fbpx
Connect with us

Labor & Economy

Behind Kaiser’s Mental Health Breakdown

“The best practices of psychotherapy state that patients should be seen weekly or every other week,” says one clinical psychologist. But at Kaiser, his average patient must wait five weeks between appointments.

Gabriel Thompson

Published

 

on

Getty Images

A strike by mental health professionals is impacting more than 100 Kaiser clinics and medical facilities.  The union has proposed that Kaiser increase staffing and cut patient wait times.


 

When clinical psychologist Mickey Fitzpatrick thinks about his job, the image that comes to mind is not of a hospital or a doctor’s office, but that of a conveyor belt. Since 2015, the 45-year-old has worked at a Kaiser Permanente hospital in the Northern California city of Pleasanton, where he sees an endless stream of patients dealing with serious mental illnesses: post-traumatic stress disorder, depression, bipolar disorder and anxiety. Each week he sees four to five new patients, and estimates that last year he counseled between 800 and 900 people, who represented a blur of needs that weren’t always easy to keep straight.

“The best practices of psychotherapy state that patients should be seen weekly or every other week,” Fitzpatrick told me. But at Kaiser, he’s never been able to get anywhere near that goal. With his heavy caseload, the average patient must wait five weeks between appointments, a figure that is consistent with other Kaiser therapists I spoke to. “We’re giving them the care that we can with the resources that we can, but we’re not able to do what we’re trained to do.”

This isn’t a new problem for Kaiser. In 2013, the California Department of Managed Healthcare (DMHC) fined the nonprofit medical-care giant $4 million after completing a routine medical survey and discovering what it called “serious deficiencies in providing access to mental health services” and the company’s failure to promptly correct the problems. The survey found that patients often did not have timely access to appointments and that their educational materials “included inaccurate information that could dissuade an enrollee from pursuing medically necessary care.”

In 2015, a follow-up report by DMHC revealed that Kaiser still regularly failed to provide mental health services as required by state law, which mandates that patients with urgent problems receive an appointment within 48 hours; those with non-urgent issues should be seen within 10 business days (or 15 business days if the appointment is with a specialist physician, such as a psychiatrist).

In a review of nearly 300 patient records, the agency found that 22 percent of cases in Kaiser’s northern region failed to meet the state’s requirements, along with nine percent in the southern region. Among the randomly selected files was a patient with suicidal ideation who waited 16 days for an appointment, and a therapist for another individual who wrote in their notes, “patient wants regular ongoing treatment so may look outside Kaiser.”

The goal of providing “regular ongoing treatment” for Kaiser patients by hiring new therapists is one of the principal demands of mental health care professionals like Fitzpatrick, who has joined 4,000 of his colleagues this week in a five-day strike. The strike, organized by the National Union of Healthcare Workers, is impacting more than 100 Kaiser clinics and medical facilities, and comes amidst contract negotiations that began in June but have stalled. During those negotiations, the union has proposed that Kaiser increase staffing with the goal of eventually seeing returning patients within two weeks, as opposed to over stretches of time that now routinely exceed one month.

Kaiser Permanente disputes the claims that it hasn’t made significant strides in providing timely access to mental health care. “We have been hiring therapists, increasing our staff by 30 percent since 2015 – that’s more than 500 new therapists in California – even though there’s a national shortage,” said John Nelson, the vice president of communications for Kaiser Permanente, in a prepared remark. Nelson also challenged the union’s assertion that the strike had anything to do with patient care, stating that one of the union’s demands was to reduce the amount of time therapists spend seeing patients, which now averages 75 percent of their days.

For Clement Papazian, a licensed social worker at Kaiser for 30 years who works in Oakland, reducing the time spent seeing patients would dramatically improve the quality of care given to patients, by allowing therapists to check in on family members by phone, write up more thorough notes and create a work environment that didn’t feel like a “patient mill.” Papazian said that he has seen many dedicated therapists drop out due to the “relentless pressure to see more patients” — what he describes as “rapid access to no care.”

Papazian acknowledges that Kaiser has hired new therapists, but argues that those new hires haven’t impacted the workload, due to Kaiser’s rapid growth — its number of enrolled patients in California has increased by nearly 11 percent since 2015. He also argues that Kaiser is well positioned to staff-up its mental health department, as the company made $3.8 billion in profit last year. “Kaiser is a big player that can really shape the industry,” he said. “What we want is to deliver on the care that Kaiser members deserve.”


Copyright Capital & Main

Top Stories