Mental Health on Hold at Kaiser: Negotiations stall as strike enters second month

With negotiations at an impasse over wages, benefits and workloads, 2,400 Kaiser Permanente mental health workers have persisted in an open ended strike for a seventh week. As the deadlock deepens, the strain on patients, workers and the healthcare system grows ever more critical in Southern California.

The National Union of Healthcare Workers and Kaiser Permanente employees warn that these chronic issues — long standing staffing shortages, low pay scales and subpar benefits, create a substandard system where the quality of patient care is compromised, providers are overworked and the integrity of mental health services is at risk. 

In response to the walkout, Kaiser Permanente stated the open-ended strike is an unproductive bargaining tactic, accusing the union of slow-walking negotiations while creating theatrical disruptions despite the strong proposals Kaiser has put on the table. The proposals offered by Kaiser include incremental wage increases and tuition reimbursement benefits, but fall short of the union’s demands.

On the picket line outside of the Kaiser Permanente facility in Panorama City, a sea of union members, Kaiser employees and supporters lined the sidewalk shoulder to shoulder, chanting loudly as passing cars honked their horns in solidarity. The energy, a mix of frustration and determination, was palpable.

Touting a picket sign that read 'The Tortured Psychiatry Department' - Adrianna Webb, a medical social worker with Kaiser explained the union's demands - “We are demanding equity for ourselves and our patients. If Kaiser really values their mental health professionals like they say they do, they will restore pensions for our members we aren't asking for anything special, we just want the same benefits and protections that our colleagues have.”

One of the benefits in question are pensions for mental health workers hired after 2014.

Pensions are provided to all other Kaiser departments — including janitors, clerks and medical technicians – but mental health professionals hired after 2014 are the only group to be excluded from these retirement benefits.  

“Let’s say you go through all the schooling required to become a mental health professional and start working here today. You won’t have a pension but the people taking out the trash will,” said Tom Gallo, a psychiatrist on strike at Kaiser in Panorama City. 

Instead of providing pensions for those hired after 2014, Kaiser is offering a defined contribution plan, where employees would automatically contribute 6% of their annual salary to a retirement account. After the initial 6%, employees have the option to contribute up to 3% more of their salary, which will be matched by Kaiser. Once the employees have decided how much of their salary they want to contribute, they choose where to invest the money from investment options Kaiser provides, ranging from stocks, bonds and insurance contracts. From then on, the employee will need to manage their own investments. 

According to Vanguard, the investment management company that manages Kaiser’s 401(k) plans, no assurances can be made that the fund will achieve its investment goals. This means that employees’ retirement savings will fluctuate based on market performance, and there is risk that the final balance may be lower than expected. 

While the investments in Kaiser’s defined contribution plan offer the potential for growth, it does not promise a fixed monthly retirement income like a traditional pension would. Unlike a traditional pension plan where income is guaranteed, employees must actively manage their investments and bear the responsibility for ensuring sufficient growth in their retirement savings over time. 

Pensions aren’t the only pushing issue. Patient care duties that fall outside of therapy sessions and appointments — tasks like managing treatment plans, emails, calls and appointment preparation are essential for effective care, but workers say they are allotted insufficient time to fulfill responsibilities that are foundational for care. 

Currently, mental health professionals receive four hours a week to do those essential tasks, however, back-to-back patient scheduling often slashes that time in half, leaving them with less than the allotted time to shoulder a mountain of responsibility. While the union is asking for seven hours of dedicated time, Kaiser has countered with an offer of six hours – a compromise that workers argue still falls short of addressing the pressing needs of both providers and patients. 

“They treat therapists like assembly line factory workers — with back to back patients and no time in between to do charting, mandated reporting or treatment planning. It’s not sustainable so therapists get burnt out and leave Kaiser and patients are left waiting long times for appointments,” said Adrianna Webb.

Members of The National Union of Healthcare Workers picket in front of the emergency room entrance at Kaiser Permanente in Panorama City, Calif. Friday Nov. 15,2024

The critical fault line in this labor dispute? Staffing shortages that leave mental health professionals overworked and patients underserved. 

The thin staffing is evident in Southern California, as Kaiser staffs approximately one therapist for every 3,000 members, according to the NUHW. As a result, clinicians experience intense burnout and leave their jobs. 

Kaiser data reveals one-quarter of the 1,508 mental health professionals who were hired between 2021 and 2024 have left their positions. Of the 367 departed workers, 64 percent left their jobs within twelve months of their hire date. A union survey found that 85% of clinicians who left Kaiser between 2021 and 2022 said they left because their workload was unsustainable. 

On top of that data, 40 therapists have departed from Southern California Kaiser to pursue telehealth opportunities in Northern California, where they receive higher salaries, more time for patient care responsibilities, and a pension.

In fact, despite having roughly 200,000 more members in Southern California, Kaiser has staffed 40 percent fewer mental health workers compared to Northern California. In 2022, Kaiser mental health workers went on a 10-week strike, effectively securing higher wages and more time dedicated to non-appointment tasks.

The spark that ignited this labor movement traces back to months of stalled negotiations. 

In September, the contract between NUHW and Kaiser Permanente came to an end. Before the contract expired, the union asked for both entities to join the bargaining table in April. Bargaining was delayed until July 31, and since union demands weren’t met by the end of September, the contract was not extended. 

“We felt that Kaiser wasn't being honest at the bargaining table. They weren’t moving or presenting meaningful solutions,” Adrianna stated during the strike. “This is our attempt to have them take us seriously and offer us what we believe we deserve. All we are asking for is what they provide everybody else.”