If you live in California, chances are you or someone you know is on a Kaiser Permanente health insurance plan (hey, you sort of know me, and I have Kaiser). Kaiser is well-known in many parts of the country for its reliable, quality integrated health care. In particular, they are seen as highly focused on preventive care. At least when it comes to immunizations, screenings, and other physical health preventive measures (but more on that later).
By contrast, you may have heard recently that things have not been going so well in Kaiser’s Psychiatry Department: throughout the state of California, Kaiser's 4,000 mental health professionals had been gearing up to go on a big strike due to rising concerns about patient and worker well-being. In mid-December last year, they did go on strike (for five days) for the same reasons. Six months later, they were still feeling Kaiser had not met their demands.
Two days ago, I learned some good news (or not, depending on how you look at it): the mental health worker strike that was planned to begin yesterday was called off. Based on recent negotiations with the large health consortium over the past several weeks, mental health staff announced over the weekend that they decided against the strike that all were expecting.
My guess, however, is that your Kaiser therapist is still pretty pissed off. So what’s been going on?
For years at Kaiser, mental health professionals have been concerned about understaffing and overburdened working conditions. The main impact of this is that patients often face long waiting times—from weeks, to months—before they get an initial or recurring appointment. Understandably, the clinicians find this unacceptable for quality patient care. In addition, staff cite being overscheduled, working through lunch breaks, and having inadequate crisis support.
According to the National Union of Healthcare Workers, which represents Kaiser mental health workers, Kaiser has recently acknowledged its mental health care crisis and proposed collaborative solutions that suggest the company is open to change. For the well-being of their patients, workers decided to no longer strike, but NUHW also reports that Kaiser has not agreed to sit down with them to negotiate their most recent set of demands (including the creation of crisis relief teams). This indicates that while things may be on pause for now, the fight is far from over.
To me, the issue of Kaiser patients having to wait forever before seeing a therapist is one of access. Imagine you are having trouble connecting with or accepting mental health services in the first place, as many people struggling with mental health and/or coming from underserved communities do. Having to wait and jump through hoops just to see your clinician can be the tipping point for deciding to give up on the idea completely. If you are in an acute crisis—such as having active suicidal thoughts or experiencing a psychotic episode—you are probably more likely to get immediate help. But this is only assuming you are able to clearly communicate important information on your crisis, a task I see as difficult not only for any person in crisis, but especially for someone from an underserved community who may not have the appropriate resources to communicate their problem. What’s more, preventive and maintenance services, not just treatment and crisis services, are crucial to averting one’s breaking point to begin with—it is troublesome to me that Kaiser does not extend its championed preventive health care model to its behavioral health side.
Finally, as a mental health clinician myself, I find it problematic when the systems in which those of us in the “helping professions” work essentially force us to limit our own self-care in order to do our jobs. It’s easy to see how systemic problems lead to staff burnout and the inability to provide good care to our patients and clients. When society doesn’t care for our helping professionals, everyone suffers.
As a society, we need to look out for those who need mental health services. We especially need to look out for those in underserved communities. And we need to look out for our mental health professionals.
I’m grateful to my fellow social workers, clinicians, and community members who continue to push for these goals. Even though the Kaiser strike was called off yesterday, advocates for mental health parity and adequate mental health services will literally be rallying in Sacramento and LA today. I support them.
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