Kaiser Mental Health Workers Prepare to Strike, This Time in Southern California

California mental health workers at Kaiser Permanente are preparing to strike for the second time in a little more than two years, citing stressful working conditions, lack of pensions and inadequate pay —with resultant impacts on patient care.

The National Union of Healthcare Workers, which represents nearly 2,400 Kaiser Permanente behavioral health workers in Southern California, on Thursday officially advised the health care giant that its members will begin an open-ended strike on Oct. 21.

The union and the company have until then to make a deal that would avert a strike. Kaiser in a written statement said it was making the “necessary preparations” for patients to access care if a strike occurs.

The previous Kaiser mental health strike, which involved Northern California mental health workers, took place in 2022 and lasted almost 10 weeks. Those workers ultimately won certain concessions, such as higher wages and more hours each week to handle patient care duties such as charting and responding to emails.

Southern California mental health workers say they now are asking Kaiser to match what their colleagues in the north of the state receive.

Kaiser representatives, in an emailed statement, said they put forward a strong offer that increases wages and enhances “industry-leading” benefits. They said they have invested more than a billion dollars since 2020 in expanding mental health capabilities in California and referred to the threat of the strike as a commonly used bargaining tactic and a distraction that “creates unnecessary concern for our members.”

“Kaiser Permanente is steadfast in our goal to build a better model of mental health care for our members and the communities we serve,” the statement said.

Turnover among mental health workers

But union organizers say the company is doing nothing of the sort and is in fact failing to bring meaningful solutions to the bargaining table.

They note that a quarter of the 1,508 therapists hired by Kaiser Southern California between January 2021 and August 2024 have since left. Some of them took better-paying jobs providing virtual therapy for Kaiser patients in Northern California, they said. Among the differences between the two — mental health workers in Northern California receive pensions; those in Southern California do not.

Kassaundra Gutierrez–Thompson, a psychiatric counselor in Los Angeles who has worked for Kaiser’s virtual ADAPT program for two years, said she doesn’t even have time for bathroom breaks. She sees up to 14 patients a day, she said; some of her colleagues see even more. During each half-hour appointment, she said, she is expected to offer therapy, schedule the next appointment, fill out the patient’s chart and squeeze in a bathroom break as needed.

The stress of the work has led her to develop migraines, she said, and “my own mental health tanked.” Some of her colleagues are reporting stress dreams and panic attacks, she said.

“It’s become a bit of a factory for our clinicians who feel really burnt out,” she said, “and it’s a factory for our patients as well.”

Kaiser Permanente’s mental health settlement

The union gave the strike notice just before the anniversary of another significant milestone in the fight over mental health care at Kaiser.

A year ago, Kaiser entered into a $200 million settlement agreement with the state of California, agreeing to pay a $50 million fine and invest an additional $150 million over five years to fix significant problems with its behavioral health system.

Representatives of the National Union of Healthcare Workers say the health giant still has not finalized a corrective action plan with the Department of Managed Health Care.

A representative for Kaiser said the company is working toward that plan. “At the same time, we started our path of transformational change more than a year ago and have made progress, though we know more work remains to be done. We remain committed to working with the (department) to meet the needs of our members and communities, and to address the agency’s findings as the health care sector continues to navigate the challenges around mental health demand and access,” the company said in a written statement.

In the meantime, said Fred Seavey, research director for the National Union of Healthcare Workers, many therapists report continuing violations of the same laws that got Kaiser in trouble.

“We do not understand why Kaiser is permitted to break the law one year later,” he said. “How long will these violations persist? Why have they not corrected them?”

Lisa Carroll, a social worker in the intensive care unit of Kaiser’s San Diego Medical Center, said she’s seen “a continuous erosion of care” at the company during her 17 years working there. She has gone on strike multiple times during that time, she said.

“I’m retiring in a year and a half,” she said. “I want to be able to say things are at least as good as when I came here — which they’re not.”

Jocelyn Wiener is a projects reporter for CalMatters, a public interest journalism venture committed to explaining how California’s state Capitol works and why it matters. Wiener focuses on mental health and health care and explores the intersection between government policies and people’s lives.