The open-ended strike is a last resort for caregivers who have fought for years to make Kaiser fix a mental health system so broken that it was fined $50 million in 2023
Glendale, Calif. – Nearly 2,400 Kaiser Permanente mental health therapists, psychologists, social workers and psychiatric nurses are streaming to picket lines this morning to begin a strike that won’t end until California’s largest HMO confronts its mental health crisis and ends the inequities that harm patients and caregivers in Southern California.
The mental health professionals, represented by the National Union of Healthcare Workers, will spend their first day on the picket lines from 6 a.m. to 2 p.m. alongside community allies Monday outside:
- Los Angeles Medical Center (LAMC), 4867 W. Sunset Blvd.
- San Diego Medical Center, 9455 Clairemont Mesa Blvd.
Workers will be available for interviews at both locations prior to 6 a.m., however most workers won’t arrive until after 8 a.m. The media contact at LAMC is Maggie Sisco, 989-802–1261 or msisco@nuhw.org
There will also be picket lines Monday in Fontana and Anaheim, however, many workers at those sites will take buses on Monday to join their colleagues at Kaiser’s Los Angeles Medical Center to begin the strike.
Click here for a full list of picket line locations and times for the first two weeks of the strike.
Substandard mental health care – particularly in Southern California
Kaiser has a long history of violating mental health laws and clinical standards. It was fined $4 million by California regulators in 2014 for denying members timely access to care, and fined $50 million last year, the largest fine in state history for violating mental health laws. In agreeing to the fine, Kaiser acknowledged that “it lacks sufficient behavioral health providers” and that “This lack of clinical staff has resulted in excessive wait times for enrollee individual therapy appointments…”
A 10-week strike by mental health therapists in Northern California two years ago forced Kaiser to provide significantly more time for patient care duties that can’t be done during appointments, while also increasing staffing and providing more services at its mental health clinics.
However, Kaiser management has refused to extend those gains to Southern California, creating in essence a two-tiered mental health system where patients in Northern California have better access to care and mental health professionals have more time to meet the needs of their patients.
Currently, Kaiser staffs approximately 40 percent fewer mental health workers who provide therapy sessions in its Southern California region, which stretches from San Diego to Bakersfield than its Northern California region which includes the Central Valley, Bay Area and Sacramento — even though Kaiser has about 200,000 more members in Southern California.
Overall, Kaiser staffs approximately one therapist for every 3,000 members in Southern California compared to one therapist for every 2,000 members in Northern California.
While Kaiser has increased hiring, it struggles to keep mental health professionals in Southern California, most of whom don’t have pensions or enough time to complete all of their patient care duties because they are back-to-back all day in appointments.
According to Kaiser data, one-quarter of the 1,508 mental health professionals who were hired by Kaiser’s Southern California region between January 2021 and September 2024 have left their positions. Of the 367 departed workers, 64 percent left Kaiser within 12 months of their hire date.
Over the past year, 40 therapists have left their jobs working for Kaiser in Southern California and taken telehealth jobs for Kaiser in Northern California, where they are paid more, given more time for patient care duties and receive a pension.
“Kaiser says all the right things when it comes to mental health care, but its actions tell a different story,” said Josh Garcia, a psychologist for Kaiser in San Diego. “Unless we strike, our coworkers are going to keep leaving and our patients are going to keep struggling in an underfunded, understaffed system that doesn’t meet their needs.”
Seeking Equity for Mental Health Care
To improve staffing levels and reduce turnover that disrupts patient care, Kaiser’s Southern California mental health professionals are seeking a contract that includes the same working conditions as their fellow Kaiser mental health providers in Northern California and comparable pay and benefits as their colleagues who don’t work in mental health. However, despite being under a state order to undertake “transformational change” of its mental health delivery services, Kaiser has rejected the workers’ proposals.
- Patient Care Time. Workers are seeking 7 hours per week for patient care duties that can’t be done during therapy sessions, such responding to patient calls and emails, developing treatment plans, communicating with social service agencies, taking notes and preparing for appointments.
Kaiser already guarantees 7 hours per week for full-time therapists in Northern California, but management in Southern California is only willing to guarantee 4 hours per week. Management is also falsely claiming that providing 7 hours per week would result in therapists not seeing patients for 40 percent of their work time even though that has not been the case in Northern California.
- Fair Pay. Workers are seeking raises that make up for several years when they received no cost of living increases and puts them on equal footing with comparable non-mental health workers at Kaiser whose salaries are up to 40 percent higher. Kaiser is currently offering lower raises than it provided recently to members of the Coalition of Kaiser Unions.
- Restoration of pensions. Nearly all Kaiser employees in California receive pensions – including doctors, clerks, medical technicians and janitors – but Kaiser eliminated pensions for all mental health professionals hired after 2014. The lack of a pension results in increased turnover and undermines Kaiser’s mental health training program because Kaiser workers would have to give up their pensions to transition to mental health jobs.
“Everything we’re proposing in negotiations, Kaiser is already providing to the vast majority of its workforce,” said Adriana Webb, a medical social worker with Kaiser who specializes in serving patients with HIV. “If Kaiser is serious about transforming its mental health care system, it has to start by ending the inequities that harm us and our patients.”
Concern over massive appointment cancellations
When therapists went on strike in Northern California two years ago, investigators with the California Department of Managed Health Care found that Kaiser illegally canceled 111,803 therapy appointments. State law requires Kaiser to continue providing mental health care during a strike, just as it would be required to maintain medical care. Kaiser must arrange for patients to receive care from out-of-network therapists practicing in the community if Kaiser’s in-network therapists cannot deliver timely and geographically accessible care.
In a recent letter to the head of California’s Department of Managed Health Care (DMHC), NUHW Researcher Fred Seavey urged the agency to inform Kaiser members of their rights and perform real time monitoring of appointment cancellations.
“Given Kaiser’s documented track record, we are concerned that Kaiser intends to respond to the upcoming strike by employing the same methods it has used during previous work stoppages,” Seavey wrote. “Such methods would jeopardize the health and safety of Kaiser’s enrollees, many of whom are diagnosed with disorders that can have life-threatening consequences.”
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The National Union of Healthcare Workers is a member-led movement that represents 19,000 healthcare workers in California and Hawaii, including more than 4,700 Kaiser mental health professionals.
