The last thing I’ll ever do as a mental health therapist for Kaiser Permanente is walk a picket line. I’m leaving Kaiser after eight years of working as a therapist in addiction medicine, and I am hardly alone.
Kaiser used to be a stable employer because of its good wages and benefits, but we’ve lost 38 therapists in San Francisco over the past two years, according to figures collected by our union. There are currently only 112 Kaiser therapists providing mental health care in The City.
Therapists like me are giving up on Kaiser for the same reason so many of our patients do — Kaiser doesn’t provide access to mental health care at a frequency that meets any clinical standard of care. In San Francisco, patients typically wait at least six weeks between therapy visits even though state law requires they be seen within 10 business days. Many patients are shuffled into groups, even if it’s not the most appropriate treatment setting.
Kaiser’s model of care forces its members to either pay out of pocket for mental health care or give up trying to receive it. And, increasingly, it’s giving clinicians like me no choice other than to look for work where I know I can provide care that meets clinical standards and the needs of my patients.
There’s a misconception in San Francisco that the mental health crisis is only for people who don’t have insurance. That’s not true. Kaiser is the largest private provider of mental health care in The City, and its members are struggling to get adequate care even though they’re paying thousands of dollars in premiums.
In many cases, people seek care from Kaiser for treatable conditions such as anxiety or depression, but their conditions get steadily worse because they can’t make progress waiting more than a month between appointments. It’s a vicious cycle made worse by Kaiser’s complete indifference to it.
I started working at Kaiser in 2014, the year it agreed to pay what at the time was a record $4 million fine for failing to meet state guidelines for providing timely access to mental health care. Kaiser forked up the cash, but it never provided the care.
We held statewide strikes in 2018 and 2019 demanding better access for patients, and my colleagues and I in San Francisco held our own one-day strike to warn about the egregiously long wait times children in our city faced to access mental health care from Kaiser.
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We thought access to care couldn’t get worse, but then came the pandemic. Demand soared, and Kaiser couldn’t hire new therapists to replace those escaping a system that was failing patients and violating their professional ethics.
In November 2020, I was one of 65 therapists at Kaiser in San Francisco who signed a letter to Kaiser management warning that patients were waiting four to five months to start individual therapy and between six to 12 weeks between appointments. Kaiser never took action and the situation hasn’t gotten better.
It’s infuriating to work for a health-care provider that reports an $8.1 billion net profit, but makes kids with severe depression wait months to see a therapist.
It’s hard to see those ubiquitous “Thrive” ads knowing how long my patients have to wait for mental health therapy, and it’s hard to read Kaiser’s statements claiming that its understaffing crisis is the result of a nationwide shortage when San Francisco has one of the highest populations of therapists in the state and Kaiser is paying the Golden State Warriors $295 million just to name the space outside the Chase Center “Thrive Plaza.”
My hope when this strike started nearly eight weeks ago was that we could finally shame Kaiser into action. But, it hasn’t happened yet, and my time is running out.
I thought I hit the jackpot when I landed my job at Kaiser. For the first time, I had health insurance, a paycheck that covered my bills and the promise of a pension. But that’s not enough when your employer is the biggest HMO in the state, and it doesn’t believe in the care that my colleagues and I so desperately want to provide.
This strike has cost my family a lot of money. But, no matter how it ends, I won’t have any regrets about going so long without a Kaiser paycheck. My only regret is that I worked for an organization so uninterested in mental health care that the best way I could help Kaiser members was to withhold my labor.
