Table 5 Summary of Themes in Focus Group 2 on Stress and Mental Health

Challenges

Emotional distress

Participants described their emotional distress during the COVID-19 pandemic, including feelings of guilt, helplessness, and uncertainty.

“One time I didn’t feel well but I had tested negative so I worked a shift because my symptoms were similar to allergies, lots of sneezing and congestion. For me, it came with a lot of guilt, thinking ‘Oh my god, I just potentially exposed 60 people and a lot of them are old.’ I felt really bad because I made a lot of money while putting 60 people at risk.”

“During the pandemic, there’s this uncertainty like there’s no control over who gets covid and who doesn’t. There’s also no control over who gets vaccination and who doesn’t or who wears a mask and who doesn’t. Because you have no control over pretty much anything except yourself, it causes a lot of stress.”

“Even if I was following all the rules, there were all these people who were not following the rules. So there was very little actually in my control about what was happening to me and my safety. That was probably the biggest drain on my mental health.”

Stressors

Participants described issues that were most stressful for their families, households, and schools in dealing with the pandemic, including staffing, changes in protocols, and constant trauma.

“For cafeteria workers, it was a huge stressor for everyone to adapt to enormous changes at the last minute. The cafeteria staff and the teachers had to pivot from eating in the cafeteria to eating in the classroom when covid protocols came into place. That was a whole new skill set that cafeteria staff had to learn immediately. And there was a short period of flip flopping back and forth.”

“So many people have left the industry during covid, so there are a lot of people now who are being given tasks and roles that maybe they’re not necessarily prepared for. So I think that causes a lot of acute stress at the moment just trying to push the food out.”

“The whole lockdown and pandemic caused trauma because we lost our loved ones and good friends. Then the hurricane hit which was like trauma on top of trauma. So there has been a lot of trauma that hasn’t been addressed or taken care of when people have to go to work just to keep on going in their days as if nothing has happened.”

“There’s a lot of uncertainty among people because you don’t know what you’re going to walk with every night. You could make 60 bucks or you could make 300 bucks. It’s really hard to count on that, so I think financial stress has been a huge source of anxiety for people.”

Mental health difficulties

Most participants strongly agree that substance abuse and addiction are prevalent among food service workers. Anxiety and depression are also described as common mental health issues in the industry.

“The elephant in the room with the service industry is addiction, and that’s the number one biggest mental health issue in the industry. I’m sure we all know people that we’ve worked with who died of a drug overdose. I’m not sure how much of it is self-medication because we don’t have access to mental healthcare but it’s definitely a huge huge problem.”

“I had one patient that his anxiety significantly improved after the vaccine mandates were dropped because that was one of his biggest anxiety producing things, having to do that at the door and having people fight him.”

“For addiction, people use alcohol to numb after a long day a lot of times. You kind of forget about how your body hurts, aches, and pains in the drink and think you can do it again.”

Successes

Financial support

Participants agreed that being financially supported helped to mitigate their stress and support their mental health.

“The fact that the pay rate has increased decently is something that has been better.”

“I worked for a restaurant, and after hurricane Ida, they paid us $250 a day which helped a lot. It was a huge support because I was able to pay my bills and everything.”

“I think the mutual aid that cropped up and is still happening in places was really huge and very affirming.”

Social support

Participants highlighted that the pandemic resulted in more communication, flexibility, and empathy from people.

“I would agree that the pandemic definitely helped some people because some restaurants realized that they need to take better care of their staff.”

“People in general have been more understanding of you. And there has been some flexibility like mental health days.”

“Communication has been a little better just on a day to day basis with people.”

Future Needs

Mental healthcare

Participants express a need for access to mental health services. Participants also agree that support groups or workshops would mitigate stress and mental health issues exacerbated by the pandemic.

“If I could do it, I would love to provide healthcare that is provided through restaurants. ECM access to mental health professionals right now is extremely difficult.”

“I think people would be interested in a program mixture of traditional therapy and urgent care where people could regularly meet but also pop in when they’re dealing with crises. Since telehealth is huge now, it could be helpful too.”

“For people who may experience substance abuse due to stress, I was thinking that support groups could be helpful.”

“It would help if the restaurants would not put a black mark on somebody who needed help in that area [substance abuse] and allow them the dignity to come back to work. I think it’s important that a person can work on something they need without being ostracized and not get their job.”