โ€œOh hey, I threw up in the bathroom.”

“I donโ€™t know how many times I’ve said that,โ€ confesses Jarboe, a barista trainer who has depression and anxiety. Heโ€™s referencing the moments heโ€™s had bad panic attacks on bar, but didnโ€™t feel like he could be honest about them. His vomit excuse isn’t real, he says, but in the moment isย “the only thing I know thatโ€™s going to get me out of this bar shift right now,โ€ he says.

Jarboe describes the feelings that overcome him as โ€œa lot of dread. A lot of feeling like Iโ€™m going insane.โ€ The worst part of it is, he says, is that you have to smile through the panic attack, lestย the customer complain about poor service. โ€œYou just have to live in it. Your heart is going to be racing, youโ€™re going to have terrible thoughts, and thatโ€™s just how itโ€™s going to be,โ€ he says.

Examining mental health in the workplace is not new. However, in the service industry in particular, the amount of emotional labor performed in a high-stress environment can make for a devastating, perfect storm that affects oneโ€™s health. One Substance Abuse and Mental Health Services Administration study found workers in the accommodations and food services industry to have the highest rate of substance abuse at 17%, compared to a national average of 9%. Another informal industry survey found that 84.8% of restaurant managers and kitchen staff reportย depression, 72.9% reportย anxiety, and 50% reportย substance abuse issues.

Dr. Maelisa Hall, licensed psychologist and owner ofย Hall Counseling Groupย in Irvine, California, specializes in workplace stress.ย โ€œDealing with people is one of the most stressful things you can do,โ€ she says. โ€œIf youโ€™re focused on customer service, a lot of how your day goes might depend on interactions you have with people throughout the day.โ€

Yet, the discussion of mental health in the specialty coffee workplace remainsย a rare occurrence.

A 2013 Sprudge survey on coffee professionalsโ€™ health revealed that 44% felt that their job was emotionally draining. Last year, Talor Browne surveyed coffee professionals for her Tamper Tantrum presentation, โ€œCoffee, I love you but youโ€™re bringing me downโ€ and found that 66% had anxiety related to their job, while 61% dealt with persistent high stress.

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Cameron*, a coffee professional who was diagnosed with bipolar disorder, borderline personality disorder, and anxiety, finds that โ€œthereโ€™s a lot of emotional labor thatโ€™s involved in working on bar.โ€ Getting through a bar shift and talking to people can be โ€œenormously difficult,โ€ often directly impacting interactions. They said, โ€œIโ€™ve had a lot of miscommunications with people who think youโ€™re being rude, standoffish, or plain bitchy.โ€

Despite one in four people being affected by a mental or neurological disorder at some point in their lives, the stigma surrounding talking about mental health is still real and can cause a disruption in oneโ€™s career.ย For those in marginalized communities, culture can play an additional role, too. One study found that young adult blacks with higher education were less likely to seek out help. Another study found that social stigma and shame prevented Asian-American immigrants from seeking help.ย Within groups like these that are underrepresented in contemporary American coffee bars, it stands to reason that seeking help may be even more difficult than it already is.

Sharon*, a coffee professional who was diagnosed with clinical depression and bipolar disorder, found that her โ€œfirst real encounter with protecting myself and standing up for myself” got her fired. After she revealed to her employer that she had had, and been successfully treated for, bipolar disorder, she says the cafe ownerย became very withdrawn and Sharonย was later let go via a phone call.

Uncompromising employers, workplace harassment, and poor communication can all affect oneโ€™s well-being. After being sexually harassed and stalked at her workplace, Megan, a lead barista, found herself โ€œphysically unable to go to work without having panic attacks.โ€ Her manager brushed off her anxiety and she ended up leaving the job.

In the last few years, Megan has learned to look for supportive workplace environments. โ€œPeople need to feel more comfortable about having bad days,โ€ she says. As part of her job, she notices when baristas arenโ€™t performing at their best. Sometimes, sheโ€™ll ask them to take a short break. โ€œItโ€™s better to take a break than to continue to mess something up because they canโ€™t focus on the task in front of them.โ€ She says, โ€œJust because somebodyโ€™s at work doesnโ€™t mean the problems go away.โ€

Even if an employer does not offer mental health care, there are still many ways that a business owner can show support for understanding mental health. Noma Bruton, human resources consultant and founder of Sagacity HRย in Costa Mesa, California, recommends education and training first. She says, โ€œFor a business owner to make the effort to educate themselves about this issue, is not only the right human thing to doโ€”the kind human thing to doโ€”but itโ€™s going to help their business.โ€

Major mental disorders cost American businesses at least $193 billion annually in lost earnings. In a small business like a specialty coffee shop, this canย play out as missed shiftsย or lower productivity levels.

Bruton says the issue is oftentimes the employer doesnโ€™t know whatโ€™s hurting them. โ€œThey can see people working for them who are not as productive as they wish they would be,โ€ she says. โ€œBut they donโ€™t know what the problem is so they donโ€™t know how to deal with the problem.โ€

Bruton calls the nationally offered Mental Health First Aid program โ€œCPR for the mind.โ€ Supporting awareness programs like Mental Health Month can also be a clear signal that you care about your employees’ wellness.

Outside of formal trainings and offering Employeeย Assistance Programs (EAPs), inviting a mental health professional to come in for a talk, providing information about free screenings, andย wrapping stress management training into standard training programs encourages anย open conversationย about mental health.

Sharon says that while she hasnโ€™t worked forย any employers with official mental health policies in place, she recalls a roasting position where her manager understood โ€œwithout making a big deal out of it.โ€ She was given a flexible roasting schedule and told, โ€œโ€˜as long as the roasting gets done for when it needs to be done, I donโ€™t care when you do it.โ€™โ€

Dr. Hall recommends a focus on finding your own self-care routine and encouraging others to do the same. โ€œMake sure youโ€™ve really taken care of all your physical needs before going to work,โ€ she says. Especially for shift work, establishing a wake-up and bedtime routine can help with maintaining consistency. During breaks, she recommends a few minutes of meditation or refocus on positive thoughts.

But theย best approach to breaking the stigma about mental health in the workplace is talking about it more. Jarboe callsย for more honesty on workplace struggles. Allowing colleagues to say “hey, Iโ€™m struggling today,” and not look down on them, he says,ย is a step in the right direction.

May is National Mental Health Month. If you are struggling with thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 in the United States.

*Names with asterisks have been changed for privacy

Jenn Chenย (@TheJennChen)ย is a San Francisco-based coffee marketer, writer, and photographer. Read more Jenn Chen on Sprudge.

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