and "felt depressed."

Back in Denver, Nikki Perri says she's grateful her employers see workers as more than just anonymous, interchangeable vessels that bring the food and drinks "and actually do care about us and see us as humans. I think that's great. And I think other places should catch up and follow on cue here."

And if that happens, she says, it could be a positive legacy from an otherwise tough time.

This story comes from NPR's health reporting partnership with Colorado Public Radio and KHN (Kaiser Health News).

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