Kaiser Mental Health: Strike Over AI, Delays & Patient Safety

The mental health of Kaiser Permanente patients in Northern California may be at risk due to changes in the healthcare system’s patient screening process, according to therapists at the organization. Concerns center on a modern system implemented in January 2024 that utilizes clerical workers – not licensed practitioners – for initial assessments, and the increasing utilize of online questionnaires for some patients. These changes, therapists say, are leading to delays in care for those with serious conditions, while potentially fast-tracking lower-risk patients and straining an already overburdened system.

Delayed Care and Rising Anxiety

Ilana Marcucci-Morris, a licensed clinical social worker at Kaiser Permanente’s psychiatry outpatient clinic in Oakland, California, describes a worrying trend: she’s increasingly seeing patients who she believes should have been sent to the emergency room weeks earlier. “Thank God they’re still alive,” she says, reflecting the severity of some cases she now encounters. Prior to January 2024, licensed professionals were typically the first point of contact for patients seeking behavioral health services at Kaiser. The shift to using clerical staff to ask scripted “yes” or “no” questions to assess urgency has raised significant concerns among clinicians.

These concerns prompted approximately 2,400 Northern California mental health professionals, represented by the National Union of Healthcare Workers (NUHW), to participate in a one-day strike in February 2026. The strike aimed to protest the changes to the patient screening processes and voice fears that Kaiser plans to utilize artificial intelligence to replace licensed therapists for certain tasks. Marcucci-Morris emphasizes the importance of human interaction in mental healthcare, stating, “Human operate needs to stay with human beings.”

Evidence of Negative Outcomes

Five licensed Kaiser therapists have reported that patients with high-risk cases are experiencing longer wait times for care since the new assessment process was rolled out. Simultaneously, they observe lower-risk patients being scheduled for appointments more quickly, adding to the strain on the system. Since January 2025, therapists have documented over 70 instances where Kaiser’s mental health screening system allegedly resulted in negative care outcomes, as detailed in a complaint filed with the California Department of Managed Health Care (NUHW Complaint).

The union’s complaint alleges that the new system is illegal. A similar complaint was also filed in Southern California in 2025. An internal survey of Kaiser’s mental health workers in Northern California, obtained by The Guardian, revealed that more than one-third of employees believe Kaiser has already implemented AI or other technologies that could negatively impact their work or patient care. Nearly half expressed discomfort with the introduction of AI tools into their clinical practice.

Kaiser’s Response and Ongoing Concerns

Kaiser Permanente maintains that the claims made by NUHW leadership regarding access and care are misleading. In an emailed statement, the organization asserts that “AI and Clerical staff are not conducting any assessments, making any clinical determinations nor conducting clinical triage.” They state that clerical staff are trained to immediately escalate cases to clinical staff if necessary. Kaiser also emphasizes that they are “growing our workforce, not shrinking it,” although NUHW representatives contend that the number of triage therapists has significantly decreased.

Kaiser acknowledges the potential benefits of AI in supporting clinicians by reducing administrative burdens and improving efficiency, but insists that it will not replace clinical judgment or human assessment. However, concerns persist regarding transparency and data retention policies related to the use of AI software like Abridge for note-taking. Kaiser states that use of Abridge is optional and requires patient consent.

The Impact of System Changes on Clinicians

Kristi Reimer, a licensed psychologist who previously worked in Kaiser’s Walnut Creek facility, left her position preemptively, sensing “the writing on the wall.” She states she wouldn’t have considered a different role within Kaiser if the mental health assessment system hadn’t undergone such drastic changes. Harimandir Khalsa, a triage worker in Walnut Creek, reports that her team has been reduced from nine staff members to just two or three over the past two years.

Despite her anxieties about the future, Khalsa remains committed to her role, valuing the opportunity to leverage her decades of research and clinical experience to assist vulnerable individuals. However, she expresses concern about the potential for clerical staff and questionnaires to inadequately perform the triage function. She wonders if her position is next to be eliminated.

Why Initial Assessment Matters

The NUHW argues that a patient’s initial contact point significantly influences whether they receive care from a licensed clinician and the type of appointments they are offered. This is why the union is pressing for more information regarding Kaiser’s use of technology in initial assessments. The union’s complaint in Southern California details how clerical staff ask patients about suicidal and homicidal thoughts, entering the responses into a software tool that generates a score and suggests a course of action. The complaint alleges that Kaiser is using an algorithm to make triage decisions, violating state law – a claim Kaiser denies, stating that its clerical staff are not making assessments or clinical determinations.

It’s currently unclear whether a similar algorithm is used in Northern California, though the union suspects it is, and Kaiser has not clarified. Kaiser has faced previous scrutiny and legal action regarding timely access to mental health services. In 2023, the organization reached a $200 million settlement with California to resolve investigations into these delays. Just last month, the U.S. Department of Labor announced a $31 million settlement with Kaiser over similar allegations, claiming that Kaiser used patient responses to questionnaires to improperly deny care. Kaiser agreed to reforms aimed at reducing wait times and improving access to quality care as part of the settlement.

However, Kaiser employees question the organization’s commitment to these reforms, pointing to the potential shortcomings of relying on questionnaires and clerical workers for triage. Therapists emphasize that triage is a complex process requiring the expertise of licensed practitioners to accurately interpret patient statements and assess risk.

Carolyn Staehle, a Kaiser therapist, notes that after the new system was implemented, she began seeing more patients with dangerous delusions and serious suicidal thoughts who required immediate emergency intervention. She also observed that the influx of lower-risk patients was slowing down the process for those in urgent need of care.

While Kaiser maintains that it delivers “timely, high-quality care,” Staehle and other workers remain focused on ratifying a new contract and securing a commitment from Kaiser to protect the roles of licensed social workers and prevent their replacement by AI.