OAKLAND, Calif. – More than 2,000 striking mental health clinicians picketed outside Kaiser Permanente facilities in Northern California and the Central Valley on the morning of Aug. 29 as they began the third week of a strike demanding the HMO’s massive staff to provide timely mental health care to its millions of enrolled patients.
And on that day, the psychologists, licensed clinical social workers, addiction medicine counselors, and marriage and family counselors who are members of the National Union of Health Workers were joined by dozens of colleagues in Hawaii who face even greater problems with the shortage of staff.
In Northern California and the Central Valley — where Kaiser maintains one clinician for every 2,600 patients — the clinicians’ contract expired last September. In Hawaii, where Kaiser employs one clinician for every 5,500 patients, the HMO has repeatedly stalled negotiations since therapists first formed their union in 2018.
Protesting outside Kaiser’s flagship medical center in Oakland on Monday was licensed clinical social worker Ilana Marcucci-Morris, a member of the NUHW’s negotiating committee, which accepts patients when they first seek mental health care.
Mental health “is a physical health problem. We have to treat it as a physical health issue,” she said. “I’m here to make sure the mental health of the community is here. A multi-billionaire like Kaiser has the resources to do the right thing, so I’m asking them to do just that.
When asked about Kaiser’s claims of a widespread shortage of mental health therapists, Marcucci-Morris said the real shortage is “clinicians willing to work for Kaiser. I have many colleagues and friends that I have worked with through grad school, community mental health, just friendships who need and want a job, but when I suggest Kaiser, they laugh at me, “No way! I will not dig my own grave!’
“There is no shortage of mental health workers, there is a shortage of mental health workers who are willing to accept the working conditions at Kaiser.”
Along the picket line, another clinician noted the long history of the struggle for a truly productive work environment. “We’ve gone on strike many times over the years,” she said. “Really what we’re dealing with on a daily basis is the inability to provide adequate care.” We were trained to do specific treatments to help people heal, and we ended up not being able to see our patients with the consistency necessary for them to receive those treatments as designed.
A longtime but soon-to-be former Kaiser patient marching with the picketing clinicians describes a lifelong struggle with a serious illness requiring extensive treatment. She said she had to pay out of pocket for the only treatment that provided significant relief after receiving mixed and inaccurate messages from Kaiser about its availability.
“I really appreciate everything that therapists and intake people do,” she said, “and I’m deeply moved that they’re not getting paid during this time because they believe in patient care. Now I have another insurance that will support my care a little better.”
A psychologist recounted how she joined the staff of Kaiser Mental Health Clinics about 22 years ago, after years as a university professor, because “the ethos of the corporation and the department I worked in was to be the best place to get care, really trying to improve mental health and health in general. We were the vanguard at Kaiser, doing things on a large, systemic level.”
But later, she said, “when we went into making millions and then billions, I think the whole structure changed, and instead of wanting to be the best, we wanted to make the most money. I don’t think the whole point was to care badly, but definitely anything that would raise funds for us.
Now she said: “People dictate from a business perspective, not from an experience perspective. And I don’t think they respected the people on the line enough.
Under California state law, Kaiser is required to provide timely mental health care to its members even during a strike, a responsibility emphasized before the clinicians’ current action by Mary Watanabe, director of the Division of Managed Health Care, which oversees health care providers. services in the state.
On Aug. 24, DMHC announced it had begun a targeted enforcement action against Kaiser based on patient complaints that the HMO was violating these requirements during the first weeks of the strike.
NUHW President Sal Rosselli said union members are pleased that state officials are “taking a close look” at Kaiser’s illegal denial of care and called for “swift intervention” to enforce the laws.
“The suffering and neglect that Kaiser patients have endured over the past two weeks is unnecessary, illegal, and yet easily remedied,” Rosselli said in a statement. “Kaiser executives must uphold the law, serve patients and end the strike by agreeing to work with us to properly operate and staff the clinics. It is time for Kaiser to respect the importance of mental health care and fundamentally change its approach to how it treats both patients and clinicians.
The next day, the state legislature passed Senate Bill 858, by state Sen. Scott Wiener, D-San Francisco, and sponsored by the state health care consumer advocacy coalition Health Access. If signed by Gov. Gavin Newsom, SB 858 would increase the fines that health care providers must pay for violating mental health equity laws from the current $2,500 to $25,000 per incident.