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The strike of 2000 Kaiser Permanente mental health care providers is now in its seventh week. On Saturday, votes were counted; the tally was overwhelming, 1349 to 222 to continue the strike.

Why? Here’s Jane Kostka, a steward with the National Union of Healthcare Workers (NUHW):

“We’re out here on the picket line today because of professional ethics denied. The strike is not about money. In fact, over the weekend on Saturday Kaiser made us a conditional offer to raise our pay if we would accept pretty much leaving the working conditions and the patient care at status quo. And that is not acceptable to us. We are striking because it’s one last resort to get Kaiser to understand that we need to see our patients at a frequency that helps the patients actually get better. And we need to have enough time in the day to take care of the patients we already have. We need Kaiser to hire more therapists and to give them a workload that is sustainable so that those therapists stay on the job and do not leave because they are burned out

“We have many, many patients who have suffered trauma or abuse. What they need is someone on their side They need someone who is accessible, someone who they can talk with regularly to help them deal with the fear and with the feeling that their life could just close in on them. When we’re working eight, nine, ten weeks between appointments, they don’t have that backup and they wind up getting more depressed, more anxious, calling us, emailing and we don’t have enough time in our daily schedule. I and many of my fellow therapists work late every day just to call back those of our patients who are the most distressed because we just can’t leave them hanging there with no answer between one day and the next.”

This is from Kostka’s speech at the NUHW’s rally in Sacramento. NUHW members have been picketing Kaiser medical centers and clinics in Northern California. They’ve held rallies in Santa Rosa and Sacramento, including a Labor Day rally at Kaiser’s flagship medical center in Oakland.

It's become a cliché to say there is a mental healthcare crisis in this country; everyone from the President down has joined the chorus – depression, anxiety, addiction, suicide, something has to be done. The difference here is that these strikers are doing something about it, and to their credit virtually every mental health care advocate in California has come out in support, as has the San Francisco Central Labor Council, the San Francisco Board of Supervisors (the Board discussed the strike on Tuesday, listening to many NUHW members), and an array of unions. The Massachusetts Nurses Association sent $25000.

Just this year, the California State Senate passed a law sponsored by NUHW, SB 221, which requires HMOs like Kaiser to provide follow-up mental health care appointments within 10 business days if recommended by a therapist. Its purpose was to put some teeth into existing legislation.

Readers here will know that Kaiser Permanente is a behemoth amongst this country’s corporate, “not for profit” health care providers, with 39 hospitals and 700 medical facilities, and 9.4 million “members” who pay for Kaiser’s services.. It’s net worth in 2021 was $43.3 billion Its CEO Greg Adams received $17.3 million in total compensation in 2020. He and the top 100 executives have the benefit of eight separate retirement plans.

The NUHW represents 4000 Northern California mental health technicians, clinicians (psychologists, social workers, psychiatric nurses and chemical dependency counselors). They have been bargaining with Kaiser since July.

In the face of this, Kaiser is defiant; it attends bargaining sessions, though most often with nothing on offer. It insists that SB 221 (of which it is out of compliance) and anything related to staffing and work load is off limits. It seems intent on using its vast wealth to outlast its workers. It also, I suspect, counts on a divided workforce; the majority of patients will receive care, only those seeking mental healthcare will suffer.

This can change, however unlikely. In Santa Rosa nurses from the emergency department joined the pickets. Here's a nurse speaking out.

“I’ve worked here in the Emergency Department for five years. I’d just like to say that I think this strike is a righteous strike and what you guys are doing is fantastic and I can’t wait to join you guys out here soon. We continuously see patients come in with the same triage note. ‘I had an appointment made for me in three weeks and I’m in crisis right now and I need to see a therapist’ and instead of getting that opportunity people are making attempts on their lives and then coming to the emergency room and then sit in a box. It’s not therapeutic and it’s disgusting and Kaiser needs to do better and so I really appreciate the sacrifice you’re making here today and again can’t wait to join you out here when we get on strike as well when we can combine and put the hurt on them.”

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There are specific reasons, I might add here, that Kaiser has consistently played hard ball (and worse) with NUHW – clearly apparent in comparison with any of the other half dozen unions that represent Kaiser workers.

First, certainly, NUHW is a union that is present on the “shop [hospital] floor,” that fights for its members, that doesn’t do concessions.

Second, NUHW’s Kaiser’s workers have steadfastly refused to give up their watchdog role – their responsibility to their patients and to the community; they consistently rejected Kaiser’s insistence on “gag rules” imposed in contracts and elsewhere. Why? The union and its members have from the beginning joined other mental health campaigners in advocating for patients and in exposing Kaiser’s negligence, while calling for parity with medical health care and supporting the rights of mental health care patients.

(It might be added here, alas, that Kaiser may be a pacesetter, but its far from alone. In denying its members mental health care they’ve paid for, it’s just a leader of the pack. See New York Times feature, “Profits over Patients,” a report about how on the medical side, patients are denied entitlements, billed in defiance of existing regulations, then, when these bills are not paid, sends them into collection, well knowing what this means to working class people.)

No wonder then that Sabrina Chaumette, a steward at the Oakland Center, says:

“During the pandemic we have had losses on a number of different fronts. People suffered all at once. Consider this like the great depression, people suffered illness, death, job loss, learning that millions of people had died from COVID or long Covid. They suffered isolation, loss of community, loss of purpose, loss of meaningful work, loss of housing. Substance abuse use went up, as people tried to survive and cope. Rates of suicide went up; rates of depression went up, anxiety went up, especially social anxiety. Imagine being home for three years and somebody tells you gotta get out of the house. So social anxiety went up and so did suicide. If this were a war, which I feel it is, this is what is considered collateral damage, they can afford to lose the ones with mental illness.”

The union doesn’t plan on losing. Sophia Mendoza, NUHW’s Secretary Treasurer, puts it this way: “If they won’t collaborate with us, it’s going to get worse, clinicians are already leaving. No one’s going to want to work at Kaiser.”

How you can help

A note from the union: We know Kaiser's playbook: Cancel thousands of appointments, make patients suffer, blame the therapists, and reject every proposal therapists make to improve care.

Here's how you can make Kaiser finally prioritize mental health care:

1. Follow and share our fight on Twitter, Facebook and Instagram.

2. Join therapists on the picket line:

3. Don't let Kaiser get away with canceling appointments. Kaiser is required by law to provide the same level of care during a strike no matter how much it costs them.

Cal Winslow’s latest book is, Radical Seattle, the General Strike of 1919. He can be reached at cwinslow@mcn.org