Hundreds of mental health clinicians that are part of the National Union of Healthcare Workers began a several-day strike, as well as lunchtime rallies, at Kaiser Permanente facilities on Monday.
At issue, they say, are staffing levels that they say force patients to wait a month or more for therapy appointments despite a pledge from Kaiser to address understaffing. Kaiser is an integrated health system, which has both a payer arm as well as clinical facilities.
The clinicians said they are seeking more authority from Kaiser to apply professional judgment to treatment decisions, such as the frequency of appointments, and whether individual or group therapy makes more sense. They are also seeking to stop referrals to firms outside Kaiser that contract with private therapists.
According to the union, Kaiser's ratio of mental health clinicians to members has remained unchanged at about 1 full-time equivalent clinician for every 3,000 members. The labor action is planned to last through the week.
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“Access to mental health care is a civil rights issue,” said NUHW President Sal Rosselli in a statement. “This strike is a clear message to Kaiser that its mental health clinicians won’t stand by silently while their patients can’t get the care they need."
According to the NUHW, more than 4,000 mental health clinicians were expected to strike. Additionally, the California Nurses Association and Stationary Engineers Local 39 provided strike sanction to allow their 20,000 members to strike in sympathy.
Former U.S. Rep. Patrick Kennedy, founder of The Kennedy Forum, who launched a campaign earlier this fall urging protests to raise awareness about lingering problems in mental health coverage, planned to participate in the rallies in San Francisco as well as Oakland. It comes a decade after the passage of the Mental Health Parity and Addiction Equity Act of 2008, also known as the Federal Parity Law, which requires insurers to cover illnesses of the brain in the same way they cover ailments elsewhere in the body.
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Kennedy pointed to recent reports from the Centers for Disease Control and Prevention which showed that life expectancy in the U.S. has fallen again due to rising numbers of overdoses and suicides. “Timely access to care is critical. Insurers who subject those with mental health and substance use disorders to a separate and unequal system of care must be held accountable," Kennedy said in a statement.
It comes just more than a year after registered nurses and nurse practitioners protested at Kaiser facilities over staffing levels in emergency departments. In an emailed statement, Kaiser assured patients its facilities would remain open and called the strike "unnecessary."
They said they have been hiring therapists, increasing its staff by more than 500 therapists—or about 30%—since 2015. They said they've spent $175 million to expand mental health care offices in that time.
"It’s particularly disheartening that union leadership would call this strike during the holiday season, when many of our patients with mental health needs may be at their most vulnerable," Kaiser officials said in the statement. "Alongside our therapists, Kaiser Permanente has been on a path to be the best mental health and addiction care program in the nation. The quality of the care we provide has been recognized by the state’s Office of the Patient Advocate, and by national quality organizations. We don’t think there is any other organization that is doing more than we are to make mental health care better in the United States. We are committed to doing even more, to innovate, to advance care, and to continually seek to improve what we do."
Kaiser said the union's principle demands have not been about access. Instead, it has been seeking higher wages and benefits, as well as performance standards which Kaiser said would reduce the availability of mental health care.