City employees face months-long wait time for mental health care

‘We are in the midst of a mental health crisis’

San Francisco city employees insured through Kaiser Permanente and seeking mental health treatment sometimes have to wait up to three months for an appointment with a therapist, a hearing during the Board of Supervisors’ Government Audit and Oversight Committee on Thursday revealed.

Supervisor Connie Chan, who sits on the committee, called the hearing in response to complaints about Kaiser-insured city employees and retirees who aren’t getting timely access to mental health care.

Chan is the board’s representative on the Health Service Board, the governing body of the San Francisco Health Service System, the agency that negotiates contracts for some 135,000 city employees, retirees and their family members. A majority of them are covered by Kaiser.

“I know the hard work that goes into putting the best options that The City can for our workers, but we all know that we’re working within a fairly broken health care system. The global pandemic has only highlighted this problem as demand for mental health care has increased significantly,” Chan said.

Although both SFHSS and Kaiser said they want to provide immediate, non-urgent mental health treatment for patients, the resources aren’t there.

Kaiser said it has stepped up access to mental health care, but a national shortage of health care specialists is part of the problem,

“We are the midst of a mental health crisis,” said Dr. Maria Koshy. “The pandemic has exacerbated preexisting mental health issues in the community and it’s reduced access to vital social support systems. So, while our country moves through a broad public health crisis, the ongoing national shortage of qualified mental health care professionals has stretched our caregivers.”

A Kaiser patient seeking mental health treatment will get a 30-minute phone assessment within about 10 days. After that, the type of treatment recommended will dictate how soon the patient can get access to treatment, Koshy said.

But for most moderate to severe patients, access to treatment can take months, “making treatment dangerously ineffective,” said Ilana Marcucci-Morris, a Kaiser social worker.

“Paradoxically, the more severe patients typically face the most wait times for appointments unless they are actively seeking to commit suicide or deemed an immediate threat to themselves or others. They will have to wait months for an appointment with a treating therapist,” she said.

Currently, Marcucci-Morris said, the earliest appointments being offered for people seeking treatment are in late January.

“We’re talking about a depressed, anxious, or otherwise really troubled individual waiting three months,” said Jeffrey Chen-Harding, a Kaiser social worker. “It’s travesty, not even on a humanitarian level, it’s a travesty on a safety level, on a liability level. I should think Kaiser would be extremely concerned about that.”

Supervisor Rafael Mandelman called the wait times “unacceptable.”

“It is true that this is a problem that is bigger than Kaiser, but Kaiser is a huge actor in this space and I think we look to Kaiser to help figure out how to solve this and actually be a leader in solving it. And I remain concerned after this hearing that we’re not there and Kaiser needs to do more,” he said.

According to Kaiser, it’s aggressively hiring mental health specialists, hiring more than 600 therapists in California between 2016 and 2020.

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