For the tenth straight week, Kaiser Permanente mental health care workers picketed Southern California medical centers Monday, preparing to take a few days off for the Christmas holiday before returning to their vigil Thursday. Underway since Oct. 21, the open-ended strike is the longest in recent memory and one that burns cash on both sides. Workers do not get paid while they are not at work, and Kaiser must pay replacement workers to see patients while their regular therapists are demonstrating for better wages and staffing changes. Kaiser and the National Union of Healthcare Workers, which represents about 2,400 striking mental health care workers, traded strained statements Monday, with the health care giant stating that “45% of our therapists have returned to work and are caring for our patients and members,” hinting that the resolve on the front lines may be waning. While union officials did not confirm that figure during a news conference Monday morning, Sal Rosselli, NUHW’s president emeritus, said that the financial hardship of staying on the picket line for more than two months has brought some back to their jobs. “Not everyone can afford to continue striking, but we are absolutely secure that everyone is supportive of a strike in our goals, even if they have to do it from the inside,” Rosselli said. Those waving signs at Clairemont Mesa Boulevard and Ruffin Road in front of Kaiser Permanente San Diego Medical Center Monday showed no signs of giving up. Among them was Olivia Aguirre, a licensed marriage and family therapist and NUHW bargaining unit member who said she has worked for Kaiser for nine years. Kaiser workers, she said, are asking for better wages and more time to perform the administrative parts of their jobs, but they are also extremely adamant that there be changes in the amount of access that patient have to mental health services. “I haven’t had any thoughts of giving up, and I won’t have them, because this is greater than us,” Aguirre said. “This is greater than Kaiser. “This is, in my opinion, a mental health revolution. We are tired of the way mental health is seen and ignored.” She said she has personally seen too many patients wait too long for care, a statement which the state seemed to reinforce in 2023 when it levied a $50 million fine, and demanded a $150 million investment in mental health care, after finding “deficiencies in the plan’s provision of behavioral health care services to enrollees including issues identified in providing timely access to care, oversight of the plan’s providers and medical groups, network adequacy, conformity to mental health parity, and grievances and appeals, among many other issues.” In its latest statement, Kaiser says it has managed to keep its Southern California mental health care patients supplied with appointments during the strike, despite so many workers joining picket lines. “Any Kaiser Permanente member who needs an appointment is able to get one,” Kaiser’s statement said. “Patients in crisis get care 24/7, those with urgent needs can get appointments within 48 hours, and patients seeking nonurgent care are seen on average within 6 days, which is better than the state’s requirement.” But the union worked to push back against the assertion that the organization has been able to hold the fort during the strike. Yesmine Florines, who said she is herself a mental health counselor in therapy due to struggles after giving birth, said she struggled for months to get a therapist before the strike occurred. She said she has been assigned a couple’s counselor outside the Kaiser network during the strike, but has been unable to find anyone who can provide eye movement desensitization and reprocessing therapy, also called EMDR. “There is no continuum of care … it’s been very, very frustrating, and that’s just kind of where I’m at now, and it’s just been very hard.” Kaiser says it has invested more than $1 billion since 2020 to expand its mental health care in Southern California, adding “nearly 1,000 mental health professionals,” and “working to recruit an additional 350.” The two sides are set to resume negotiations on Jan. 9, 2025.