Nearly 2,400 mental health professionals are striking Kaiser Permanente in Southern California, demanding that the nation’s largest non-profit HMO fix a mental health system that’s so broken the state of California fined it $50 million last year.
The NUHW members, who include psychologists, social workers, psychiatric nurses, addiction medicine counselors, licensed clinical counselors, and marriage and family therapists, provide behavioral health care for Kaiser’s 4.8 million members in hospitals, clinics, medical offices, and homecare settings from San Diego to Bakersfield.
“This is about equity for mental health care,” said Jessica Rentz, Kaiser therapist in Fontana. “We want to be with our patients, not on a picket line, but we can’t keep working in a system that treats mental health care like an assembly line job and denies us the time and resources to provide the care we know our patients need.”
The strike began on October 21, three weeks after the workers’ contract had expired. Picket lines have been festive throughout Southern California, with strong media coverage and frequent visits from elected officials.
Congressman Adam Schiff, who is likely to win election to the U.S. Senate in November, supported us with a post on X: “Kaiser’s mental health workers are on strike for better patient care, fair wages, and pensions. I stand with the National Union of Healthcare Workers in their fight — because quality mental health care requires quality pay and benefits.”
The strike has already been covered by CNN and CalMatters, Los Angeles Times, San Diego Union Tribune, Orange County Register, and many other local papers throughout the region.
Every major TV news station in San Diego and Los Angeles covered the first day of the strike. That included KCAL, NBC-4, Fox-11, ABC-7, Telemundo, and Univision in Los Angeles, and NBC-7, ABC-10, CBS-8, Fox-5, and Univision in San Diego. The first day of the strike was also covered by KNX Radio in Los Angeles, KFI News Talk Radio in Orange County, NPR affiliates, KPPC in Los Angeles, and KPBS in San Diego and KBAK in Bakersfield.
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….”
Two years ago, a 10-week strike by NUHW-represented mental health therapists in Northern California 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 in which patients in Northern California have better access to care and mental health professionals have more time to meet their patients’ needs.
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 in 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.
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 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 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.
With Kaiser still unable to produce a state-approved plan for correcting the deficiencies cited in last year’s state investigation that resulted in a $50 million fine, its refusal to provide equal working conditions and access to care in Southern California is a big red flag to its behavioral health professionals.
“Kaiser’s corrective action plan won’t be worth the paper it’s printed on as long as it insists on denying us enough time to do our work and paying us less than our peers who don’t work in mental health,” said Gena Porter, a psychiatric nurse for Kaiser in Riverside. “What we’re proposing is necessary for Kaiser to have the staffing and resources to fix its mental healthcare system, and Kaiser’s refusal to consider it shows they aren’t serious about improving care.”
Seeking Equity for Mental Health Care
To improve staffing levels and reduce turnover that disrupts patient care, NUHW members seek 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 seek 7 hours per week for patient care duties that can’t be done during therapy sessions, such as 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 also falsely claims that providing 7 hours per week would result in therapists not seeing patients for 40 percent of their work time.
- Fair Pay. Workers are seeking raises that compensate for several years of no cost-of-living increases and put 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 recently provided to members of the Coalition of Kaiser Unions.
- Restoration of pensions. Nearly all Kaiser employees in California still 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. Kaiser data shows that mental health professionals without pensions are twice as likely to leave Kaiser as those with pensions.
“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.”
