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To casual bar and restaurant patrons, the cooks, servers and bartenders they interact with on any given night are largely invisible.

They might notice water glasses refilled, plates removed, a tab placed unobtrusively on the table as the evening wraps up. They don’t see the hectic work environment lived by many in the food service industry: Late nights and unpredictable schedules. Demanding bosses and lack of control. Easy access to alcohol but rarely affordable access to health care.

These realities place food service workers at a higher than average risk for addiction, depression, sleep problems and other health problems — issues that gained prominence after the death of celebrity chef Anthony Bourdain.

Recent studies by the American Journal of Epidemiology and the U.S. Department of Health and Human Services reported that people in the food service and hospitality sectors are at greater risk of mental illness than other industries and have the highest rate of substance abuse disorder.

Sarah Webster Norton and Adam Borgen, two veterans of the Twin Cities service industry, are out to change that.

Serving Those Serving, a nonprofit they started three years ago, connects bar and restaurant employees with free, in-person counseling and other resources to handle problems they might be facing at work and beyond. Earlier this year, the organization partnered with Sand Creek Workplace Wellness, a Stillwater-based company with a network of hundreds of health care providers in the region.

In less than a year, Serving Those Serving has branched out to more than 33 restaurants and 1,100 employees across the state, including Rochester. Their one-of-a-kind partnership has received endorsements from the Minnesota chapter of the National Alliance on Mental Illness, the Minnesota Restaurant Association and Minneapolis Mayor Jacob Frey, an advocate of the city’s food and drink scene.

For Norton — whose profile rose while organizing for paid sick time and tip recognition, along with a higher minimum wage in Minneapolis — the drive was personal. At 43, she has already buried seven friends in the service industry, she said.

“This whole time, I’ve had health insurance, I’ve had access to mental health care,” she said. “And then I’m working side-by-side with people who are working just as hard as I am, who are just as valuable, and they have access to nothing.”

Borgen, 36, a bartender at Smack Shack in Minneapolis’ North Loop, has also witnessed the camaraderie and self-destructive behaviors that often go hand-in-hand in this industry.

“I’m sick of seeing them dying for one reason or the other, whether it’s overdose, addiction struggles or suicide,” he said of people in his social circle. “I’m sick of seeing my friends financially struggle because they can’t manage their cash on hand.”

Struggles among restaurant workers rose to the surface after Bourdain, who detailed the chaotic inner workings of the industry in his book, “Kitchen Confidential,” died from suicide in 2018. To Borgen, his death showed that even the wealthiest and most famous can fall, and that there needs to be somebody helping everyone, “from owner to dishwasher.”

That year, the two partners decided to leave politics behind and focus on creating a social services safety net. Serving Those Serving developed a mission to bring health benefits to an industry they saw had few to offer.

Through a personal connection, Norton was guided to Sand Creek, which offers an “employee assistance program” (EAP) that connects workers with counseling. Serving Those Serving acts as the liaison between them and the member restaurants. (The group also has a running list of resources for other issues common in the industry, including immigration, housing and transportation.)

For an annual fee of $45 per person — which is paid by the employer — workers, their partners and dependents are given four free therapy sessions per issue per year, and a bilingual, 24/7 hotline. Employees have used the EAP for a variety of reasons, Norton said, including addiction, workplace conflicts and financial struggles.

About 4% of employees served by the nonprofit have used Sand Creek’s services so far this year, which is on par with the national average, according to a summary of utilization data. Anxiety and post-traumatic stress disorder are primary reasons food service workers have reached out, with substance abuse being a secondary factor.

Ultimately, Serving Those Serving wants to use that data to push change within the industry, leading to healthier employees, happier customers and more profitable restaurants.

“If you have a successful and mentally sound culture, you’ll have a successful, mentally sound restaurant,” Borgen said. “And if you have a mentally sound restaurant, you will have a mentally sound bottom line.”

Borgen and his colleagues took advantage of Sand Creek’s services after Jon Jacklin, Smack Shack’s director of operations, died suddenly of an aneurysm in February. “He was the guy that everybody went and talked to when they had their problems,” he said.

Within three days, the restaurant partnered with Serving Those Serving and was able to provide loss and grief counseling. Since then, employees have used it to deal with other issues, he said.

Kyle Turner, a bartender at Minneapolis’ Aster Cafe and Jefe Urban Hacienda, said he benefited from the program. After years of bartending, the after-work culture, which included drinking and partying, began to take over his life.

“I was just getting to a point with myself where I just, frankly, didn’t like what I was doing, I didn’t like how I felt,” he said.

Referred by a manager, he called the Sand Creek hotline and received a full month of therapy sessions. The experience was encouraging and stabilizing, and it reminded him of aspects of the job he loved, he said.

He has stopped drinking and hasn’t had to reach out to Sand Creek since — though he keeps their number on his fridge. “It’s a really great tool and there really aren’t any strings attached,” he said.

In early November, Norton and Borgen presented their program at McCoy’s Public House in St. Louis Park. Employees, nearly all of them dressed in black, listened attentively as Norton explained the benefits of Serving Those Serving. Most were cautiously optimistic — if not altogether shocked.

“It’s just too good to be true,” one employee said after learning they would not be billed for the therapy sessions. “I like it.”

Norton agreed. “I see the suspicious look,” she said, to smiles. “I’ve looked at it every other way. It’s not too good to be true. It just is.”

Marty Collins, who owns McCoy’s and NOLO’s Kitchen & Bar in the North Loop, knows that managers aren’t always the best people to help with personal struggles. Serving Those Serving, he said, offers something simple but hard to come by in the industry: someone to talk to.

“Dealing with life is hard and sometimes you can’t rely on friends and family for everything,” he said. “This is what it’s intended for. It’s supposed to be used and it’s not embarrassing at all. It’s life and life is hard and sometimes you need a little bit of help.”

Borgen said they’re not looking to admonish anyone for their behavior. “We’re not trying to change anybody’s life. We want them to know that we’re here when they’re ready to have us,” he said.

Norton said she wishes that, one day, working in bars or restaurants will come with a release valve — and a support system “that doesn’t support toxicity.”

Serving Those Serving has gotten requests from industry representatives in New York City, Austin and Seattle, among other cities, Norton said. She hopes to one day expand nationally, although she wants to see the effort become successful in Minnesota first.

“I’m shocked that nobody else has done this yet,” she said. “I’m not sure why it took a cranky waitress to figure it out, but that’s exactly what it took.”