Strike against Kaiser is a last resort to protect mental health patients

Mental health workers begain picketing Kaiser Permanente facilities in California Monday, including this one in San Francisco.
Mental health workers begain picketing Kaiser Permanente facilities in California Monday, including this one in San Francisco. Associated Press

Kaiser Permanente is failing its mental health patients.

I see it firsthand every day. I have worked for Kaiser for nearly 22 years, 11 years as a front-line adult psychiatry therapist and the last eight years as a behavioral health education provider, providing therapeutic groups and classes that support psychiatric patients.

Last year, the California Department of Managed Health Care fined Kaiser $4 million for its “serious” and “systemic” understaffing of its Psychiatry Department. Kaiser’s violations of state law continue.

While it is in the process of hiring a small number of new staff in our particular clinic, Kaiser has not hired enough psychologists, social workers and psychiatric nurses. Instead, management has merely shifted its resources, directing staff to see our first-time patients at the expense of returning patients.

My colleagues’ schedules are booked solid for weeks, even months. At Kaiser clinics in the Sacramento area, patients have to wait four to nine weeks between appointments, making effective, ongoing therapy nearly impossible. For patients suffering from depression, anxiety and other debilitating mental conditions, these delays are often insurmountable obstacles.

And the situation is only getting worse.

This year, under the Affordable Care Act, Kaiser’s enrollment has increased by 250,000 in California. Staffing levels are not keeping pace. Withholding services while increasing membership is an effective way to increase profits, but it has led to woefully inadequate care, as well as four class-action lawsuits filed by patients and families who say Kaiser’s violations contributed to tragic outcomes, including suicides.

For more than a decade, Kaiser mental health clinicians have tried to change staffing from within the department. Because Kaiser management has consistently chosen profits over quality mental health care, it has left us no choice.

Kaiser Permanente’s 2,600 California mental health clinicians are going on strike. We have an ethical obligation to advocate for our patients. When our patients are not getting the care they need in our increasingly corporatized healthcare system, it is our job to stand up for them.

We started Monday and will be picketing more than 35 Kaiser facilities statewide, including the Sacramento, South Sacramento and Roseville medical centers.

For four years, Kaiser has stonewalled its patients and caregivers while making a series of blatantly evasive and contradictory statements to journalists covering the crisis. At various times, Kaiser has claimed it had no problems with its mental health services, all its problems have been solved, the problems are common to all health care providers and that it cannot solve its problems because clinicians are standing in the way.

We are eagerly awaiting the follow-up survey from the Department of Managed Health Care that was due more than a year ago. We are desperate for official enforcement of mental health care standards, especially the severe problems with timely return appointments.

Instead of addressing the staffing shortage, a reoccurring theme from Kaiser management is that clinicians need to work more “efficiently,” rather than follow professional guidelines and standards. Meanwhile, our patients are suffering and our staff is exhausted.

Mental health clinicians hate to strike. But Kaiser is letting our patients down every day. Every day we have to apologize and explain why they cannot get the timely, appropriate care they pay for with their monthly premiums and that Kaiser is required by law to provide.

In December, we presented Kaiser with a common-sense solution – clinician-management committees in each facility that can work together to determine adequate staffing levels and outsourcing needs, with help from a neutral, outside expert if the two sides cannot agree. It is a simple and effective solution already in place in other health care systems.

But once again, Kaiser failed to even acknowledge the problem, much less take steps to solve it.

Kaiser’s position as a market leader makes this crisis all the more alarming. As Kaiser goes, the industry goes. With soaring profits, Kaiser needs to step up, take responsibility for its members and lead the way in finally making mental health care a priority in this country.

Ann Amato of Carmichael is a licensed clinical social worker at Kaiser Permanente Sacramento Medical Center and a steward with the National Union of Healthcare Workers.