Occupational Hazard is a series about how different jobs affect workers' mental health.
Standing before a corpse, Laura Hardin, 29, began the embalming procedure as she had done hundreds of times over the past six years. One: Wash the body in disinfectant. Two: Create an incision in the artery. Three: Replace blood with chemicals. Four: Drain the organs. Five: Set the features; use two plastic "eye caps" to secure the eyelids in place.
But in March 2016, panic attacks began to interrupt Hardin's methodical routine. Within a week, she was experiencing a panic attack every hour. "I felt like I was having a seizure," Hardin recalls. "It was like I was in a dream. I was losing reality."
With the responsibility of embalming around five bodies a day at a family-owned mortuary chain in California, Hardin was feeling extremely overwhelmed. She turned to her primary-care physician for answers. At the end of the visit, the doctor told Hardin that her line of work might be the cause of her sudden anxiety.
In a field centered on caring for the deceased and their bereaved families, the mental health of the death care professional is seldom considered. With long hours, unpredictable workweeks, and emotional demands, funeral directors are continuously exposed to significant psychological stressors.
A funeral director, also referred to as an undertaker or mortician, is a professional in the death care industry involved in the business of funeral rites. In addition to the planning and arrangement of a funeral service, funeral directors' tasks often include embalming and cremation. Hardin chose to specialize in embalming bodies rather than planning funeral logistics.
This high level of stress and anxiety commonly reported among caregivers is also known as "compassion fatigue," or CF. Hardin said she'd heard it called "funeral director fatigue" in mortuary school. CF is an emotional and physical exhaustion that affects helping professionals over time, says Charles Figley, a professor and distinguished chair in disaster mental health at Tulane University and co-founder of the Society for Traumatic Stress Studies. Figley, who coined the term, associates CF with higher rates of depression and anxiety disorders, rising rates of stress leave, and degradation in the workplace.
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A 2006 study in the American Journal of Orthopsychiatry found that CF is directly correlated to workplace environment, rather than negative life events or personal trauma. But as Hardin thought about her doctor's diagnosis, she realized it wasn't the dead causing her anxiety—it was the living.
Hardin never once attributed the sight of a dead body to her anxiety; instead she believes the onset of her CF was a result of long hours and demanding expectations. Although her schedule was supposed to be from 8 AM to 5 PM, Hardin typically started work an hour early, worked through lunch, and left around 6 PM.
While the preparation of a regular case takes about one to two hours, an autopsied decedent can take up to four hours, and an organ donor can take up to eight hours. In addition to embalming bodies, she was also responsible for dressing, cosmetizing, and casketing the decedents. But the duties didn't stop there.
Hardin also had to oversee the identification of the decedents, as well as remove of any medical devices before cremation. Driving to the casket warehouse and regular cleaning of coolers was yet another responsibility.
"You become a martyr," she says. "You're expected by the managers and owners not to tend to your own issues." As one of two employees embalming around 3,000 bodies a year, Hardin grew extremely stressed. Within her two years at the care center, she claims she never got a break.
"In the industry, there's this culture where workers feel they need to suppress their own feelings," says Alan Creedy, former chairman of the Funeral Service Foundation. "You have to walk that narrow line of being a vendor and a caregiver, simultaneously."
Hardin was far from the only employee who felt the impact of CF. One co-worker unraveled before her eyes. "He became so stressed out from work that he crashed one of the company vehicles," she recalls. "I was watching the same thing beginning to happen with me happening with him."
Alexandra Mosca, a funeral director for almost 35 years in Queens, New York, believes many are unaware of the emotional drain that comes with working in the industry. "People need to realize how this work gets to us," she says. "We see awful things, things I wish I hadn't seen in my lifetime."
While many funeral homes offer grief and support services to their clients, very few offer these programs to employees. "This is an area where it's not encouraged to express one's feelings," Creedy says. "Just like soldiers coming back from a war, they're not really supposed to be affected, but they are. We all know they are."
Although Hardin grew aware of what was happening to her, she found it nearly impossible to bring up her anxieties for fear of losing her job. "If you start to visibly express mental health issues, [funeral owners] look at you like you're a liability," she says. "They start to tell you maybe you're not cut out for this work."
Another characteristic of CF is an inability to separate your personal life from your professional role. For those in the funeral industry, this boundary is blurry. Many funeral directors are on call 24/7, receiving calls and texts about the deceased even after they leave work.
After realizing that her job was hurting her personal relationships, Hardin put in her two weeks' notice. She's now an independent contractor working as a trade embalmer. Many mortuaries no longer hire full-time embalmers thanks to a rise in cremation rates, so Hardin embalms bodies in-house for several mortuaries for a flat fee. She's now her own boss and determines her hours.
Now that she's finally able to separate herself from her work, Hardin hopes people's opinions of funeral owners will soon change. "We aren't just robots churning out funeral services," she says. "We're humans."
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