NEWS Mental Health News Why Thousands of California Mental Health Care Workers Are On Strike By John Loeppky John Loeppky LinkedIn Twitter John Loeppky is a freelance journalist based in Regina, Saskatchewan, Canada, who has written about disability and health for outlets of all kinds. Learn about our editorial process Updated on September 16, 2022 Fact checked Verywell Mind content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Karen Cilli Fact checked by Karen Cilli Karen Cilli is a fact-checker for Verywell Mind. She has an extensive background in research, with 33 years of experience as a reference librarian and educator. Learn about our editorial process Share Tweet Email Print Justin Sullivan / Getty Images Key Takeaways More than 2,000 unionized mental health workers are going into their second week of strike action in CaliforniaThis isn’t the first time that Kaiser Permanente, the strikers’ employer, has faced worker backlash over patient care and appointment wait timesThe strike comes amidst a heavy wave of resignations by staff in healthcare On August 15, 2022, more than 2,000 California mental healthcare workers went on strike. These members of the National Union of Healthcare Workers walked off the job after announcing an open-ended job action in order to protest the working environment and the level of patient care they say they are seeing at their employer, Kaiser Permanente. As one union member said in a statement at the outset of the action, “We’re not willing to be part of a system that disrespects the work we do and prevents us from providing ethical care. Kaiser has no excuse to continue treating mental health care as a separate and unequal service, and we’re going to keep striking until that changes.” Experts, from local mental health practitioners to the US Surgeon General himself, are clear that the strain being put on healthcare workers is unsustainable. The Root Cause of the Strike Despite the comparatively low number of unionized mental health staff in the United States, this isn’t the first time that Kaiser has faced the prospect of a walkout. In 2021, a deal was struck two days before 32,000 staff were set to strike across the western US; and, in 2019, 4,000 mental healthcare workers took to picket lines. Then, same as now, one of the core issues is that staff say patients are not getting timely care when they need it. Data provided by the union puts the average ratio between therapist and patient at 1 in 2600. Dr. Vivek H. Murthy, MD, MBA and US Surgeon General Burnout manifests in individuals, but it’s fundamentally rooted in systems. And health worker burnout was a crisis long before Covid-19 arrived. — Dr. Vivek H. Murthy, MD, MBA and US Surgeon General California-based therapist Dr. Benjamin Caldwell, PsyD, LMFT, an instructor and author who is currently working on a book centered on burnout amongst those in critical fields like healthcare and education, says that this level of resistance is because staff believe that their employer is systemically failing at aligning with their values as mental health professionals. “Often, when you have clinicians who are experiencing burnout, it's framed as an individual problem. When instead, what many clinicians are experiencing seems to be this concept of moral injury, which happens when people come to realize that they are active participants in a system that operates in ways that are inconsistent with the individual's values.” That’s a message that was echoed by Dr. Vivek H. Murthy, MD, MBA, US Surgeon General, in the New England Journal of Medicine last week when he wrote about the industry more generally.“Burnout manifests in individuals, but it’s fundamentally rooted in systems. And health worker burnout was a crisis long before Covid-19 arrived…Burnout is not only about long hours. It’s about the fundamental disconnect between health workers and the mission to serve that motivates them.” Addiction Treatment Expands, but Remains Unequal What Does This Mean for Care? The strikes come amidst a wave of resignations that has hit the healthcare sector particularly hard. According to preliminary data from the US Bureau of Labor Statistics, the US healthcare sector lost 2.7% of its workforce due to resignations in June, equivalent to 551,000 staff. What makes this strike different from the rash of recent actions taken at places like Amazon and Starbucks is that the core of the protest isn’t about staff wages. Instead, the main issue the union is pushing is a patient/staff ratio that they say is 2,600 to one. Dr. Benjamin Caldwell, PsyD, LMFT ...one of the common indications of burnout is when you have providers who experience less empathy and more judgment toward their patients. In other words, we're not bringing our best selves to the table. — Dr. Benjamin Caldwell, PsyD, LMFT Caldwell says that burnout at a practitioner level can lead to poorer quality care.“In fact, one of the common indications of burnout is when you have providers who experience less empathy and more judgment toward their patients. In other words, we're not bringing our best selves to the table. And that that has predictable negative impacts on the care that we're able to provide.” A Physician and Therapist Talk Disparities in Healthcare What Next? In previous media coverage, Kaiser has repeatedly pointed to the pandemic as the reason why the demands of the union cannot be met. In turn, the union has highlighted the legal issues Kaiser has found themselves embroiled in and taken to Twitter to express their concerns under the hashtag #KaiserStrike. Caldwell says that bringing staff back to the bargaining table will likely take more than just paying people better, or giving people more time off. For him, systemic failure is where the concept of self-care falls down as a human resources strategy. For these workers, it’s not about needing to find time for themselves, it’s about addressing the needs of their patients. “Those things are nice, and they can help. But fundamentally, if you're a clinician and working in a system that you come to realize is structurally inconsistent with your values, then you're going to leave. If you don't feel like you can change that system from within, you have to figure out how to come to terms with this moral conflict.” What This Means For You If you're a patient in the California Kaiser Permanente system you may be met with high wait times or picket lines when you seek an appointment. The Debate Surrounding Court-Ordered Mental Health Treatment for the Homeless 1 Source Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Murthy VH. Confronting health worker burnout and well-being. N Engl J Med. 2022;387(7):577-579. doi:10.1056/NEJMp2207252 By John Loeppky John Loeppky is a freelance journalist based in Regina, Saskatchewan, Canada, who has written about disability and health for outlets of all kinds. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.