Kaiser Strikers Say When Therapists Burn Out, Patients Suffer

I am a licensed clinical social worker who has been on strike against the Kaiser Permanente health care system for 53 days now.

I work as a medical social worker in the infectious diseases clinic, working primarily with patients who have been diagnosed with HIV and AIDS. I help my patients navigate Kaiser’s complex health care system, get access to needed resources, and figure out how they can afford a life-sustaining medication that often costs thousands of dollars per month.

I see firsthand how Kaiser’s mental health system is failing these patients. It’s nearly impossible for them to get access to timely mental health care, and because Kaiser treats its therapists like assembly-line factory workers, so many therapists get burned out and leave.

That leads to patients getting moved around from therapist to therapist, which fundamentally damages the therapeutic relationship. So many of my patients walk away from Kaiser’s broken mental health care system feeling worse than they did before they tried to access care.

It was clear to me that as an ethical clinician, I couldn’t continue to work within this broken system. So I decided that I had to do what we are taught to do as social workers: advocate for myself and my patients.

ALONE WITHOUT A PENSION

I joined the bargaining committee for my union, the National Union of Healthcare Workers, and sat across the table from Kaiser executives for months, asking them to care about their mental health professionals and their patients.

We worked nights and weekends, crafting detailed contract proposals to address the problems we see. Kaiser’s response was always “The current contact language works for us” or “We hear you, but that doesn’t mean we agree.”

Kaiser would often walk back to the bargaining table with a so-called “comprehensive list of counter-proposals,” which was a list of 10 rejections. But we knew we weren’t asking for anything outrageous or impossible, because everything we’re asking for is what they already provide to our colleagues in Northern California.

We want enough time to do our jobs, which means seven hours per week to prepare for appointments, devise treatment plans, provide resources, file mandated reports, go to the bathroom, and so on. We want wage increases that are equitable with our colleagues.

And we want the pension restored for the 1,700 of us who do not have it—the only people within the whole of Kaiser without a pension. I’ve worked for Kaiser almost 10 years; I was hired four months after Kaiser stopped offering a pension for mental health professionals.

Kaiser officials keep telling us, telling the media, and telling patients that they value and prioritize mental health, but then turn around and say “current conditions are working for us.”

‘IT WORKS FOR US’

After months of trying to work with Kaiser at the bargaining table, it was clear to me that they do not see any problems with their mental health care system—even though just last year the California Department of Managed Health Care fined Kaiser $50 million and forced it to pay an additional $150 toward mental health programs throughout the state.

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As part of the settlement agreement, Kaiser acknowledged that it doesn’t have enough mental health professionals and that consequently patients wait too long for care. But when we brought this up at the bargaining table, Kaiser negotiators just kept saying the system “works for us.”

We knew that it didn’t work for us or for Kaiser members—and we realized we would need to strike for as long as it took to force Kaiser to fix these issues.

So we got to work organizing. We started with smaller collective actions like wearing buttons, signing petitions, and informational leafletting to patients and community members.

We gathered feedback from union members about their struggles, through surveys and town hall meetings. We created WhatsApp groups to stay connected to each other and share resources.

We helped members find temporary and contract jobs to be able to sustain the financial hardships of an open-ended strike. We talked with the media, community organizations, and political allies to build public support for our fight.

And then we walked out.

IN IT FOR THE LONG HAUL

It’s been 53 days now, of organizing and picketing and sharing our message with the public. We continue to see Kaiser’s expensive ads in the newspaper that they say are “committed to reaching a fair agreement with NUHW,” but the company still has not scheduled new bargaining dates.

Kaiser continues to pay replacement workers $13,000 per week during the strike, but it won’t consider the $2,000 per year, per employee that it would cost to reinstate a pension for all of us who don’t have one.

After four weeks without paychecks, we were given grocery donations by the L.A. Labor Federation—and Kaiser refused to let the delivery drivers deliver the groceries, blocking the donation of this food to members.

The bosses continue to try to demoralize us by delaying bargaining, hoping that we will feel our efforts are futile. But we know that we cannot continue to work within their broken system.

They have severely underestimated how connected we all are, how resourceful we can be, and how determined we are in our demand for equity. Every day I talk with my colleagues on strike and I hear over and over again, “I am in it for the long haul.”

If nothing changes, then nothing changes. And we cannot continue to live and work within a system that needs change, without doing something about it. So this is why my colleagues and I are striking, and will continue to strike until we win a fair contract.

Adriana Webb is a medical social worker at Kaiser in Panorama City, Los Angeles.