Dozens of Kaiser Permanente mental health workers picketed in San Rafael on Thursday as a regional strike neared the end of its third week.
Nearly 2,000 therapists and other employees represented by the National Union of Healthcare Workers have been on strike since Aug. 15, trying to pressure Kaiser Permanente to increase staffing. The union says staffing is so thin it has made patient care almost impossible, with months-long waits for intake and weeks or months between appointments.
The strikers want a commitment from Kaiser in a new contract to reduce the massive caseloads they say they have been forced to take on.
The picketing in San Rafael was at Kaiser Permanente San Rafael Medical Center on Montecillo Road in Terra Linda.
“Our team is highly understaffed and many clinicians have left Kaiser over the last few years due to the systemic issues,” said Lily Krauss, a Kaiser psychologist who works in San Rafael.
Kaiser has said the labor action is an effort to decrease the time staff spend with patients. But therapists working for Kaiser say they are juggling up to 150 patients, five or six times the number handled by private practitioners.
“By the time you see your patients every six weeks, you just end up spending 30 minutes of your hour just trying to catch up,” said George Pulis, a Kaiser therapist who works in Santa Rosa.
Patients from marginalized communities typically have the hardest time accessing mental health care, said Alexis Petrakis, a child psychologist for Kaiser.
“We do have a large Latino population and Spanish-speaking population, and right now in my clinic, in San Rafael-Petaluma, we don’t have any Spanish-speaking therapists for children and families,” Petrakis said.
She said mental health workers are not given adequate time to get new patient information to begin with, and when they need the help of interpreters, they have to eat even further into that time.
“We have a large exodus of our Black, Indigenous and people-of-color therapists because they’re seeing the inequities and can’t really tolerate it anymore,” Petrakis said.
Of the hundreds of workers who have left Kaiser Permanente statewide, “the No. 1 reason was workload,” Petrakis said.
With access to mental health care dwindling, more and more patients wind up in physical danger, strikers said Thursday.
“When patients can’t get mental health care, you will see a lot of it showing up in our emergency rooms,” said Stephanie Quintana, a Kaiser nurse in San Rafael. “You’re getting suicidal attempts, suicidal ideations, manic episodes — patients could have had this treatment prior but they don’t get any care until it’s reached crisis level for them.”
The staffing shortage is hitting nurses hard. too.
“We go days and shifts on end with no break,” said Colleen Gibbons, also a nurse. “We’ve had one nurse work, I believe, almost 30 days straight with no day off to make sure there’s a nurse taking care of a patient.”
With medical organizations unwilling to hire more professionals, the cost is passed on to taxpayers, with police officers, firefighters and medics fielding increased calls for service “for what’s really a mental health issue,” said Quintana.
A statement by Kaiser Permanente said the union “has deliberately tried to create a crisis in access to mental health care as a bargaining strategy.” The company said it had been close to reaching an agreement on a new contract.
“We know that many patients have elected to forego appointments with alternate care providers and are waiting for their therapist to return to providing care,” the statement said. “We strongly encourage our therapists to consider the impact of their actions on our patients.”
While its own professionals have been on strike, Kaiser has begun reaching deals “with hundreds of community-based mental health providers to open their schedules — for at least two months — to be able to treat more of our patients,” the company said.
“We are grateful and look forward to a continued relationship with them should the union’s open-ended strike go on,” it said.
But with the strike heading towards its fourth week, employees say they have made overtures to resume negotiations and gotten no response from Kaiser.
“We’re dying to get back to work,” Pulis said. “If Kaiser says they are willing to work on these patient care issues, we want to be back to work tomorrow.”
“It is so hard for us as therapists not to be there with our patients right now, and we are thinking about them all the time while on strike,” Krauss said. “We are out there fighting for them, trying to create a mental health care system that better meets our patients’ needs, and hoping that Kaiser will also support their employees with sustainable working conditions.”