Mentally Ill Get a Chance

SAN FRANCISCO -- In the eyes of many employers, James Flannery would be damaged goods.

As the lunch rush packs a tiny restaurant here, he stands timidly behind the cash register, dressed in his red apron, fighting off the doubts that he will ever be able to keep all these orders straight. He avoids eye contact, convinced that every stranger is staring at him, laughing at him, assuming that he’s somehow stupid when he knows that he is a very smart person who happens to be mentally ill.

For most of his 33 years, Flannery has suffered from depression. At times, he has lain frozen in bed. The simple act of showing up for work can trigger a debilitating fright.

And so, to rejoin the job force, he has placed his faith in Cafe Phoenix, a bustling eatery that opened last month.

At the Phoenix, almost all of the employees battle mental illnesses -- from delusions and schizophrenia to bipolar disorder to paranoia.

To say the least, Cafe Phoenix is no ordinary restaurant. Workers grapple with their problems under the watchful eyes of counselors while dealing with demanding customers, negotiating kitchen politics and juggling the never-ending flow of orders.

Cafe Phoenix is the newest venture by a Bay Area nonprofit called Hire-Ability, which runs a host of vocational training programs for the mentally ill.

Operating in the agency’s converted cafeteria in a warehouse district south of downtown, the restaurant is open for breakfast and lunch, catering to a mixed working-class and white-collar crowd with such fare as a spicy catfish sandwich for $5.95 and a grilled ham and cheese for a buck less.

The four tables inside and three outside are usually packed, thanks to recent news reports and to the cafe’s nearest competitor’s being blocks away.

The cafe has become a proving ground for workers who are often heavily medicated, but who long to earn paying positions -- and independence.

“This is a chance for me,” Flannery said. “I can show I’m a capable person. But even if I get nervous and mess up, that’s OK; they’re not going to fire me. Around here, they almost kind of expect it.”

Odds against a career comeback once were long for someone like Flannery. Federal studies suggest that the unemployment rate nationwide for people with severe mental illness is nearly 90%. More than 645,000 Californians suffer from “severe and persistent” mental illness, with 100,000 of them so sick that they qualify for state disability benefits, according to the Little Hoover Commission, a watchdog agency that has done two recent studies of the state’s mental health system.

Though state-funded agencies provide programs for an estimated 467,000 of the mentally ill, between 500,000 and 1.7 million more go without services. “When it comes to the mentally ill, the public health system is grossly underfunded,” said Jim Mayer, the Little Hoover Commission’s executive director.

Stepping into the breach are a handful of nonprofits such as Hire-Ability, a subsidiary of Richmond Area Multi-Services, whose programs send a small but steady stream of society’s castoffs back to work. Mayer said: “To assume that the mentally ill are too far gone to be trained is a dangerous and hurtful misunderstanding. Programs like Cafe Phoenix should be the light, to show us what we really can accomplish.”

At the Phoenix, counselors are training the first round of cashiers, busboys and cappuccino-makers. The workers know this may be their last chance to help set their lives straight.

Working alongside Flannery are people such as Mark Tiedtke, 51,a Texas native who one Valentine’s Day checked himself into a hotel and tried to kill himself. He was in a coma for three days. And there’s Allison, who did not want her last name used, a 48-year-old manic-depressive who still doesn’t know what to say when asked “So, what do you do for a living?”

But a job at Cafe Phoenix comes with the support of people like Daniel Michael, Hire-Ability’s director of vocational services. While in college, he started a landscaping business staffed entirely by schizophrenics. His work-study supervisor warned: “You can’t just go around providing mentally unstable people with sharp-bladed instruments.” But the business thrived.

And there’s Onnyx Walker, Hire-Ability’s veteran chef who knows that the drill-sergeant antics employed by most cooks wouldn’t work in this kitchen.

“Doesn’t make much sense to go around yelling and acting like a prima donna,” Walker said, his blue-and-white chef’s hat cocked to the side. “Underneath, these folks are no different than anybody else. The way I see it, we’re all mentally or emotionally challenged at some point in our lives.”

*

James Flannery’s greatest fear is that he will suffer a nervous breakdown in front of his friends.

He worried about it all through high school and during his first year at the University of South Dakota, when his moods began to fluctuate and he became frustrated and angry without ever knowing why. That’s when the Minneapolis native often locked himself in his room for a good cry.

But never in public. “I was afraid I’d look weak,” he said. “I never wanted to lose my cool in front of my friends.”

After his illness forced him to leave school, Flannery moved to San Francisco in 1995 to work in his sister’s catering business. Soon the darkness settled in again. He had a breakdown and eventually, with his sister by his side, checked himself into a psychiatric ward at San Francisco General Hospital.

He was briefly strapped to a gurney against his will. It was a low point in his life, and caused him to avoid institutional treatment. He went on state disability insurance and lived alone, leaving his apartment just once a week to buy food and relying on talk radio as his lifeline to the outside world.

After years, he finally found the right medication. And he found Hire-Ability. For months, he worked in the company warehouse manufacturing small decorative tiles. Slowly, he found his confidence and then, Cafe Phoenix.

There he met Tiedtke, who looks more like a college professor than a newcomer learning how to boil milk to make a cappuccino.

For Tiedtke, success means just having the ability to work again.

“I know that doesn’t sound like a lot to most people, but for me it would be the greatest thing on earth,” he said.

“When I was 15, a psychiatrist told me something that I now realize is so very true. For the mentally ill, work is the best therapy.”

Even before Cafe Phoenix served up its first chicken pesto sandwich, vocational director Michael prepared for the jokes and the insensitive quips like, “You’ve got to be crazy to work there,” or “Waiter, there’s a Prozac in my soup.”

“There’s still the old stigma that these people are all dangerous,” he said. Movies often make their murderers criminally insane, he said, although there are some signs of acceptance of the mentally ill. The new animated film “Finding Nemo,” for example, includes a character wracked by anxiety and an exaggerated fear of the deep ocean and three sharks on a 12-step-type program to quit their addiction to eating fish. “Even a few years ago, that kind of everyday nod to people with emotional problems would have been unthinkable,” he said.

When an employer hesitates to hire the mentally ill, Michael has a word of advice. “I tell them, ‘You’ve already done it. You just didn’t know it.’ ” Then he quotes a U.S. surgeon general’s statistic: that one-fifth of all Americans will have a diagnosed mental illness in their lifetimes. “Mental illness is all around us,” he said.

Before they put on their aprons, Cafe Phoenix workers are trained to deal with difficult customers and how not to fall “into the weeds” -- a restaurant term for getting behind in their tasks. Michael knows there is a chance for a worker to have an emotional lapse. So there is always a psychiatrist -- or at least a counselor -- in the house.

Not all customers know his staff’s personal stories. “I want people to first be happy with their food,” Michael said.

“Then later on we can say, ‘By the way, the money you spend here goes to helping the mentally ill.’ ”

Customers give mixed reviews to the concept. “I advise them to keep their kitchen open so people can see inside,” said software worker Gary Nixon. “I want to see if anyone is wiping the soles of their shoes before making my lunch.”

Countered customer Kristin Groos: “I’ve been here five times and the food is great. I know the philosophy behind the restaurant and I totally support them. But the food comes first, and they’re getting it right.”

Fighting workplace stereotypes against the mentally ill will soon become a national priority. In a program to start in January, employers will be encouraged by federal officials to hire the emotionally disabled.

“The idea is to end the social distancing,” said Ann Arneill-Py, executive officer of the California Mental Health Planning Council. “The public wants to keep a wide berth between themselves and the mentally ill. We’re going to try and make the workplace more accepting.”

For Michael, the solution is simple. “With a restaurant staffed by the physically disabled, people don’t make snap judgments,” he said. “My staff have illnesses like any other and should be treated as such: with honor and respect.”

*

The register is jammed and the man in the backward baseball cap isn’t happy.

“Did you fix it?” he sighs, waiting for change.

“I don’t know,” comes James Flannery’s tentative response

“You don’t know?” the customer snaps.

Flannery watches the man lean close, invading his personal space. This is precisely the kind of person he must politely face up to, to confront his own demons.

“No, I don’t,” he answers softly. “But I’m going to find out.”

The brief exchange is typical of Flannery’s first days on the job. He remakes a latte when a woman complains that she wanted soy milk. He explains to an insistent woman that the cafe has run out of the soup of the day. And no ma’am, the restaurant doesn’t yet accept credit cards.

He knows his medication may slow his handling of even simple tasks. But he recalls the advice from chef Walker “that it might take us a bit longer to serve our customers, but give us a little patience and we’ll get the job done.”

Then six firemen storm the counter. At once, they bark out orders, requiring Flannery to repeat the three types of cheese and choices of sliced bread or rolls. They want separate checks and they peer over his shoulder as he writes out the order ticket.

Only once does Michael have to rescue him. Flannery runs the orders back to Walker, who looks up from his chopping block to offer him a reassuring “Thank you.”

There are no breakdowns, no tears and no loss of face. Flannery might not be ready yet for the big time: a job at a McDonald’s, Starbucks or even a fancy San Francisco restaurant. But he knows he’s one important step closer. “A few times I felt like a complete idiot, like some guy just trying to play cashier,” he says. “But I did it.”

Then a fellow Hire-Ability client walks in. Flannery stands statue-like at the register, his face expressionless.

“James, you know what?” the friend says. “You look good working here. You look real professional.”

Flannery remains silent. But his face beams.