SAN DIEGO (FOX 5/KUSI) — Thousands of mental health workers at Kaiser Permanente locations across Southern California hit the picket lines on Monday for the first day of an open-ended strike, calling for measures to reduce employee turnover and better patient care. The stoppage comes nearly a month after the workers' previous contract with the healthcare network expired at the end of the September. The union representing the workers, the National Union of Healthcare Workers, had been in negotiations for the next agreement since July. The unionized mental health professionals — encompassing therapists, psychologists, social workers and psychiatric nurses — have been demanding Kaiser address issues in their next contract that have contributed to "substandard" care in Southern California. San Diego County sees slight drop in unemployment According to the union, this includes chronic understaffing, which has made it difficult for workers to balance client appointments with patient paperwork. They also say below par wages and guaranteed benefits have contributed to many leaving the workforce. “Kaiser says all the right things when it comes to mental health care, but its actions tell a different story,” Josh Garcia, a psychologist for Kaiser in San Diego, said in a press release Monday. “Unless we strike, our coworkers are going to keep leaving and our patients are going to keep struggling in an underfunded, understaffed system that doesn’t meet their needs.” Last year, California behavioral health regulators flagged several of these problems when it hit Kaiser with a $50 million fine — the largest-ever penalty issued by the department — for failing to provide timely care to its patients as part of a wider $200 million settlement agreement. "Our agency could lose its Medicare license because we have five days to see our patients and, because our unsustainable caseloads, patient care is being delayed," Elizabeth Meza, a San Diego-area hospice worker, told KUSI Monday morning. "We are only able to provide the minimum amount of care that they need." The Southern California Kaiser behavioral health care staff are seeking similar pay and protections won by their counterparts in the northern half of the state following a 10 week strike back in 2022. Among the benefits the some 2,500 unionized staff want are guarantees of seven hours for therapists to complete their duties outside therapy sessions, a restoration of pensions, and pay that is comparable to non-mental health Kaiser employees. These measures, the National Union of Healthcare Workers says, would help reduce turnover and better patient care. “Everything we’re proposing in negotiations, Kaiser is already providing to the vast majority of its workforce,” said Adriana Webb, a medical social worker with Kaiser who specializes in serving patients with HIV. “If Kaiser is serious about transforming its mental health care system, it has to start by ending the inequities that harm us and our patients.” In a statement, Kaiser officials called the strike "entirely unnecessary" and criticized the union for demands it called as "unreasonable." The healthcare network said it already gave a strong offer to the workers, including wage increases and enhanced benefits. "The union isn’t calling for more time to care for patients. It is demanding more money for therapists to spend LESS time seeing patients," Kaiser said in its statement, referencing the union's demand for guaranteed time to complete paperwork. MTS approves changes to rules regarding fare enforcement During the strike, Kaiser said it would work to ensure patients do not see disruptions to mental health care, including urgent and crisis services, by giving them the opportunity to see other professionals in its care network. "NUHW is putting pickets before patients," Kaiser continued. "Instead, NUHW should engage sincerely at the table to reach an agreement that is good for our therapists and our patients … We understand give and take. We will continue negotiating in good faith until a deal is done. We ask the same of NUHW." According to Kaiser, additional bargaining sessions are scheduled for Wednesday, Oct. 23 and Friday, Oct. 25.