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Kaiser Permanente mental health clinicians to go on strike starting Monday

“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, said Sal Rosselli, president of the National Union of Healthcare Workers.
2021-11-12 Kaiser Permanente Redwood City hospital 1
Kaiser Permanente Redwood City

More than 2,000 Kaiser Permanente unionized mental health care clinicians across Northern California have announced their intent to strike beginning next week. 

The health care clinicians — consisting of psychologists, therapists, chemical dependency counselors and social workers in Northern California — are striking in response to Kaiser Permanente rejecting their proposals aimed at increasing mental health care staffing and improving access to care, according to a statement from the National Union of Healthcare Workers. 

The union, which represents nearly 2,000 of our mental health professionals in Northern California, said Kaiser mental health patients deal with long wait times, and clinicians have heavy workloads. 

Although the hospital system has a Kaiser medical facility in Redwood City, the union workers plan to picket in the following locations: Fresno Medical Center, Sacramento Medical Center, San Francisco Medical Center and San Jose Medical Center. The strike will begin from 6 a.m. and until 2 p.m. 

“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, said Sal Rosselli, president of the National Union of Healthcare Workers.

"Our members plan to use the tools of a union to achieve for their patients the care they deserve and parity required by law,”  Rosselli added.

Octavia Neal, a decade-long licensed therapist who has been working at Kaiser Redwood City since last year, feels the burden that understaffing has put on both clinicians and patients.

“Sometimes I have to double book patients back to back to back to back,” she said. “I get no breaks, I don’t have space, I don’t have time to breathe because I’m trying to provide that patient care.”

Neal, who feels a deep commitment to her work and her more than 100 patients, often finds herself working 12-hour work days just to keep up with the caseload. In addition to exhaustion, the long hours have become a burden on her home life.

“I have a three year old. So the difficulty is, I'm having to make a lot of choices between, can I be there for my daughter? Can I be there for my patients?” she said. “And that's a really hard place to put me in.”

Kaiser Permanente has been in bargaining with the union since early 2021, said Deb Catsavas, a senior vice president of human resources at Kaiser Permanente, in an emailed statement. The NUHW contract expired back in September of 2021

"We understand that NUHW has announced plans to strike – sadly, a bargaining tactic this union has used every time it has bargained a new contract with Kaiser Permanente, over the past 12 years of its existence," Catsavas said. "We are still in active bargaining and are committed to resolving the issues and reaching an agreement." 

According CalMatters, the number of clinicians that have left Kaiser in the last year has doubled, from 335 to 668. In a survey, 85% of clinicians said they were leaving because they felt that their workload was unsustainable and "they did not have enough time to complete the work." Another 76% said they "were unable to “treat patients in line with standards of care and medical necessity.”

Reflecting on her own experience coming to Kaiser, Neal attributed low staffing levels to extensive hiring processes that can take months to complete. She also worried that the pandemic, along with greater awareness around mental health issues, had increased the demand for care, exacerbating burnout—or “compassion fatigue”—among clinicians.

Since starting at Kaiser, Neal said she’d seen at least one therapist leave each month, often seeking a slower pace and more manageable caseload.

“We’re hearing these stories, these narratives of people really struggling, and that impacts us,” she said. “We got into this field was because we wanted to help people through some of the darkest parts of their lives. And when I can't help you with that, or god forbid, I'm part of the problem, because I can't give you support fast enough—that also impacts the clinicians.”

Additionally, she said, patients have expressed their own frustrations with the system, including difficulty making appointments or accessing the clinicians for individual care when they need it.

“I call it ‘therapist guilt’ when we don’t have space or I can’t make room for a patient just based on my schedule,” she said.

Catsavas said that it was "disappointing that NUHW is asking our dedicated and compassionate employees to walk away from their patients when they need us most."

"We have nothing but appreciation and gratitude for our mental health professionals and the extraordinary care they provide to our members," she said. "We take seriously any threat by NUHW to disrupt care."

Catsavas also said the hospital system would prioritize urgent and emergency care and would continue to provide mental health services in some capacity. 

"Some nonurgent appointments may need to be rescheduled for another day or with another clinician," she said. "Any patient whose appointment may be affected will be contacted directly prior to the date of the appointment to ensure they receive the care needed." 

For the clinicians, however, going on strike is not an easy decision. As working parents, Neal and her husband will have to figure out childcare for their daughter. On top of which, building relationships with patients takes time, and she's worried about leaving them indefinitely.

“To do an open ended strike in mental health is really intense," Neal said. "The type of relationships that we build with our clients or patients—that's not something that someone can just jump in and like take over.”

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