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Reflecting on the longest ever mental health strike

This month marked the one year anniversary of the settlement that ended the longest strike by behavioral healthcare workers in U.S. history. For 172 days, NUHW-represented providers for Kaiser Permanente walked picket lines to demand a first contract that improved conditions for themselves and their patients.

While Kaiser found itself under intense political and public pressure to end a simultaneous strike by therapists in Northern California where it’s the largest private provider of mental health care, the giant HMO faced less pressure in Hawaii, where it’s not the largest operator. But Kaiser executives weren’t counting on the resolve and determination of the NUHW members who held out for six months until they got a first contract that preserved pensions, raised wages and set forth rules that managers could no longer violate.

Below is a Q&A with Rachel Kaya, a psychologist for Kaiser on Maui, reflecting on the strike. The interview has been edited for length and clarity.

Q: How were you feeling when you went on strike in August of 2022?

A: Determined and scared. We were all angry at Kaiser for being such a bad employer, and anger is a great driver of energy.

Q: Why were you ready to strike?

A: Because my patients are worth it. It’s always been about providing the kind of professional treatment that I was trained to do and that my patients deserve. Maui is a tight-knit community. These are our aunties and neighbors whose needs were not being met by the second-largest insurance provider and that was not acceptable.

Q: How did you sustain the strike?

A: On the picket line, we liked each other and we knew we were right. There was also so much support from the community. People stopped and fed us, Maui County Council and our professional colleagues supported us. They knew that we were doing what needed to be done. Even now, I’ll meet someone new who tells me they remember our red t-shirts and tell me they honked at us every time they drove by.

Q: What surprised you most during the strike?

A: In the beginning I was very shocked by the callousness and disregard for decency by the upper levels of management. I naively believed that everyone in health care cares about people’s health. But I learned that was not the case.

Q: The contract preserved pensions and increased salaries. Are there other accomplishments you see from the strike?

A: Just getting our first contract after five years of negotiations. I think Kaiser would have been happy to have never signed a contract with us. Now we have this written, printed document that management is required to follow. It’s not perfect, but it’s 50 pages more than management would have ever given us voluntarily and that makes it all worth it.

Q: Have you seen the benefits of the contract already?

A: Yes. When management wanted us to come to work in person two days a week, we were able to make it happen in a way that made sense clinically as opposed to just being told to do it the way management wanted.

One of our biggest complaints that made us organize as a union was the random and unreasonable ways in which we were managed. It led to poor morale, but now instead of management telling us to do something because they say so, they have to come to us about potential decisions that impact our work.

Q: Has there been any disappointment about the contract?

A: Appointment wait times for patients are still too long. A lot of my colleagues used the strike time to reflect on their personal and professional values, and as a result many have opted to leave Kaiser employment. We’ve lost a lot of good providers. The need for mental health care in our community is greater than ever, and Kaiser has been sending more patients out-of-network, and we’re still not fully staffed up.

Q: How do you feel about not accomplishing everything you wanted?

A: I would rather leave a place in a better position than where I found it. I think getting a first contract that can be built upon is a big accomplishment.

Q: Do you ever miss being on strike?

We joke all the time about how much we miss being financially insecure, sweating and standing in the street all day, throwing shakas to traffic! Even on days when we’re in the office, we’re booked hour-to-hour, so we barely see our teammates. We don’t have that relationship time we had on the picket line — that constant reassurement and support from people who got it.

Q: Did you reflect on the strike on the one-year anniversary of the settlement?

A: No. Going back to work was anticlimactic. Going on strike was something that’s memorable. It’s something that I’m always going to be proud to have been a part of. This is my first union. Unions are not traditionally a mental health thing, but should be. I think people who have their heart and souls in doing the right thing — joining together to do it as a union just makes sense.

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