Kaiser accused of not providing timely mental health treatment to patients

In some of the darkest days, Barbara McDonald would turn to music. She says she would "sit downstairs and hear her crying and I would play guitar." Her daughter would cry, battered by her struggles with mental health.

"My younger daughter was exhibiting some behaviors like self-harm, disordered eating, things like that" she says, "and when she was an adolescent, even though the care seemed to be somewhat 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 last couple of years has told a different story.

"We've been at it in for a long time," she says sighing, "You know, she's on medication and that no one at the Kaiser fulfilled, you know, does that prescription, but they don't follow up with her. So the last time she saw a psychiatrist was probably six months ago."

 She says now, "I just feel in total despair in trying to get anything from Kaiser. Like I’ve given up on Kaiser helping my family thrive. I don't even get the sense that they care if we survive."

That struggle is echoed by April Jorden 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 need to go back to that therapist. I need. I need help. I need. I need you," she said. 

Jorden also says Kaiser had helped in the past and had hoped therapists would be able to help him again. But she says all he got were phone numbers.

"He said it was just a total run-around. He did not get any help. He did not get anybody," Jorden explains, saying "his girlfriend took him a week before he died, and he was very upset, and he'd been having, I think she said panic attacks and anxiety was high and depression was high. And he went in there, and they waited in the lobby for over two hours. And he was like, I’m not leaving till I talk to someone. 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 one week before he died he tried hard as he could."

She believes self-medicating his symptoms led to his death, saying "he was left to his own devices, which was inadequate. That led to his death. Yes."

Both their children were patients at Kaiser and with a strike by therapists entering its 8th week, Kaiser and its care have taken center stage.

Clinical psychologist, Dr. Jessica Bergstrom told us "I want to cry. You know, we all went into this field to be able to help people. And we're not able to. Because of the system. People are really struggling and so is the system. And it's crushing for everyone involved."

She wrote a blog called "A Day in the Life of a Generalist Department Therapist: An internal dialogue."

She says the problem in part is that health care systems are using a medical model as a mental health model and that doesn't work.

"That's not how complex trauma is. That's not how depression is or anxiety or grief," she said. "And so because we have so many patients, we're booking people once every six to eight weeks for therapy. And that's no longer therapy at this point. That's, you know, giving the patients the ice pack and the hot tea to help with the symptoms and not actually getting down to the root of the cause of that infection."

They are issues State Senator Scott Weiner hopes will be addressed by a bill he wrote, SB 221 that went into effect in July.

"So, as SB 221 says, you as the health care must provide access to mental health appointments within two weeks of initial appointment," Weiner explains, "And then two weeks later, unless the health care provider says you don't need that level of frequency. It's an accountability measure."

He says he doesn't believe it’s an issue of available therapists. He believes this is about a bottom line.

"For mental health, there's much more of an incentive financially for them to minimize treatment or delay treatment," explains Weiner, "And when they have to provide more timely, comprehensive access to mental health treatment, it does impact their bottom line. And that's why really we have some of these problems."

That creates more inequities. If you have money you can get help, if you don’t, you can’t.

Mcdonald says to get her daughter the specialized care she needed she had to pay tens of thousands of dollars out pocket, she drained her savings and had to ask her friends for help calling it, "a huge financial burden that I can't 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 issues," acknowledges Weiner, "but Kaiser, from what I have been able to tell, is more extreme. And part of that is because of Kaiser’s model, where it's a self-contained system. And so Kaiser controls everything."

Kaiser defended itself in an emailed response to KTVU and said that it supports the aim of SB 221 and calls the implementation "challenging for all health plans not just Kaiser Permanente"

Kaiser also pointed to a lack of mental heal professional calling it "real and well documented" and says its launched a "$500,000 recruiting initiative to recruit new clinicians."

Kaiser is currently under review by the state in both what's called a non-routine survey and an investigation.

The Department of Managed Health Care telling KTVU in a written statement it is "also concerned about the potential for immediate harm to enrollees based on the very serious nature of allegations that Kaiser is not providing timely appointments to enrollees required by the law."

And so the strike continues. The investigations continue. The push by lawmakers continues as patients and their families wait for help to come.

"It's ridiculous. It's ridiculous," says Jorden.

Mcdonald echoing that frustration saying, "my older daughter once said, what do I have to do to get a psychiatric appointment with Kaiser? Do I have to hurt myself and go to the emergency room? That's what it feels like."