After years of lobbying Kaiser Permanente to hire more mental health clinicians to meet growing patient demand, thousands of mental health employees in California will take their fight to the streets during a strike scheduled to kick off next week.
Nearly 2,600 psychologists, therapists, and social workers represented by the National Union of Healthcare Workers (NUHW) will picket at 35 locations across the Golden State. Joining them will be 700 members represented by NUHW who don’t work in mental health. Union representatives announced their plans in a letter to Kaiser on New Year’s Eve.
“We feel that we’re overall helping patients and helping these issues by striking,” Jim Clifford, a Kaiser therapist and NUHW member, told ModernHealthcare.com.
The impending strike comes months after Kaiser paid a $4 million fine after state regulators found that the health care provider violated the California Mental Health Parity Act by “imposing lengthy and illegal appointment delays” on mental health patients and falsifying patients’ appointment records. Union representatives said that instead of becoming compliant, Kaiser shifted resources, giving care to more than 387,000 clients newly enrolled through the Affordable Care Act at the expense of others returning for follow-up care.
In recent months, patient wait time has increased three-fold, a reality that some people say has posed deadly consequences. Kaiser currently faces at least four class-action lawsuits filed by patients and families who say that its violations played a role in patient suicides.
“For patients suffering from depression, anxiety, and other debilitating mental conditions, these delays can be insurmountable obstacles, sometimes leading to tragic outcomes,” Clement Papazian, a clinical social worker at Kaiser in Oakland and president of NUHW’s Northern California chapter of mental health clinicians, told Pharmabiz.com. “We don’t want to see patients being ignored. Kaiser’s actions are doing real harm.”
The gap in mental health care has long been an issue for many Californians, due in part to staff shortages that union representatives say Kaiser could have solved using a portion of the more than $14 billion profits that it has amassed since 2009. According to the data compiled by the California Health Foundation, the number of psychiatrists and nurses with prescribing privileges in the California mental health system falls well below the national average. To make matters worse, many mental health employees can’t treat low-income patients because a state law that restricts participation as Medi-Cal and Medicare providers to county clinic staff.
That’s why more than 60 percent of adults in California with mental illness — many of whom live in the rural regions of San Joaquin Valley and the Inland Empire — don’t receive outpatient, inpatient, or prescription medication treatment. The lucky few who maintain contact with mental health professionals usually don’t fare any better. In many clinics, patients often wait one to two months for non-urgent individual therapy appointments because of the lack of available professionals.
Across the United States, more than 91 million people with a mental disability often find it difficult to schedule an appointment with one of nearly 93,000 licensed psychiatrists. The poor and geographically isolated fare much worse in receiving essential mental health care treatment. Rural areas account for more than 85 percent of the locations that the federal government designated as “mental health professional shortage areas,” places described as having a dearth of practicing psychiatrists, psychologists, or social workers.
Leaders of psychiatrist associations point to the shortage of mental health professionals and low reimbursement rates as contributing factors in decisions by the few available psychiatrists to only take on cases for more well-to-do patients, especially as they approach retirement age.
NUHW representatives who plan to participate in the strike said they want to address the issue of mental health staff shortages as an issue of medical ethics, especially since a failure to act quickly has negatively impacted many lives.
In response to criticisms that the strike will further incapacitate California’s mental health care system, NUHW President Sal Rosselli said that union representatives have tried their hardest to get Kaiser’s attention through conventional means, even recommending that each facility in the state creates a clinician-management committee that would devise staffing and outsourcing solutions during a meeting in December.
“With soaring profits and a $30 billion reserve, Kaiser needs to step up and lead the way in finally making mental health care a priority in this country,” Rosselli told Pharmabiz.com. “The law requires it and Kaiser’s ethical obligations as a health care provider demand it.”