The union representing mental health therapists at Kaiser Permanente says patients are still waiting too long for their next available appointment.
More than three years after therapists held a 172-day strike over severe understaffing, compensation and the inability to treat patients according to clinical standards, the union says these same issues continue to linger as negotiations are underway for a new contract.
The National Union of Healthcare Workers shared recent survey results, which found that the majority of Kaiser therapists continue struggling to provide timely and appropriate care to their patients in Hawaii.
“At our clinics, patients who are struggling with depression or the loss of a loved one still have to wait more than a month for their first appointment and another month for their next appointment,“ said Kathleen Rubio, a Kaiser Oahu therapist, in a news release. “We do everything we can to support our patients, including staying late and working extra hours, but the system keeps failing them, and Kaiser has no interest in making things better.”
Kaiser, in a statement, said it remains focused on ensuring its members and patients have access to timely, high-quality mental healthcare.
“Demand for mental health care has grown significantly since the pandemic and stayed high,” said Kaiser in the statement. “We have been working to address the shortage of mental health professionals here in Hawaii. We have made meaningful investments over the last several years to expand mental health access — including growing our clinician workforce, expanding our network of community providers, and increasing capacity to meet patient needs.”
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But the union contends these efforts have fallen short and that there’s a stark contrast between staffing levels for workers in Hawaii and California.
The union said Kaiser still staffs just about one mental health clinician for every 5,500 members in Hawaii, compared to one mental health clinician for every 1,916 members in northern California.
The survey was distributed online in February and March to most of the 50 Kaiser behavioral health professionals in the union who work on Oahu, Maui and Hawaii island, including psychologists, social workers, marriage and family therapists, and licensed clinical counselors across various departments. Nearly 80% of workers surveyed responded.
Among the survey’s findings were that 85% of therapists in Hawaii who participated reported their next available return appointment to be at least 21 business days, or about a month, away. Clinical standards typically require therapy sessions at least every two weeks, the union said.
An overwhelming majority, 96%, of survey participants reported having to work beyond their regular hours at least once a week due to not having enough time to complete all their daily tasks. A majority, 84%, said there was not enough staff in their departments to provide appropriate and timely care for patients.
Survey results also indicate low morale, with more than half, 62%, saying that they have considered leaving Kaiser during the past six months due to working conditions.
Kaiser and the union are in talks for a new contract covering about 50 mental health workers in Hawaii, including social workers, psychologists, mental health therapists and addiction medicine counselors.
Negotiations began in November, but the union says Kaiser has insisted on lower raises than it gave other workers in Hawaii and is slow-walking negotiations.
The two sides met in early May and are scheduled to meet again on Monday.
Kaiser says, “We are actively engaged in bargaining with NUHW and will continue to work in good faith toward an agreement that supports our workforce and meets the needs of our members and community.”
Rachel Kaya, a psychologist for Kaiser on Maui for 16 years, says many of the same issues still persist today as in 2022, when workers went on strike.
“The shortages still persist, and the shortages mean the wait times for patients still persist,” she said. “If we had staff shortages and inadequate access to care under the previous contract, it would make a lot of sense to want a better contract to improve conditions for patients.”
The workers’ contract expired in March, she said, following a one-month extension.
Kaya said for her, the top priority is staff recruitment and retention, which would involve better wages to keep pace with the cost of living. Following the Aug. 8, 2023, Lahaina wildfires, she recalls how a new hire quickly discovered the pay was not enough to cover monthly rent.
“You can’t provide care if you don’t have staff to provide it,” she said. Morale is low, she said, and burnout is high, as “we are constantly overworked and underpaid.”
The 172-day strike that began in August 2022 succeeded in winning pay raises and preserving pensions, the union said, but understaffing remained an issue.
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UNION SURVEY FINDINGS
>> 96% said they have to work beyond regular working hours at least once a week in order to complete all of their daily tasks.
>> 95% reported that weekly individual therapy appointments at their clinic were not available to those who needed it.
>> 86% said they believe Kaiser has a higher level of commitment to physical healthcare than to behavioral healthcare.
>> 85% said their next available return appointment was at least 21 business days (about a month) away; 75% reported their next available initial appointment was 21 business days away.
>> 84% said there wasn’t enough staff in their department to provide appropriate/timely care to patients.
>> 70% of adult and child therapists said they were forced to schedule visits further into the future than clinically appropriate.
Source: National Union of Healthcare Workers (Survey conducted in February/March 2026)