By Sheri Williams
Backed by state politicians, patients and union allies, Kaiser Permanente mental health workers went on strike in August, demanding increased staffing for the overburdened managed care giant.
More than 2,000 members of the National Union of Healthcare Workers (NUHW) took to picket lines across Northern California, including Sacramento, to demand action from Kaiser. The union and outraged patients said that many wait months for therapy sessions and lack the real parity required by law for mental health services.
Those on the picket lines included unionized psychologists, therapists, chemical dependency counselors and social workers.
“Patients are getting ripped off while Kaiser’s coffers are bulging,” said Sal Rosselli, president of the National Union of Healthcare Workers. “We don’t take striking lightly but it’s time to take a stand and make Kaiser spend some of its billions on mental health care.”
Most of the nation’s mental health clinicians are not represented by a union. Rosselli said that lack of representation is one of the reasons mental health care has not attained parity in services.
“Our members plan to use the tools of a union to achieve for their patients the care they deserve and parity required by law,” he said.
The U.S. is experiencing a parallel pandemic to COVID-19 in mental health, the union said. In California and across the nation, even across the globe, a record number of patients are reporting that they are suffering from stress, anxiety and depression.
National survey data shows that the rate of anxiety and depression tripled from 2020 to 2021, while last year the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry declared a “national emergency” over a “shocking” rise in families seeking urgent mental help for their children. Yet as demand has surged at Kaiser, the largest non-profit HMO in the nation and the largest healthcare provider in California, the HMO has responded by making patients wait even longer for one-on-one therapy sessions, according to NUHW.
Lack of funds isn’t the issue. Kaiser reported an $8.1 billion net profit last year. The HMO has a stunning $54 billion in reserves, said NUHW. Yet strikers say Kaiser Permanente refuses to adequately invest in additional staff, take steps to reduce the burnout of current employees, and do what is necessary to bring its mental health clinics into parity with other health services the HMO provides.
In Northern California, Kaiser staffs approximately one full-time equivalent mental health clinician for every 2,600 members. As a result, patients who should receive therapy every week or two weeks are waiting months just to start their therapy regimens, and between four to eight weeks between appointments, in violation of state parity laws and clinical guidelines. Unable to provide ethical care amid unrelenting caseloads, therapists are leaving Kaiser at a record rate.
Kaiser has been fined by state regulators for its lack of mental health care, sued by local prosecutors and is now facing a new state investigation following a sharp rise in patient complaints last year. Kaiser also has failed to comply with a new state law requiring follow-up mental health therapy appointments be provided within 10 business days.
Internal Kaiser documents show that patients who received an initial mental health assessment on June 13 weren’t scheduled for follow-up appointments for a month in San Francisco, more than two months in Sacramento and three months or more in other parts of Northern California.
After a year of contract negotiations in which Kaiser has rejected proposals aimed at increasing staffing and improving access to care, clinicians voted in June to authorize their first ever open-ended strike to compel Kaiser to put an end to its gaping disparity between the care it provides for mental and physical health conditions.
“We’re serving a strike notice because our patients aren’t receiving needed services.” said Shay Loftus, a psychologist in Kaiser’s Napa/Solano region. “We’re not willing to be part of a system that disrespects the work we do and prevents us from providing ethical care. Kaiser has no excuse to continue treating mental health care as a separate and unequal service, and we’re going to keep striking until that changes.”
Many state politicians have voiced support in recent days for the striking workers.
Lt. Gov. Eleni Kounalakis, issued a strong statement in support of the strike, saying that, “I strongly support the National Union of Healthcare Workers and applaud their courageous decision to strike and call attention to the challenges too many Californians face when trying to access much needed mental health services. … Kaiser has a duty to deliver high-quality services to the millions of Californians who rely on their care. I strongly urge Kaiser to work with NUHW and find ways to improve access to mental health services and alleviate the burdens clinicians face as they attempt to treat their patients.”
State Senate President Toni Atkins and Assembly Speaker Anthony Rendon issued a statement commending Kaiser clinicians for “standing up for themselves and the wellbeing of their patients.”
“The decision to strike impacts workers, families, and entire communities—it is not a decision taken lightly,” the statement read.
“The stress, uncertainty, and upheaval of the last two and a half years has taken a toll on all of us, especially young people and people who struggle with mental illness, and has made it abundantly clear how critical our mental health workers are. The psychologists, therapists, social workers, and psychiatric nurses across Kaiser’s Northern California branches have played a central role in caring for patients, saving lives, and supporting our communities—now we have the opportunity to support them in return.
“Kaiser’s reputation for providing accessible, quality care is made possible by the longstanding labor partnerships that have ensured fair wages and benefits for the health care workers responsible for delivering that care. We trust Kaiser will rise to the moment with NUHW to work diligently to come to an agreement that avoids disrupting the mental health delivery system, hurting patients, and alienating essential health care workers,” the statement concluded.