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The strike by 2,000 Kaiser Permanente mental health professionals in Northern California continued through its fourth day Thursday. These psychologists, therapists, chemical dependency counselors and social workers are striking over years of deteriorating working conditions in San Francisco, Fresno, Sacramento and San Jose.
A central issue that is emerging in the strike is the need for workers to break out of the isolation imposed on them by the National Union of Healthcare Workers (NUHW) and expand the struggle to health care workers not only at Kaiser Permanente but throughout the entire medical system.
On Thursday, it was announced that 50 Kaiser mental health professionals in Hawaii would be joining the strike on August 29 over inadequate staffing. A report yesterday in Courthouse News wrote: “The health giant’s accreditation in Hawaii faces ‘corrective action’ after clinicians filed a complaint documenting long wait times for mental health appointments. The National Committee for Quality Assurance investigators concluded these access issues are ‘a potential patient safety risk’ and said ‘Kaiser’s prior efforts to improve access have largely been ineffective.’”
This is a welcome development but raises the question why more Kaiser workers are not also being called out. Kaiser has about 149,000 health care employees plus 16,000 physicians in California. Some 700 Kaiser operating engineers in Northern California, who struck for three months last year, are still operating without a contract.
Last November, tens of thousands of Kaiser health care workers, primarily nurses, were poised to strike, only for the unions to cancel it at the last minute and force through a sellout contract with sub-inflation wage increases and no staffing guarantees. Nurses opposed to the sabotage of the struggle by the UNAC/UNHCP (United Nurses Association of California/Union of Health Care Professionals) formed a rank-and-file committee to fight to give the struggle new leadership outside of the union bureaucracy.
The possibility exists for a powerful unified movement of health care professionals against the unending assault on public health. However, this requires a fight by health care workers against the isolation of their strike by the health care unions.
Al, a mental health professional, told the WSWS that “burnout” was consuming the profession.
“We can’t give the care that we want to give,” he said. “We want to give patients timely appointments so that we can meet their medical necessities, but we can’t do that. We don’t have enough people, and appointments are three weeks, even a month, or a month and a half out. We just don’t have the staffing for it. We don’t have the resources, and we need more. We’re all stretched so thin, and people are leaving quickly.”
Many of these professionals experience severe mental hardship requiring immediate care, including suicidal ideation.
Al explained how overstretched the staff is. “We’re working nonstop. I mean, there’s no time really for anything. You barely get a breather for lunch.”
Cindy, another striking worker, told the WSWS, “Patient access to mental health is really poor.” She continued, “People are not being seen as regularly as they need. People can get appointments but it takes a while. The return appointments are four to six weeks out, so if someone is in crisis, that’s not good.”
She said that turnover was a major problem. “We don’t have enough mental health workers. They [Kaiser] can’t keep them. They can attract them, but they don’t stay long. The turnover is really high.” Cindy explained this was because of the working conditions. “There’s not enough time. You can’t see the patients when you want to see them. It’s not a good working environment.”
She had also participated in the 2019 strike. She said that since then, “nothing” had changed, and “It’s actually gotten worse.”
Cindy raised the demand for clinicians to be given more time for documentation. She explained they needed more “documentation time, better access to appointments, and more clinicians so that we can address demand.” She continued, “Demand has never been higher, but the supply has never been shorter. I don’t think this is specific to Kaiser necessarily; I know it’s pretty much everywhere.”
She also noted the effect of the pandemic on their working conditions, including the need to write more CPS (Child Protective Services) reports and the incidence of more domestic violence cases.
Sarina, another mental health professional, explained how difficult it was for anyone but the most severe cases to get help. Speaking about her adolescent patients, she said, “If they’re not suicidal, but they’re not functioning, for example, [if] they are severely depressed and can’t even go to school, we might not see them for six to 10 weeks because they’re not suicidal. So we can’t squeeze them into our schedule.”
Then, Sarina explained, their manager will tell the clinicians, “Well, if you need to see the patient, book them in your off time or book them in your documentation time (time set aside for clinicians to document their patients’ health for official purposes).” Effectively they are being asked to take on extra work for no pay, stretching them totally thin. Sarina continued, “We’re now adding more patients and then we’re adding more work … that we are now supposed to do after work. So clinicians are forced to stay outside their work hours to finish their notes.
“We’re getting burnt out and leaving. Kaiser talks about having 200 clinicians; they hired 200, but 400 have left. The work environment is not sustainable. … We’re not replacing these clinicians that leave, so patients don’t have access to care—it’s all intertwined. I am so mad about it.” The work environment was so bad, she said, “It’s almost hostile.”
There are plenty of resources to meet these demands. In 2019, the sum of the 25 highest executive salaries at Kaiser Permanente was over $55 million. California is home to 186 billionaires, including Google co-founder Larry Page and Facebook CEO Mark Zuckerberg, some of the wealthiest men on earth.
Having gone on strike multiple times during her career, Sarina said, “There is not too much difference between the last strike and now. I mean, there are small changes but minimal.”
All the workers the WSWS spoke to agreed with the need for an expanded strike of all Kaiser workers, placing the issues of patient care and work environment front and center.
Charles, another health care worker, whose name we have changed for anonymity, told the WSWS that a rank-and-file organization fighting for joint action outside of the union would be great. “I really like the idea,” he told us, “that you said thinking outside of our own union, outside of the box in a way and collaborating with other workers.”
“I think we should all be striking,” said Sarina. “Because, I think, overall, the Kaiser system is broken. It’s a billion dollar industry, but they can’t put their resources into helping like their most acute patients?”
Sarina said that she was “absolutely” in favor of a joint strike with other Kaiser workers. “I think our whole Bay Area team and Northern California team would go on strike with everyone else.”
Al said that Kaiser Southern California mental health workers “should do the same” and go on strike. Asked about a rank-and-file movement fighting for joint action, he replied, “That’s a good idea I haven’t thought about until now.”
Ashley, another worker, said that there should be joint action across the workforce. “Different departments are coming up against similar issues that we are fighting for. Kaiser would be happy with the status quo. I think the more people we have, the more change.”
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