With her dog at her side, Laura Bramble spends a lot of time at the picket lines in front of Kaiser Permanente in Walnut Creek these days. She stands in solidarity with the striking National Union of Healthcare Workers (NUHW) Kaiser mental healthcare workers, whose contract expired last September.
Before the strike began on Aug. 15, Bramble saw her therapist as often as twice weekly. She’s now missed more than six appointments. “I’ve called the main line (because my therapist is on strike) and said this is ‘me’ and I need help, and no one calls me back. I don’t blame my therapist. This is because Kaiser doesn’t prioritize mental healthcare,” Bramble says. “It’s not fair and it’s not right and it’s people like me who are left hurting. I can’t even begin to imagine what it’s like for the people who are still waiting for appointments or are still not in the system.”
Karissa Tom, NUHC organizing coordinator, says that while patients like Bramble may be without care in the short run, the strike really is all about patient care.
“Right before our members went on strike, Kaiser tried to offer them a last minute deal to avoid the strike. Essentially they were offered a huge bump in wages, but the deal didn’t address any of their concerns about workload or patient care,” Tom explains. “Members felt it was hush money, and they obviously didn’t agree to that. They’re not on strike for wages. They’re on strike for better patient care. They’re asking for things like recruitment of more staff, retention efforts, a staffing committee so they can better care for patients (in a sustainable way without burning out).”
Tom says NUHC members have led the fight on passing legislation like SB221 that holds healthcare providers like Kaiser accountable for providing timely access to care for its members. NUHC workers have also advocated for the passage of SB 855, which would increase fines per incident of canceled appointments from $2,500 to $25,000, adds Tom.
That bill is sitting on Gov. Gavin Newsom’s desk waiting to be signed. If the bill is signed into law, it would likely push Kaiser’s hand in coming back to the bargaining table, as there are currently some 2,000 mental healthcare providers on the open-ended strike.
“This is now (among) the longest healthcare worker strikes in U.S. history,” Tom says. “The members are waiting for Kaiser to come back to the table.”
Meanwhile, Kaiser’s striking mental healthcare professionals are torn in the dilemma of feeling like they’re temporarily abandoning their patients while fighting for better working conditions and increased access so that they can better serve their patients.
Dr. Lori Ono, a psychologist in the Walnut Creek mental health department, who has been with Kaiser for 22 years, choked back tears when asked about her patients. “It hurts a lot. I worry about my patients. I don’t want to be doing this,” Ono says while swallowing hard. “There’s a point at which you have to do what’s really, really in the best interest of the people (you’re caring for), and you have to fight.”
Over the years, Ono has worked as a therapist in the intensive outpatient program, she’s worked as a generalist and in intensive services, and in her current role as a case manager in intensive services. “When I was a generalist (without a caseload cap), I kept getting more and more patients in my schedule. I would be able to see my patients about once every two months,” Ono recalls. “It was horrible.”
The consensus among the picketing therapists is that consistent access to therapy on a weekly or biweekly basis is the standard of care that allows patients to get better. Without that consistent access for those in need, therapists say patients end up in the ER room with chest pains, anxiety attacks and other health conditions that they say can sometimes be curbed or managed through mental healthcare. “The mind and body are definitely connected,” Ono says.
Ono and other mental health care professionals on the picket lines say they regularly end up taking both work and worries home, sometimes spending up to an hour on weekdays and a few hours on weekends responding to messages and updating case files. Many picketers described being so busy that they can’t find time to use the bathroom during their regular work days. “It’s like overfilling a trash bag,” Ono says. “If you keep stuffing a trash bag with more and more stuff, eventually it’ll burst.”
While many of the therapists acknowledge that they could simply leave Kaiser and go into private practice for far more money, those on the picket lines say they don’t want to do that. “We have a heart for the patients. We care deeply about them,” Ono says.
Paddy Poupeney, a per diem marriage and family therapist at the Walnut Creek facility, says there is a gendered component to the profession. “This is largely a feminized profession. Who’s working in the mental health profession? It’s mostly women.”
Poupeney started her journey to becoming a therapist in her late 30s and landed a job at Kaiser at the age of 62. “Through my own therapy, I realized my self worth, left a marriage that wasn’t healthy and realized I had something to offer. That’s how I started my journey to becoming a therapist,” Popeney says. “It wasn’t easy. It took me 10 years to get my 3,000 hours as a single mom of two kids.”
The licensing hours range from unpaid to low wages or stipends. “People don’t always realize that to get our hours to work in this profession, many of us have to live below poverty level with our families. I was a welfare mom and then I got a gig earning $24,000 a year while getting my hours.”
Getting to the place she’s in today was a struggle, but Poupeney says she’d do it all over again. “I left another job due to burnout and started at Kaiser when I was 62. I’ve been here for eight years now, and I absolutely love it.” As a per diem professional, Poupeney shares in the workload of colleagues so that patients can get continuous care when others are out. While she’s not unhappy with her personal workload, she is advocating for better conditions for her colleagues.
“There are people I work with, who’ve accumulated personal and paid time off, and there’s nobody to fill in for them if they want to take a vacation day or accompany their child or spouse to a doctor’s appointment. I’ve been the only per diem person who can jump in and help (in those cases),” Poupeney says. “It’s not amenable to a healthy balance of work and family.”
Members of NUHW on strike say that Kaiser members who need medical or mental healthcare should continue to seek it at Kaiser. Mental health patients whose appointments have been canceled can call 1-888-466-2219 to file a complaint. In terms of other ways to support the striking Kaiser mental health care workers, NUHW organizing coordinator Karissa Tom says it’s all about showing up, sharing time and resources and amplifying their message.
“We’d love people to join us on the picket lines if they have the time and help spread the word. Those with financial resources can also contribute to the strike fund to help the striking members meet their basic needs while they’re without paychecks.”
