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The Patient Trap

Kaiser needs to improve follow-up care for mental-health patients



I'm a psychotherapist who until recently worked with adults in the psychiatry department at Kaiser Permanente in Santa Rosa. I've been there over seven years. I recently turned in my resignation because I can no longer do the work I do best—eye movement desensitization and reprocessing (EMDR) therapy for people with severe trauma—effectively and safely. There's simply not enough time for the patients. But as I'm leaving, I'm trying to improve the system for the multitudes of mentally ill clients still to come through Kaiser's doors.

Kaiser is the number one mental-illness care provider in California. Therapists are to mental healthcare what primary care physicians are to the rest of healthcare. Yet the average wait time between therapist visits in Santa Rosa is currently five weeks. In other Kaiser mental-health clinics, the waits are even worse.

I became a steward for the National Union of Healthcare Workers a scant three months ago, with the intent of joining the ongoing campaign to provide better basic care to our clients. The union has been doggedly addressing the deficiencies in our system for the three years since they were voted in as our union. In 2012, they were successful at triggering an investigation by the Department of Managed Health Care (DMHC), the state's regulatory agency that oversees HMO behavior. In June 2013, the DMHC fined Kaiser $4 million for failing to provide timely initial access to services.

To avoid future fines, Kaiser transferred resources from follow-up care to initial care. Therapists started seeing people more quickly for their first visit, but subsequent visits got pushed further and further away. The clients had better access, true, but not to care. Kaiser is still attempting to beat the original $4 million fine. The case, a face-off between the DMHC and Kaiser, is set to go to court in Oakland in mid-May.

People with mental illness deserve more than a timely first visit. If the laws are unclear about the basic services Kaiser needs to provide its members, it's time to clarify the laws.

Andy Weisskoff lives in Sebastopol. His blog, chronicles his efforts at improving managed mental healthcare from the inside out. Open Mic is a weekly feature in the 'Bohemian.' We welcome your contribution. To have your topical essay of 350 words considered for publication, write


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