OAKLAND, CA – On some of her darkest days, Barbara MacDonald turned to music. She says she’ll “sit down and hear her cry and I’ll play the guitar.” Her daughter would cry, battered by her mental health struggles.
“My younger daughter was exhibiting behaviors like self-harm and eating disordered and things like that,” she says, “and when she was a teenager, even though the care seemed somewhat of an experience, you know, like therapists and training and things like that, we felt very supported and all the different components of her care.”
But her daughter is now 19 and the past few years have told a different story.
“We’ve been dealing with this for a long time,” she says with a sigh, “You know, she’s on medication and that nobody at Kaiser has, you know, done that prescription, but they’re not tracking her. So the last time she saw a psychiatrist was probably six months ago.
Now she says: “I just feel completely hopeless trying to get anything from Kaiser. It’s like I’ve given up on Kaiser helping my family thrive. I don’t even feel like they care if we survive.”
That struggle was echoed by April Jordan, whose 24-year-old son called her last spring.
“He called me at the end of April this year and just said, I can’t do this anymore. I need help. I have to go back to that therapist. I need. I need help. I need. I need you,” she said.
Jordan also says that Kaiser has been helpful in the past and hoped that therapists would be able to help him again. But she says all he had were phone numbers.
“He said it was just a complete run-in. He didn’t get any help. He didn’t get anybody,” Jordan explains, saying that “his girlfriend took him a week before she died and he was very upset and he” I think she said the panic attacks and anxiety were severe and the depression was severe. And he went in there and they waited in the lobby for over two hours. And he said I’m not leaving until I talk to somebody. I’m not leaving until I talk to someone. He was there for over two hours and they came out to give him another phone number, you know. No help a week before he died, he was trying his best.”
She believes that self-medicating his symptoms led to his death, saying “he was left to his own devices, which was inappropriate. This led to his death. Yes”.
Both of their children were patients at Kaiser, and with the therapists’ strike entering its 8th week, Kaiser and his care are taking center stage.
Clinical psychologist Dr. Jessica Bergstrom told us, “I want to cry. You know, we all went into this field so we could help people. And we are not able. Because of the system. People really struggle and so is the system. And it’s devastating for everyone involved.”
She wrote a blog called A Day in the Life of a General Department Therapist: An Inner Dialogue.
She says part of the problem is that health care systems are using a medical model as a mental health model, and it’s not working.
“It’s not that complicated an injury. Depression, anxiety or grief is not like that,” she said. “So because we have so many patients, we book people in once every six to eight weeks for therapy. And it’s no longer therapy at this point. It’s, you know, giving patients an ice pack and hot tea to help with their symptoms and we’re not really getting to the root cause of this infection.”
These are questions state Sen. Scott Weiner hopes to address through a bill he authored, SB 221, which took effect in July.
“So, as SB 221 says, you as a health care provider must provide access to mental health appointments within two weeks of the initial appointment,” Weiner explains, “And then two weeks later, unless the health care provider say you don’t need that frequency level. It’s a measure of accountability.”
He says he doesn’t believe it’s a problem with available therapists. He believes that’s the bottom line.
“In terms of mental health, there’s a lot more financial incentive for them to minimize treatment or delay treatment,” Weiner explains, “And when they have to provide more timely, comprehensive access to mental health treatment, that really impacts the end result. And that’s why we really have some of these problems.”
This creates more inequalities. If you have money you can get help, if you don’t you can’t.
MacDonald says that to get her daughter the specialized care she needed, she had to pay tens of thousands of dollars out of pocket, she drained her savings and had to ask friends for help, calling it “a huge financial burden that I can not afford. “
But the question is, is this a Kaiser problem or a bigger one?
“I mean, Kaiser is not the only health plan that has these problems,” Weiner admits, “but Kaiser, from what I’ve been able to tell, is more extreme. And part of that is because of the Kaiser model, where it’s a stand-alone system. And so the Kaiser controls everything.”
Kaiser defended itself in an email response to KTVU, saying it supports the intent of SB 221 and calling implementation “challenging for all health plans, not just Kaiser Permanente.”
Kaiser also pointed to the shortage of mental health professionals, calling it “real and well-documented” and says it has launched a “$500,000 fundraising initiative to recruit new clinicians.”
Kaiser is currently being reviewed by the state in both a so-called non-routine review and an investigation.
The Division of Managed Health Care tells KTVU in a written statement that it is “also concerned about the potential for immediate harm to enrollees based on the very serious nature of the allegations that Kaiser is not providing timely enrollee appointments as required by law.”
And so the strike continues. Investigations are ongoing. Pressure from lawmakers continues as patients and their families wait for help to arrive.
“It’s ridiculous. It’s ridiculous,” Jordan says.
MacDonald echoes this frustration, saying, “My older daughter once said, what do I have to do to get a psychiatrist at Kaiser? Should I hurt myself and go to the emergency room? That’s the feeling.”