Reflecting On Kaiser’s Mental Health Services
Image by Andrej Lišakov.
Mental health services are crucial to our well-being. I think that most people will agree with me. As I write, mental health workers employed at Kaiser Permanente in Southern California and represented by the National Union of Healthcare Workers are beginning month three of a strike over work conditions. As these workers see it, their employer’s rules are harmful to them and Kaiser patients. Count a young family member of mine among the latter. What follows are my reflections on his experience with Kaiser’s mental health services.
It is a truism that time is money in a modern economy. Accordingly, the time mental health workers spend with their patients costs a nonprofit enterprise such as Kaiser Permanente money. Nothing is free in a modern economy. Having worked in the public and private sectors, I know that firms need money to pay employee salaries, keep the lights on and so forth.
In the case of my youthful family member, he began to receive mental health services from Kaiser Permanente as a preschooler. Why? In desperate brevity, his behavior in and out of the home forced that move, taken with an eye to the benefits and risks involved. Social stigma is a possible pitfall to ponder. There are others. One is medication side effects.
Following a Kaiser intake process, there were sessions with a mental health worker. He was a young man with a big smile and cheery demeanor. He had a fondness for handouts and website referrals. I never thought of understaffing. It is a big issue among Kaiser’s mental health workers. They are quite dismayed at the lack of their time with patients. Later, this mental health worker referred the youngster to see a psychiatrist.
On one hand, the psychiatrist refrained from sharing handouts and website tips. This was a welcome relief. I saw this as a kind of self-serve process, a little like using a scanner for a retail checkout. In the meantime, the psychiatrist listened to him and me, also asking questions. On the other, she spent scant time getting to know the boy, in my view. I think that this approach did him a disservice. Maybe I am wrong. However, I know him. He relates to adults in and out of the health care field partly based on the time they take with him.
A consequence of the Kaiser clinician’s time limits was a missed diagnosis. To be clear, she did diagnose the boy. I write this in hindsight, which is always clear. What the Kaiser clinician failed to discover was a condition that three years later a psychologist in private practice discovered. How? As I see it, the answer is straightforward. She spent more time with him than did the Kaiser clinician. I sit accused of simplifying this narrative, boiling it down to money and time.
This private psychologist spent hours on his case. Many were her questions. Consider this. This psychologist spent an entire morning giving him a battery of tests. With her, he had breaks and treats to help him keep focused. I lost track of how many forms that I finished for her assessment of him. I am not complaining. I would do it again in a heartbeat.
This was a completely different experience in terms of quality and quantity of therapy from Kaiser’s mental health services. The phrase night and day comes to mind
Once diagnosed fully, doors for treatment opened to services and targeted at his once-hidden conditions. Increased clinician time out of the Kaiser system improved his life, a step forward.
At the end of the day, mental health therapy should prioritize the needs of the patient. It did not for Kaiser’s delivery of mental health services. The HMO’s workers lacked the time to diagnose properly what ailed him. Did they choose their time with patients? In and out of the health care industry, employers control employees’ labor time
I do not blame the mental health workers who Kaiser employs for partial treatment of my boy. The National Union of Healthcare Workers blames Kaiser management for cutting mental health workers’ time treating patients to allocate money elsewhere. In sum, mental health workers’ working conditions drive their patients’ therapy, according to the NUHW. I agree.
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