San Diego mental health workers join SoCal Kaiser Permanente strike

Nearly 2,400 mental health workers at Kaiser Permanente facilities are poised to strike Monday amid contract talks and allegations of a "broken" system of care, while Kaiser officials say the union has been "slow walking" the negotiation process and planned to strike before labor talks even began.

According to the National Union of Healthcare Workers, the impacted workers include psychologists, social workers, psychiatric nurses, addiction medicine counselors, licensed clinical counselors and marriage and family therapists who "provide behavioral health care for Kaiser's 4.8 million members in hospitals, clinics and medical offices [and] homecare settings from San Diego to Bakersfield."

The union's contract with Kaiser expired Sept. 30.

The labor dispute comes one year after Kaiser reached a $50 million settlement with state regulators who said the health care giant's mental health care system lacked adequate staffing that caused lapses in access to care for patients.

Kaiser officials said the organization has invested more than $1 billion since 2020 to expand its mental health capabilities in California, including hiring more therapists, the addition of resources and reductions in wait times for patients.

The union, however, says shortages are still persistent in Southern California, insisting Kaiser has about one therapist for every 3,000 Kaiser members, compared to one per 2,000 in Northern California. That ratio has limited the time available to therapists to respond to patient calls and emails, to develop treatment plans and prepare for appointments, leading to burnout and causing newly hired therapists to leave their jobs, the union contends.

The union contends that one-fourth of the 1,508 mental health professionals hired by Kaiser's Southern California region between January 2021 and September 2024 have already left their positions.

Kaiser officials said in a statement that the health care system is committed to continued negotiations "until this deal is done." But it said the union has been focused on a strike since the beginning of talks, and has been "slow walking the negotiation process, including on the very issues the union has identified as key to reaching a contract."

"It is apparent that their strategy all along has been to move to a strike," according to a Kaiser statement. "They have been threatening to strike since before we began bargaining in July and have operated without a sense of urgency, declining to accept or counter the strong proposals Kaiser Permanente has put on the table. Most concerning, the union presented a proposal that could result in a full-time therapist spending 40% or more of their work week not seeing patients."

According to Kaiser, it has presented the union with an offer that includes an 18% wage increase over four years, and also "enhances the comprehensive benefits our mental health professionals enjoy plus provides therapists more non-patient time for planning and preparation."

"Today, some of the employees represented by the National Union of Healthcare Workers (NUHW) are choosing to walk away from their patients at various Kaiser Permanente facilities in Southern California to take part in an open-ended strike called by union leaders," Kaiser said in a statement released Monday.

"All Kaiser Permanente members will continue to have timely access to individual therapy appointments during the strike. Patients have the opportunity to be seen by a professional in our extensive network of highly qualified, licensed therapists if their regular provider chooses to take part in the strike. Where necessary, we are contacting patients and offering options that meet their needs."

Kaiser said the strike is "entirely unnecessary and unfortunately not surprising. NUHW leaders have been threatening to strike since before we began bargaining in July. The union has been slow-walking negotiations, despite the strong proposals Kaiser Permanente has put on the table. The union's proposals at the table have been overreaching and unreasonable.

"The union isn't calling for more time to care for patients. It is demanding more money for therapists to spend less time seeing patients. A key issue is how much time the union wants to take therapists away from direct patient care. The union is proposing that full-time therapists increase the amount of time they are not seeing patients to nearly half of their time -- at least 19 hours a week. This is unacceptable and would significantly decrease access to appointments for mental health care for our patients."

Union officials said they are seeking an agreement similar to that reached with Kaiser mental health workers in Northern California, who went on strike for 10 weeks two years ago.

The union is asking that Kaiser guarantee full-time therapists seven hours per week for patient care duties such as responding to patient calls and emails, developing treatment plans, communicating with social service agencies and preparing for appointments. Union officials said Kaiser is guaranteeing only four hours per week.

The union also wants raises to put the workers on par with non-mental health care employees, who the union claims earn 40% more. It is also calling for a restoration of pensions that the union says were eliminated for newly hired mental health professionals a decade ago, even though pensions are still in place for other workers ranging from doctors to janitors.