The three-day strike by Kaiser Permanente mental health professionals set to start today signals a move by unionized workers in that specific negotiation process, but it should also be seen as a warning sign of a much larger problem across Hawaii.
Even predating the COVID-19 disaster but accelerating since then, there is a mounting need for mental health services across the health-care sector, and a shortage of personnel with the training to deliver them.
First, the immediate alarm bell: More than 50 psychologists, licensed clinical social workers, medical social workers, psychiatric nurses and chemical dependency counselors were due to walk off the job this morning through Friday.
The basic grievance by the union, the National Union of Healthcare Workers (NUHW), is that the staffing is insufficient to meet the demand, leaving patients waiting for care to be scheduled and the therapists overwhelmed by the caseload.
NUHW filed a complaint with the state Department of Commerce and Consumer Affairs in November, citing a months-long wait for a first therapy session for patients with a range of conditions. Among its other points was that Kaiser has contracts with out-of-network mental health therapists but that only 28% are accepting Kaiser members as new patients.
In a written response, Greg K. Christian, the Hawaii market president for Kaiser Foundation Health Plan Inc. and Hospitals, acknowledged a long-term shortage of mental-health resources, even pre-pandemic. Christian added that, in addition to its efforts to hire more clinicians, Kaiser is leveraging telemedicine to enable virtual visits for patients, where that’s appropriate.
The union counters that managers should implement its suggested incentives for clinician retention and recruitment. That specific dispute is for negotiations to resolve.
But in general, it is crucial that the issue is not ignored. Other health organizations, locally and nationally, are contending with the same shortage of mental-health providers trying to serve a growing population in need.
Jack Barile, interim director of the Social Science Research Institute at the University of Hawaii at Manoa, was a co-author of a study, issued last October by the Centers for Disease Control and Prevention, noting an increase in adult anxiety and depression. The especially harsh economic outcome in Hawaii likely deepened that impact here, Barile said in a UH report about the research.
Mental Health America conducted a screening from January to September 2020. Among its findings: Since the beginning of the pandemic in March 2020, more than 8 in 10 people who took a depression screen consistently scored with moderate to severe symptoms.
Further, May is National Children’s Mental Health Month, an opportune time to recognize the 1 in 5 youths nationally experiencing a mental health challenge. And in few places can social-emotional problems be seen more plainly than in the schools, where educators cite the lack of resources to solve them and to help youngsters struggling to cope.
Mahina Anguay, principal of Waimea High School, was part of a public schools team that met recently with the Honolulu Star-Advertiser editorial board.
“We are talking about families and students who have endured severe trauma,” Anguay said. “I’ve put in to pick up an extra counselor. Well, there aren’t any extra counselors lying around in Kauai.”
On every level and for people of all ages, the system for addressing mental health needs is fraying. Paying due attention to this crisis — finding help in the near term and training more professionals for Hawaii’s future — defines the only path to full health recovery for Hawaii, through the pandemic and beyond.
