By the end of this week the 2,000 California mental health therapists, psychologists, social workers, and chemical dependency counselors who are part of the National Union of Healthcare Workers (NUHW) will have been on strike for 27 days to demand that their employer, the health care giant Kaiser Permanente, provide timely and good care for their mental health patients.

Five days before the August 15 start of the strike, the mental health workers told Kaiser that they were in agreement with the corporation’s wage proposals. But, they said, improvements in wages and benefits did not address the fundamental issue that would send them to the picket lines: chronic understaffing and access problems for their patients. On August 29, their peers in Hawaii also went on strike. They had joined together as a union also with NUHW four years ago, animated by care access issues. The union’s demands in both states focus on their patients’ needs.

Access to mental health care for Kaiser patients has deteriorated during the pandemic. Throughout the US, rates of depression and anxiety have soared, but NUHW members report that Kaiser staffs just one full-time-equivalent therapist for every 2,600 members in Northern California and approximately one mental clinician for every 5,500 patients in Hawaii, despite the corporation’s having reported an $8.1 billion net profit last year. Saddled with unrelenting caseloads that leave patients routinely waiting four-to-eight weeks between appointments—in violation of a new state law that requires follow-up appointments be provided within 10 business days—therapists are leaving Kaiser in search of places to practice where they can better provide care to patients.

The movement of social justice unionism is not new. It is typified by the belief that a union exists to fight for all working people—not just its members. It was that principle that energized the successful strikes of the Chicago Teachers Union in 2012 and 2019 and those in 2018–19 by teachers in Denver, Los Angeles, Oakland, Oklahoma, West Virginia, and elsewhere that focused on demanding resources for students, from smaller class sizes to more school nurses to an end to the school to prison pipeline.

It is what animated the successful 301-day strike of nurses at Tenet St. Vincent Hospital in Worcester, Mass., who are members of the Massachusetts Nurses Association, who demanded and won safe limits to the number of patients the for-profit corporation could order RNs to care for at any given moment.

“Kaiser’s mental health care system is falling apart,” said Kenneth Rogers, a psychologist at Kaiser in Sacramento. “We don’t have enough hours in the day to see patients and do all the preparation and follow-up work that goes into every appointment. Patients are suffering, while Kaiser sits on billions of dollars.”

There is another phrase that that has driven hospital workers to the streets. It, too, is not new, but has come into the public’s consciousness acutely since the start of the pandemic: moral injury, and the refusal of health care workers to accept it. This is defined as a cognitive response akin to PTSD that occurs after events that violate a person’s moral code, such as when health care professionals are forced to violate their training in treating their patients and therefore witness terrible negative outcomes day in and day out.

“We can’t in good conscience agree to a proposal that doesn’t fundamentally change Kaiser’s approach to mental health care,” said Chelsea Wise-Diangson, a therapist for Kaiser in Santa Clara. “Our patients’ health and our professional ethics are at stake. We need Kaiser to provide us with sufficient staffing and resources to help our patients get better.”

The union is accepting contributions to its strike fund and hardship fund for striking therapists. For that, as well as other ways to demonstrate support, go to: https://nuhw.org/kaiser-dont-deny/kaiser-strike/.

“It’s reached the point that I can’t help patients get better because I just can’t see them as often as they need to be seen,” said Andrea Kumura, a licensed clinical social worker at Kaiser’s Waipio, Hawaii, clinic, whose next available appointment isn’t until November. “If a patient goes into crisis, the only thing I can do is pray that someone else cancels. I’m not a healer anymore; I’m a holder of people’s pain.” That pain is being transformed into a struggle to end its cause. Says Darah Wallsten, a clinical psychologist at Kaiser’s Hilo Clinic, “The only choice we have at this point is to strike for as long as it takes to make Kaiser meet the needs of our patients.”