Podcast: Depression, Addiction, and the Restaurant Industry

The restaurant and hospitality industries are high-paced and high-stress—and have some of the highest rates of mental illness in any field.

Jenn talks to Food & Wine Magazine’s Kat Kinsman, MIDA Boston’s Douglass Williams, and McLean Hospital’s Ipsit Vahia, MD. Together they discuss mental health in the restaurant and hospitality industries, cover ways to recognize crisis in yourself and others, and share methods to have constructive—and productive—conversations about mental health.

Kat Kinsman is senior editor at Food & Wine Magazine, author of “Hi, Anxiety: Life With a Bad Case of Nerves,” host of Food & Wine’s Communal Table podcast, and founder of Chefs With Issues. She is a frequent public speaker on the topics of food and mental health, won a 2020 IACP Award for Personal Essay/Memoir, and has had work included in the 2020 and 2016 editions of The Best American Food Writing.

Douglass Williams earned a degree from The Academy of Culinary Arts at Atlantic Cape Community College. In his culinary explorations, he has traveled through Southeast Asia, working at an entirely sustainable resort in Chumphon as well as Sardinia. Following working in Michelin-starred restaurants in New York and Paris, he opened MIDA, an Italian influenced neighborhood restaurant, in Boston’s South End.

Ipsit Vahia, MD, is a geriatric psychiatrist, clinician, and researcher. He is the associate chief of the Division of Geriatric Psychiatry and director of Digital Psychiatry Translation at McLean Hospital. He is also director of the Technology and Aging Laboratory. Dr. Vahia serves on the American Psychiatric Association (APA) Council on Geriatric Psychiatry and the Geriatric Psychiatry Committee of the American Board of Psychiatry and Neurology.

Relevant Content

Episode Transcript

Jenn: Welcome to Mindful Things.

The Mindful Things podcast is brought to you by the Deconstructing Stigma team at McLean Hospital. You can help us change attitudes about mental health by visiting deconstructingstigma.org. Now on to the show.

Hi folks, and thanks so much for joining, wherever you are and whatever time it is there for “Depression, Addiction, and the Restaurant Industry.” I’m Jenn Kearney, and I’m a digital communications manager for McLean Hospital. And I hope wherever you are, you are having a great day so far.

Before I officially kick the session off, I’m actually going to hand the mic over to Seth Gerber, who has been a major partner in the coordination of the session, to say a few words. So go for it, Seth.

Seth: Yup. Hi everybody. My name is Seth, I’m the founder of RISE Hospitality and partner with Douglass at MIDA restaurants. I’m beyond excited and proud to be involved with today’s event.

Just to introduce RISE, which stands for the Restaurant Initiative for Social Enterprise. It was founded for a very simple reason. There are over 10 million restaurant workers in America that need more out of their jobs.

The restaurant industry needs to change, just plain and simple. And at the center of it is the need to invest directly in the welfare of our employees. We will not flourish until we can cultivate social and financial prosperity as well as mental and physical health for our workers.

And it is the latter that brings us here today, to engage with the medical, mental health community so that we can better understand the blight that depression, addiction and anxiety has on our industry. And more importantly, what we can do in our own rights to participate in the healing process.

So, I offer a huge thank you to the McLean team and Dr. Vahia for engaging with our industry experts, Kat and Douglass. It’s truly an honor, and I hope you all enjoy.

Jenn: Thanks Seth. So, on my behalf, it is an honor to have, and for lack of better term seasoned veterans in the restaurant hospitality and mental health industries with me today. And while I know that many folks in the fields are fully aware, I just want to be completely upfront about this.

There are many crises in these industries happening every single day and from the resiliency and fortitude that chefs, managers, bar keeps and their entire staffs in these industries portray, a member of the public or someone who doesn’t know someone in these industries may not be able to see that there are cracks that are forming under the surfaces of these service roles.

It’s up to all of us then to stop stigma and shed light on what folks are struggling with before it truly is too late. And typically when I run these webinars, I like to introduce guests, but I am so very aware that doing it on the behalf of the folks that I have with me today is not going to reflect their intellect, empathy, and insight into these crises.

So, without further ado, I’d love for you to each take a moment to introduce yourselves and share what’s drawn you to the intersection of mental health and the restaurant industry.

Ipsit: My name is Ipsit Vahia. I’m a psychiatrist. I work primarily with older adults, but I’m also the medical director of the McLean Institute for Technology and Psychiatry.

What’s drawn me to this topic specifically beyond the fact that I’m a regular customer of the restaurant industry is I think because I work with older adults so much, the nature of my work is such that we’re trained to look for mental health issues or crises, or even just symptoms with people that may not be comfortable talking about them, with people that may not even recognize that they’re there.

And I think there’s an interesting parallel there working with the older adult community and working with the restaurant industry, which if anything, skews heavily young.

But I think it’s that process of understanding that a lot of mental health issues lurk in places and among people that may either be unaware or uncomfortable or by virtue of social constructs, that they have no control over, create layers of stigma or an environment where it’s not okay to talk about them, where they feel like they’re just supposed to grin and bear it.

I think that’s an interesting parallel that’s drawn my interest too about this, and I’m deeply honored to be sharing the panel with Seth, Kat and Douglass today.

Kat: Hi. I’m Kat Kinsman, I am senior editor at Food & Wine and author of a book called “Hi, Anxiety: Life with a Bad Case Nerves.” I am so grateful to everyone who made this come together and everybody who is listening to this because it’s so incredibly important that we talk openly about it.

I’m a person who’s had the privilege to be able to be pretty open about my mental health, been mentally ill my whole life. I started getting treatment for depression when I was about 13, 14 years old. I was lucky enough to have parents who saw that there was something not okay with me and got me help at a very early age. And it saved my life.

I make no bones about the fact that I wouldn’t be here had that not happened. And so, it’s always felt kind of like a duty to use that, the privilege that I have as a sort of straight, white cisgender woman who is married and has health insurance and all these systemic factors. If I can’t talk about this, who can, really?

And so I’m a food editor and in the course of that, while I was working at CNN, before I was at Food & Wine, I was working under the umbrella of the lifestyle section. And I had to write about some things other than food. They say, write what you know.

So I had started writing about my own mental health and that of people in various groups out in society and because I’m also a food editor, chefs started talking to me during interviews when usually we would be talking about, whatever dish they were working on or something, when we would take a pause, they would say like, “Hey, can I talk to you about something?”

And that started to happen more than 50% of the time, I started realizing there was really an issue going on here. So, I started a website called “Chefs with Issues” January 1st, 2016. It’s down right now, somebody put malware on it, trying to fix it, but I quickly, quickly realized that this was a massive crisis in the industry.

The month after I started it, people started telling me about suicides in the industry. There were four in the February after the January that I started it. And I was like, that is one per week. And if you start doing the math on that, that is incalculable and unacceptable loss in the industry.

So, I started to basically form a place where people could talk about this stuff online. I started a survey that since I, it was not clinically vetted when I started it, I have since gotten the results clinically vetted. I thought I would maybe get a few dozen responses.

There are thousands of responses to this, that point to the fact that people are suffering, often in silence and they just really needed somewhere safe to talk about it. So, I started a Facebook group as well. And for a while that just had a few hundred people in it.

And then the night of Anthony Bourdain’s suicide, we got 1,200 new members overnight and realized we really, really needed to talk about this. So, I try to provide a platform and a nexus and connection for people who are suffering out there so they know that they don’t have to do it alone.

Douglass: So, thank you for everyone for having me. My name is Douglass Williams. I came into this industry as a very young person, 15 years old and honestly, my first job was... Can everybody hear me okay, first of all? Yeah. Okay.

I was 15 years old and I was like, I need some summer money. And Wendy’s was my choice. I thought their burgers and their nuggets were like spot on. I was like, well, I think I should probably try to work here.

And what happened was, instead of getting money, I really got ignition into the beginning of becoming a man, becoming a professional and learning what a professional is, as opposed to just working.

And once I realized there was a difference and realized there was opportunity with becoming a professional and many gifts that come along with it, mostly for yourself and for a lifetime that don’t go away, I started to read a little more, I started to dive in a little more.

I started to, when you’re around food, you end up being around people that like being around food, whether that’s people that work with you or in your family, and you just find out more and things just kind of come around and you start stirring in that pot.

And a year later, I got Crohn’s disease and that changed my life, again, and put me on a different trajectory, still in food somehow but now it’s leading to a place of not only just eating and cooking and working, but now of actually being able to live a better life based off of what I am ingesting and how I’m ingesting it and how much of it I’m ingesting.

And having that be my perspective and into the rest of the world and how I jumped into Europe and to Asia, then into New York and now obviously into Boston and where that’s taken me. So, I’m happy to be talking about all this and how it all relates and talking to hopefully the 15 or the 18 or the 25 year old me on this cast, so I’m excited.

Jenn: And I think that everything that all of you have provided so far just shows that these, the restaurant and the hospitality industries are so inclusive of folks of all backgrounds, pre-existing conditions, sexual orientations, et cetera.

And even for the handful that are so forthcoming and so transparent, there’s still a substantial amount of stigma that, around mental health. And I know Kat, you yourself mentioned that many are still suffering in silence.

I would love to hear your thoughts about what you think or feel is keeping folks in these industries from reaching out and seeking help.

Kat: Well, folks here who work in restaurants can definitely attest that for a really long time, there had been a mantra to shut up and cook, like leave yourself at the door, leave any part of you at the door and don’t whine, don’t whatever, just like man up and do it in the same way that if you burn your hand, you muscle through, if you get cut, you glue it back together and get back to work.

There’s this tremendous irony about the fact that people who work in restaurants are serving other people and feeding other people and taking really crappy care of themselves and that being valorized.

If somebody, I feel like this attitude is changing because of good folks like Seth and Douglass, but for a very long time, if the person who won was kind of the person who beat themselves into the ground the most, and the people who tended to restaurant work aren’t always the people who came from the most stable backgrounds, whether it’s family, it’s work, it’s addiction issues.

Original restaurant workers were people who had, a lot of times were either coming back from war or coming out of prison and those were the jobs that they could get. And they maybe didn’t have, they weren’t taught self-care along the way, or come from cultures where it is seen as weak somehow to be dealing with mental health issues.

And God forbid you try to talk about it because people would be just like, think you’re a wuss, you would get soundly abused about it even if the person next to you was suffering from the same kind of thing. This sort of macho valorism has been killing people for years and I feel like we’re finally turning that around some.

Jenn: So I’m curious, we had someone write in asking, can we talk about actual protection for restaurant worker jobs? Often there’s a culture of retaliation and silent mantra sometimes, sometimes outspoken mantra of if you don’t like it leave and that can make employees bottle up their feelings for fear of being fired.

Sometimes employees are given the manifest message that we are the most important resource as the employer, but then told on the other side of the coin that everybody’s replaceable. Do any of you have ideas for solutions to this or how to address this?

Douglass: I guess I’ll start. I think it’s about perspective, right? I mean, if you’re in a job, then, if you’re the employee, then technically that job is replaceable, right? So, it’s about how you kind of come into it and, you know, Seth always, we talk daily, and what we always talk about is that we work for our employees essentially.

And that gives us the perspective that, I feel like I’m replaceable as far as the boss, right? All you have to do is say, I don’t want to be here anymore, adios. When you quit a job or when you leave a job based on the conditions or the attitude, whatever it is, just general dislike, location, whatever it is, you have to be in a place that you are ready to leave and it severely disrupts your life.

And not just like, okay, I want to leave. I want to go somewhere else. You have to now change so many things and you don’t get paid for two more weeks. It disrupts financial, disrupts emotional, disrupts everything.

I always want to feel like I owe it to my employees to work hard for them and work hard to be the best that I can be. Instead of telling them be the best they can be, that’s obvious because I’m showing up being who I am and I’m trying to be a representation of what I want out of them.

So, I have to essentially be my own best employee for them in order for them to see what to emulate and what to be like and what to progress towards, whether it’s cook or server. I can carry a tray with the best of them. I can carry three, four plates and do whatever.

I love being the leader in that way and showing what it can be like, showing what it should be like, and also doing it with a smile and doing with general joy and just jubilance. So, I try to bring that every day.

So, hopefully we don’t get to that stage of feeling very disgruntled. Obviously, there’s conditions and there’s things that happen that you ultimately can’t prevent, but you can remedy and you can support and you can bring your best, and your best heart to the situation, but ultimately it will become about timing and what is right for that life stage both for the restaurant and for the employee. But we try to do the best we can. It looks like you have something right on the tip of your tongue. I want to hear that.

Kat: I just wanted to kick a question over to you guys too, because I want to know how much did you have to unlearn from previous places where you had worked?

Because I know it takes this, these attitudes didn’t come from nowhere, they’re handed down. And I would love to know how much of this stuff you’ve had to sort of actively deprogram from yourselves?

Douglass: Is that directed to...does anyone else want to...

Kat: You, Seth, anybody here actually, I’m sure you’ve had stuff too.

Ipsit: This is less of an answer and more of a question. I think one of the things like, in the broader world of mental health, I think there’s a movement towards precision care or personalized care in the sense that one size doesn’t necessarily fit all.

Now, we’ve been talking about the restaurant industry as sort of this monolith, but is it really, I mean, I would imagine that term captures everything from Michelin star restaurants to Starbucks or independent coffee shops.

And I guess my question for you is, does the culture differ depending on where and what kind of restaurant you work in? Is it different than like a McDonald’s versus a restaurant like yours, chef, where there’s more craft and maybe a slightly different culture?

And I did want us to touch on that because I think I’d want us to caution against the idea that the problems are universal and in some places that are much more sophisticated and then a McDonald’s that has high turnover somewhere by a freeway may be a very different culture.

So, I would want us to kind of touch on that, what can be universal and what has to be done on a person to person or restaurant to restaurant basis?

Douglass: Well, I’ll answer the best I can. I think, there’s lots of studies within that or around that, but essentially it comes down to discipline and expectation, right? Not everybody knows going into a restaurant there’s going to be an extreme amount of discipline required, but there is, right?

Anything with a system that you have to work within requires a lot of discipline to work with that, especially if it’s high stress, especially working around nothing but sharp things and fire and timing it’s basically, in a light sense, it’s militaristic and that’s why I think that there’s such a pinch point and a squeeze when it comes down to a certain expectation that it becomes very, very high pressure, bottled up pressure and silent bottled up pressure.

And you have something like that, especially if you already have a little damage inside of you, most people in the restaurant industry do have that. Well, that’s why I got in it, to essentially escape out of normal life and get into something that I can focus on extremely finely and very close zoom.

That’s why I initially ended up falling in love with it, because it was an escape from normal life. And I think, there’s a lot to say, but it basically comes down to a worker’s expectation of what’s expected from them. And I think a lot of those questions don’t get asked in an interview, right?

There’s something called a stage. A stage is essentially a day, a month, a week, sometimes even a year and it’s essentially a cross interview, right? The employee gets to interview their place of employment and the employee gets to interview them essentially in a physical, working, moving fashion and that allows them, my employees to say, “No, I’m all good. I don’t want to be here. Thank you so much. It’s a little too this, a little too that.”

And that’s not for them. And I think that it’s an internal look also, when you’re in the job, when you’re in a place of employment, you have an option. And as an employer, I have less option because it’s almost like a person I don’t get to always choose all my employees. I like everyone that we hire, we always feel like we can change. We always feel like we can grow them.

And someone who has less acumen in this field, they come on and they have the personality of someone we know, a family member, an uncle, a cousin, some part of them we love, even though there’s something that is either broken about them or just not quite put together for this, we feel like we can bring that person together and make them whole, because that’s what it did for me.

And that’s what I think also it did for Seth. And there’s something beautiful about that. It doesn’t always work out and it doesn’t always work in our favor or for that employee’s favor, but we can’t help but try because we’ve seen it for ourselves, but also for so many people that either saw this as a quick summer job or a quick thing to get over.

And there’s a dangerous beauty within the restaurants that I see every day of people that don’t expect to have this as a lifelong profession, but end up rising from back server or bar back to a server and then rising to bartender and rising to manager, which is honestly a lot of what we experienced in our restaurants, especially MIDA, grow from within.

There is nothing, nothing better. It’s like almost seeing a child grow. And it is seeing a child grow actually into someone that they didn’t even know that they were trying to be or trying to develop into and that is what we see in ourselves, but we also see in people across the table from us when they sit down for an interview.

Kat: I think you just named your memoir dangerous beauty right there. I did...

Douglass: Thank you.

Kat: I’d read it, let’s go to my agent right now. I did also want to just bring up the fact that it’s also very different, like front of the house and back of the house sometimes, because when you’re front of house, Seth can speak to this, and I’m point in that direction, because that’s the direction Seth is on my screen, that it’s a different set of muscles too, because you really do have to check your personal day at the door and put on this face and there can be a lot that comes from having to do that.

Jenn: So, I’m curious about, when talking about the differences between front and back of house and having to sometimes put on the mask that everything’s okay, I know a ton of folks in the restaurant and hospitality industries and Ipsit, I’m sure you’ve even seen this in the hospital, so many folks are operating under the premise that resilience is everything, burnout is totally expected and understood, and that if you’re having an off day or you’re just not really feeling like yourself, that that’s more often than not a sign of weakness.

Ipsit, this question is pointed more toward you, but what are the short and long-term mental health implications of these kinds of impressions and precedents that we put on ourselves and how can we try to offset them?

Ipsit: Excellent question. Comes down to culture, doesn’t it? I think the circumstances that you described, grin and bear it or suck it up, or, terrible use of the expression, but if you can’t handle the heat, get out of the kitchen, but there is a choice there.

I think if a place is of that culture, that’s not by accident. It may not be by design, but it may be from neglecting what’s happening or neglecting the culture there. I really like what Douglass said earlier that, you were talking about how you bring people up from the bottom up at MIDA and kind of build your own.

But really what you were talking about was the importance of a supportive relationship and a culture of supportive relationships. Now, this is not unique to MIDA. It’s actually not unique to the restaurant industry.

This is just basic teamwork and basic team management. It’s what we would recommend the course of psychotherapy, that if someone is actually seeing me for depression, one of the things I do is assess what the network is like, where do you live? Are you alone? Do you have family? Where is your family? Are you close to your family? What is the quality of the relationships? Do you have friends?

The past year has seen a sea change in all of this and that we were all forced into isolation. We learned that technology allows us to subvert that, and we’ve since learned the limits of technology-based communication in that after op-eds a year ago, saying the handshake and the hug might be extinct forever, we are finding that that could not be farther from the truth.

All anyone really wants to do is find people that they can hug, right? So personal relationships matter, social support matters. Humans are not solitary by nature. I think this is a cornerstone of treating depression.

I think it’s a cornerstone of interventions, like 12 step programs for addiction, but in the context of environment and networks, it’s a cornerstone of just making sure that there are healthy relationships and support available. This is universal.

I think it applies in a sense more to the restaurant industry or more acutely to the restaurant industry because of the nature of how it works. It is this fast-paced, high stress, almost militaristic environment.

I will say one more thing. I think both Kat and Douglass touched on this without explicitly naming it, but it’s this idea of validation. It’s one thing to work so fast and so hard and get no recognition for it and that you’re a small cog in a large machine and your only job is to serve the machine.

There is no any... I mean, yes, you get a paycheck, but beyond that, there is no reward that validates the effort you put in because you get all of the pain, you put in all of the effort, but do you really get a share of the glory?

And I think environments where each role is celebrated or at least acknowledged, I think are likely to be much healthier, but it’s this issue of the culture of the restaurant, the front of the house or the back of the house.

But this restaurant versus the restaurant down the block or the fast food restaurant across the street. And people that lead it or people that are running the team, I think do have a fairly active role that they can play in controlling some of this. Be it the chef or the owner, everything I know about the structure of restaurants, I learned from reading Anthony Bourdain, so my knowledge maybe...

Douglass: You and me both.

Ipsit: Yeah.

Jenn: So, I know that we have all alluded to the like militaristic style of a restaurant. So when talking about employees of a restaurant, whether it’s a manager, a bus boy, et cetera, how can these folks who are, for lack of better term, in the trenches with one another check in on each other and themselves, what is like the baseline that they can do?

And this question is for anybody, whether you are somebody who’s a seasoned vet of the industry or Ipsit, you are dealing with patients who very well may be members of the industry themselves.

Ipsit: I will just say, I’ll add a quick tip, and it’s something that we’ve been using in our clinical services, because this comes up a lot, there are fortunately conversations happening about mental health.

So I get asked, what can I do? And three words, are you okay? You’d be amazed by how far, just asking that question get, not how are you, not all good, but, are you okay? Because asking that specific question, doesn’t start with the assumption. It’s not a greeting, it’s a question.

It doesn’t start with the assumption that you’re okay. It gives someone the room to say whether or not they are okay, rather than, when you ask, how are you, someone might feel inclined to say I’m fine or respond by asking, how are you.

If we could just make everyone more comfortable with asking that question and realizing that you can give at least a semi honest answer that alone, it’s shocking how important that can be.

Kat: Can I amend that a little bit? A friend taught me to do this and it’s worked so well when people have done it for me and I’ve started using it for other people, are you okay or like, how are you doing and please feel free to give me the real answer and let them know that you’re not gonna run away. That it is okay for them to be their full self in front of you, they don’t have to pretend.

There’s a chef named Patrick Mulvaney in the San Diego area who has developed a really great check-in system at the beginning of shift. They sort of have a triage system of where everybody can kind of check off anonymously, I think or they can use their name with it and let people know how they’re doing in kind of a scale that day.

So, people know that there’s somebody working that day who was in the red zone and they may not know who it is, but they know to maybe take a little bit of extra care that day so people don’t necessarily feel singled out unless they want to be, but there’s just this general attitude of care.

But the fact that that is just baked in is such a huge thing. And he makes sure to have all these resources on the wall about if people don’t feel comfortable or just, free resources that they can use to articulate this, places they can go or steps they can take, or even phrases that they can use to check in with folks.

But you’re absolutely right. That question has saved so many lives. The, are you okay? Just having one person give a damn about you is everything.

Jenn: I think that that’s such an invaluable thing to know, especially Ipsit, it never dawned on me until you said, when you ask somebody how they are, that also serves as a greeting. So people might dismiss it as you just acknowledging their presence and not actually checking in on how they truly are doing.

And I think that, that, I mean, I’m having a mini mind blown moment over here, but thank you for sharing that insight. I did want... We have had a couple questions about substance use, particularly alcohol.

So, I wanted to talk about a lot of folks who are feeling the overwhelm of mental health combined with job stressors can often cope with low-hanging fruit. And for many who are in restaurants, it could be drinking every night after their shift. It could be using drugs or even having drinks while they’re on their shift.

What are some other ways, and this is a question directed at everyone, what are some other ways that folks in these industries could cope, especially if they’re feeling that their stressors are being largely misunderstood by others?

Ipsit: That’s a loaded one, knowing nothing of what happens in kitchens around alcohol first hand, I actually turned it into a question for chef and for Kat or Seth. But would you say that people that run kitchens or run restaurants can pick up on when one of their staff members might be drinking excessively or may have a drinking problem?

Is it possible from where you stand to be able to judge these things accurately or otherwise? It may not be something that’s spoken about, but is it often clear about who may be a heavier or problematic user of alcohol than others?

Douglass: It’s not hard because we’re talking about a very individual basis, but it’s a very broad subject, somewhat specific, but it’s already hard to train and to get someone’s emotional status just on a daily basis, let alone, if there’s something added in, let alone there’s outside things, but I’ll try my best.

Yes, there are some signs, especially the farther you work in this industry and the more years you work, the clearer certain signs become. And it usually has to do with impatience, right? Impatience is, for me, one of the first triggers or consistency or inconsistency, impatience or with patience.

And that is the first thing, that all of a sudden they almost can’t stand the skin they’re in and you start to say certain things or they feel like they revealed, there’s a palatable vulnerability that is now a bubble around them, right?

Usually it’s inside of them and their body and their emotional state is able to protect them and be their shield as we all have. But alcohol, drugs, severe damage, things that kind of come up from past or stress about the future, whether it’s there, whether it’s not there, that starts to surround you.

And that starts to be your reactor. And that starts to be the things that actually start it, starts to be the thing that does your answering for you, right? Or does you’re talking for you or becomes your voice box or not voice box, and that’s how you also know, when there’s not a lot of talking, not a lot of verbiage, not a lot of correspondence.

I’m not an expert on the alcohol substance piece, so I don’t want to speak out of my lane, but I also do have my own set of damage of father being gone, mom being sick early in my life and then passing away, but dealing with that the whole time, and then carrying that with me into adulthood.

So, you can see other people’s damage, but it may not be in the severity of your own, but there are things that you know inside of yourself as a mature man, woman or any gender that we all talk the same language, and if you’re not talking the same language, something’s wrong. If you’re talking the same language and something sounds a little off, you have to step in and just bring your arms around it.

And one thing that you usually do is like, “Hey, you want to go for a drink?” That’s the one, it’s a hard one to untangle. But again, this industry, because it produced so much adrenaline, it doesn’t make you want to go out and eat a wholesome meal after shift.

It doesn’t make you want to, go home and read a book. It makes you want to go out and burn off that stress or try to burn off that stress. And really what you realize after a certain amount of time is you really can’t burn off. You have to do it with things that we have to do with good people around you. You have to do it by talking and by expressing and by going sometimes within.

And that’s also difficult, and sometimes it’s the only way you can do that is by alcohol. So, especially cause there’s nothing open except 7-Eleven and your favorite bar past 11, 12 o’clock, and it’s just a big circle that needs some sort of interjection in, some sort of person to bring you out of that. So, it’s a vicious cycle, for sure.

Kat: Well, again, you with the beautiful damage, like you were saying, and I just, my mind was going, as you were talking about that and something you said, there’s an easy word replacement where you were saying, it’s usually let’s go for a drink. Let’s go for a walk.

I mean, if you say to the person, I’ve seen a lot of friends who are GMs, who are chefs, who are owners or whatever, and even just that leaving the physical surroundings for a minute. I know it’s so hard to leave the line and you feel like you’re really abandoning, but you’re no good on that line if you are not okay in that moment. So sometimes I’d walk around the block.

But I’ve also seen a lot of chefs and other people in, I don’t want to keep talking about chefs because it’s like hospitality wide, but I’ve seen a lot of people who have struggled with alcohol or drugs, or whatever it happens to be, have this big transformation especially over the last few years, there’s really been this sea-change with that, especially, I think a really important marker of that was when Sean Brock started talking really publicly about his sobriety.

But there’s somebody sort of near and dear in Boston, Matt Jennings, who I saw completely reinvented his life and really transformed that thing that drives people who work in restaurants, that adrenaline junkie kind of thing that need to have that intensity.

And this isn’t specific to restaurants, but I’ve seen a lot of people who are addicts, who crave that particular thing, transmute that into something else and go heavy into exercise or things to do with the body.

So, I’ve seen a rise of in restaurants like after work run clubs, or even before shift, basketball or running, or some other physical activity or group yoga or any of these other things. And seeing people do really tremendous things like trading off with a regular, who’s a body worker or a trainer or some other kind of thing, and finding healthier ways to deal with all of that.

And I also want to shout out Ben’s Friends, which is an extraordinary now national organization, specifically dealing with addiction in the hospitality industry. They have, during this time pivoted toward online meetings and they’re just an extraordinary group for, and by people in hospitality.

Ipsit: I got a couple of other factoids though, right? So, we know that at any given point in time that they estimate that only about 5% of people with diagnosable substance use issues are actually in treatment.

So, this goes well beyond the restaurant industry. About 80% of people that may have a substance use issue are in what we call the pre-contemplation or the contemplation stage. There’s a theoretical model that talks about the five stages of behavior change.

The first one is pre-contemplation where there’s not even awareness that there is a problem. Then there’s contemplation where there’s a recognition that there may be a problem, but no will to actually make the change.

Then there’s a stage of preparation which may be finding out resources and things like that. Then there’s the action stage and the maintenance stage. I think the overwhelming majority of people in the restaurant industry are going to be pre-contemplation perhaps, the contemplation stage. So I think setting reasonable expectations is key.

But I keep coming back to this. I think the culture of the environment matters. Kat had brilliant suggestions about simple things that one can do to minimize the day-to-day triggers or the day-to-day burdens that may do this.

But if all you could reasonably aim for industry-wide was to get more people from pre-contemplation into contemplation, which is realize that maybe this is something they should be thinking about. I think that represents a gigantic win and is much harder to do than you might think.

So, I think that’s the right way to think about this, that for all the people, because confronting someone that’s not ready is going to be counterproductive. It may make them feel judged, it may make them leave. Making it more complicated is the fact that in many ways, restaurants are where people go to enjoy a drink, right?

So, there’s an innate paradox between talking about problematic drinking in the place where it’s actually safe to drink. And a lot of the culture of alcohol comes from restaurants. And the elevation of the culture of alcohol comes from sommeliers and mixologists and things like that.

So, I think the bar needs to be set low as far as expectation goes, that we aren’t in fact going to change this overnight. But if you can acknowledge the fact that maybe people need to pay attention to how much they’re drinking, that’s all, I think that’s a big win.

Jenn: I think your remarks about pre-contemplation are super valuable because my next question is about, it’s a lot of things bundled into one, and it’s a question for any of you to answer.

So, I was doing a lot of research prior to the session and the amount of things that are common in these industries was really surprising to me, probably not for folks who are a part of it, but the list includes, but is not limited to sexual harassment, depression, anxiety, imposter syndrome, substance use, attempted suicide, successful suicide, these are all commonplace.

So in your opinions, whether it’s in the restaurant or mental health fields, do you all feel like these industries are in the middle of a mental health epidemic? And if so, what do you think we should do to start addressing it? Do we take it bite by bite? Do we do it all at once? Or is it some sort of amalgamation of the two?

Ipsit: I think the whole world is in the middle of a mental health epidemic. We’ve known that’s a cute sound bite, but it wasn’t intended to be. We know that the past year represents the sort of global, like we’ve never seen anything like this, even when we’ve had things like world wars, it hasn’t actually impacted directly every individual on the planet.

The last pandemic, maybe the last time we’ve seen something on this scale and because the world was a less complicated place, it wasn’t quite as disruptive, right? So, it would not be a stretch to say that no one is quite okay. And if someone pushes back on this, I will debate them.

You know who amongst us hasn’t had times when you’re feeling out of it or languishing, that’s the now word for it when you’re otherwise well rested and secure, like there is no economic uncertainty, your job is okay, you’re making money, the kids are fine, you’re sleeping okay, you’re in good health, but you don’t feel like you should.

I think that’s a subtle form of the fact that a stressor like this over a year and a half takes its toll. I think we need to, first of all, just step back and say, yes, that I am probably, I have some healing to do. And no one is exempt. I think that there are definitely degrees, but no one is exempt.

Trauma and grief, even if you’ve not lost a loved one, it’s the fact that life as you knew it may be gone and it may or may not come back the way it used to be. So incredible stress. So I think that certainly everyone is suffering from mental health challenges.

Now that’s not the same as saying everyone has mental illness, that though these two are not the same thing, but I think everyone’s mental health is stressed.

Now, in places like the restaurant industry, for all of the reasons we’ve talked about, where there’s other older forces mixing with this, I think it’s safe to assume that the burdens and the fallout may be felt more acutely, seen more acutely.

I also felt as though of all the areas that have been disrupted, we’ve talked about the restaurant industry a little bit more lately. This is a good thing, because I think we’ve realized without meaning to how essential it is to a sense of normalcy.

I feel like we gauged how well a city or a town or a country was doing based on whether it was okay to go to a restaurant or not, like that’s been the barometer. Like when outdoor dining opened up in Boston in April, everyone seemed to feel a little bit better because yeah, now you can go.

So, I think it’s a little bit more visible. I think it’s valued to our fundamental sense of normalcy and wellbeing has been recognized. It’s also why mental health challenges, we’re having this session and we’re not talking about the aerospace industry, or I don’t know, the financial industry though we could, it’s because there’s a little more valence to eating out in everyone’s day-to-day lives than there is from some other things.

So, if you’re talking about these issues in the context of the restaurant industry kind of spreads and gets us to think across the spectrum about mental health in the workplace or personal mental health and how it interacts with professional lives, I think that’s a really good way to think about it.

So, no pressure whatsoever on Kat, Seth and Douglass, but I think you guys are playing a role in shaping a much broader conversation than any of us may fully appreciate at the moment.

Kat: I think we just both give a damn and are tired of seeing people suffer who we love. And the single best thing that I did for myself in the past few years was to train as a crisis counselor with Crisis Text Line, and it’s 30 some hours of training. And then you can go in and do the volunteer shifts as you want, but it gave me a vocabulary.

And I mentioned this because that’s the thing we all need, the American culture, and I know a lot of cultures worldwide are notoriously really crappy at talking about mental health. We just don’t have a vocabulary for it.

We are not taught that, we’re taught the vocabulary of shame or the words crazy and saying all of these kinds of things that are just part of how we are taught to speak.

And we are not taught to ask people these questions about, how they’re doing and to be prepared to have the real answer and to have somebody prepared to give you an answer that might be painful to you and being afraid that you’re going to give the wrong answer and if there were more of a standardized mental health first aid, I know it exists disparately in all different cities.

And I know Seth is actually working on some incredible educational stuff for the hospitality industry that I think is going to be a game changer. But I think it’s really, really important if, and I know there’s various entities working on it FairKitchens from Unilever has done a bang up job, working on a lot of resources for that.

But if that could be part of hospitality training and yeah, just training in general, where we all know how to look for signs or all have phrases we can use, sort of flow charts of what to do, like they taught us for risk assessment as crisis counselors, I think we would all be in an infinitely better state.

Jenn: We had a couple of folks write in asking about how folks are feeling as employees of the restaurant industry post pandemic or on the tail end of the pandemic. More specifically, how can folks who are employed by the restaurant industry that are dealing with customers that are not taking into account, what restaurants are going through, how can they keep that from impacting their mental health?

Kat: Seth, you wrote an article about that.

Seth: Yeah, I don’t want to eclipse the panelists, but I do feel I have to chime in real, real quick. I just think it’s one of the biggest obstacles that we have. I don’t want to call it an issue because I don’t think that it’s a us against them thing, but I think it’s up to management and ownership to be the shield that protects their staff and get in front of the issues and support.

Jenn: And I believe the next question is geared more toward Ipsit. Would you say that the changing schedules and oftentimes very late night shifts can contribute to mental health issues for hospitality workers? And if so, do you have any advice on how to navigate that additional circadian rhythm challenge?

Ipsit: Well, that’s a good one. So yes, of course. I think we know just as a rule of thumb that routine and some sort of regularity of schedule and especially regularity of sleep are important. Sleep especially, I think the importance of it can’t be overstated, if it’s just putting my researcher hat on.

Disruptions in sleep are actually markers of depression, of anxiety, certainly impacted by substance use. And later down the lifespan, there’s reason to believe that poor sleep earlier in life may even be a risk factor for things like Alzheimer’s disease.

So, just as good general health advice, I think regular steady sleep matters. In the restaurant industry, probably varies from place to place, but yes, if it’s working till 5:00 PM on one evening and then midnight on another evening, that doesn’t let sleep settle, is it likely to be a risk factor? Absolutely.

You can compensate for it to some extent by making sure that at least there are seven to eight hours of sleep within a 24-hour window, that may or may not always be possible. If we were to do a full blown scientific study, we would find, I think, that the burden of things like depression and fatigue is highest in people with the most disrupted schedules.

If there was alcohol use layered on top of that, that complicates things further. So, I think when we say that this is a population with a higher burden of risk factors than the average non restaurant worker, that’s an accurate statement.

I don’t off the top of my head, know of anyone that’s actually studied this, but you don’t always need data to tell you what’s obvious intuitively. Can you protect against this? That’s a question for your specific ownership or front of house person, the people that make the schedules.

I think to the extent that there can be some steadiness, I think it would help, but there are so many factors that go into making such a decision, right? I think mental health and overall wellbeing, one of, being one of them, but if it can be elevated on the list of priorities, I think that would be a good thing. It would certainly help people.

Jenn: And I know we are bumping up just against the hour. So, before I get to the last question, I just want to say, thank you all so much for joining.

I can’t tell you how valuable the session has been, not just for me, but I’m sure for everybody who’s been tuning in, but I’d love to hear from each of you in 60 seconds or so, what can we do to address our own mental health and the mental health of those around us, whether or not we are members of the restaurant industry?

Ipsit: Oh, I could take another hour answering that question. But I think at this moment in time, we keep it simple. Let’s start with acknowledge that your mental health matters, mental health in general matters.

And as you’ve probably felt on some mornings where you’re not feeling quite like yourself, I think acknowledging it to yourself, but also acknowledging it to other people and maybe lowering your expectations, just a tad could go a very long way.

When it comes to the restaurant industry, I think realize that a server isn’t a server. They’re a person, don’t take your bad day out on them. A little kindness may also go a very, very long way.

Jenn: Alright, Kat, you were nodding so vehemently that you are up next.

Kat: Oh my God. Seeing the humanity of people is huge. I want to shout out a person who I see in the attendees list here, Melinda Dorn, who runs an incredible group called CHOW in Colorado and they really, really take care of the industry and I’m so grateful for everything that they do.

So I would say breathe, first of all, give yourself the luxury of breathing. When is the last time that you, unless you meditate every day, like I have learned to do, to manage my own mental health. It’s giving yourself the luxury of stopping, rooting yourself to the ground and taking some really deliberate breaths in and out can just do absolute wonders for it.

Ipsit, probably knows the biological reasons for that better than I do, but it’s an incredibly grounding thing. And it’s something that you can do and nobody will notice, even if you’re in a crowd, even if you’re on the line, you can do that and it’s such a great way of placing yourself in your body.

Second, I would say, go into the walk-in at your restaurant or whatever counts as the walk-in in your life and scream, scream from your stomach so you don’t hurt your throat. And it is one of the most healing things you can possibly do to release tension and emotion in a non-harmful way, unless you are screaming from your throat again, do not do that.

And it can also be a really incredibly powerful thing to do with a group of people who you all need to let your stuff out and just take a moment, bellow from the bottom of your stomach and let that all go.

Douglass: I’m a second that on, on the letting go part. And also, for me, the letting go is a big part and that’s half of the baggage that we all, at least in the restaurant industry have, which is why we love to please people.

And while we love to give back and do that, and when we don’t do a good job, we feel terrible about it. When we do a good job, we also still, sometimes we feel better about it but we still feel a little bit bad. I don’t know why that is, but that’s just, we’re weird. Weird is good, in my opinion.

But I also feel like, for me, it was like, I was kind of fed up. Like sometimes it takes you to be fed up to do certain things in life. And I was sick of being a little high tension or high stress. And even though I come off as calm and cool I am, but I also hold onto a lot of stuff.

And I hold on to things that I don’t even have control over, that I don’t even have a decision on, that are in the past, that are done, that are book closed, never coming back again but I still hold on.

There’s regret, there’s all sorts of stupid, those little tidbits that carry on into adulthood and into professional life, no matter how successful you are, no matter what level you’re at, no matter how much money you make, it doesn’t matter, it always comes along.

And if you can just let a lot of those go, that has been one of the biggest healing tools in my progression as from a little tiny cook to someone who’s trying to have more influence and put more structure into his own industry.

And that has been the biggest thing is to follow on Kat’s point is by letting go and developing and progressing yourself as a person and as a professional.

Jenn: Wow, I cannot believe how much information you all have given us over the last hour plus. So thank you so much. I am humbled, I’m inspired, I’m blown away. And for our folks who work in such selfless industries, it’s so important that you’ve all shown us that looking after yourself is not a selfish act. And I think that that is a major takeaway we can all take from today.

So to all of you joining, thank you so much. This concludes our session. Huge thanks to Dr. Vahia, Kat Kinsman, Douglass Williams, Seth Gerber, RISE Hospitality, the MIDA Boston team, Food & Wine Magazine, deep tremendous thank you.

Until next time, be nice to one another, but most importantly, be nice to yourself. Thank you again and take care.

Thanks for tuning in to Mindful Things! Please subscribe to us and rate us on iTunes, Spotify, or wherever you listen to podcasts.

Don’t forget, mental health is everyone’s responsibility. If you or a loved one are in crisis, the Samaritans are available 24 hours a day at 877.870.4673. Again, that’s 877.870.4673.

- - -

The McLean Hospital podcast Mindful Things is intended to provide general information and to help listeners learn about mental health, educational opportunities, and research initiatives. This podcast is not an attempt to practice medicine or to provide specific medical advice.

© 2022 McLean Hospital. All Rights Reserved.