‘Thank God they’re still alive’: Kaiser therapists claim its new screening system puts patients at higher risk by delaying their care
In recent months, therapists at Kaiser Permanente have expressed serious concerns regarding a new patient screening system that they believe is jeopardizing patient care. The system, which was implemented in January 2024, has reportedly led to delays in treatment for patients with mental health issues, raising alarms among healthcare professionals.
Changes in Patient Screening Process
Ilana Marcucci-Morris, a licensed clinical social worker at Kaiser Permanente’s outpatient clinic in Oakland, California, has observed a troubling trend. She notes that patients are arriving with more severe mental health conditions than they did two years ago. “Thank God they’re still alive,” she reflects on the patients who finally make it to her office.
Previously, licensed professionals were the first point of contact for patients with behavioral health issues. However, the new screening process introduced clerical workers who are not licensed practitioners. These workers ask scripted “yes” or “no” questions to assess the severity of patients’ conditions and how urgently they need to be seen. Additionally, Kaiser has implemented e-visits, which are online questionnaires that patients complete before being scheduled with a licensed healthcare professional.
Concerns from Mental Health Professionals
Marcucci-Morris joined approximately 2,400 mental health professionals employed by Kaiser in Northern California for a one-day strike to protest the changes in the patient screening process. The National Union of Health Care Workers (NUHW) organized the strike to raise concerns about the potential use of artificial intelligence (AI) to replace licensed therapists for certain tasks.
Five licensed therapists reported that since the new assessment process was introduced, patients with high-risk cases have been waiting longer for care. Meanwhile, lower-risk patients are sometimes fast-tracked to appointments, exacerbating an already strained system. According to an administrative complaint filed by the NUHW with the California Department of Managed Health Care, therapists have reported over 70 instances of negative care outcomes linked to the new screening system since its implementation.
Kaiser’s Response to Criticism
Kaiser Permanente has pushed back against the claims made by the NUHW, asserting that the union’s leadership has made misleading statements about access to care. In a statement, Kaiser emphasized that clerical staff are not conducting assessments, making clinical determinations, or performing clinical triage. They also noted that clerical staff are trained to escalate cases to clinical staff when necessary.
The organization maintains that it is expanding its workforce rather than reducing it, despite claims from NUHW representatives that the number of triage therapists has significantly decreased. Kaiser stated, “We believe AI can be helpful when it supports clinicians by reducing administrative work or improving efficiency, but it does not replace clinical judgment or human assessment.”
Legal Complaints and Employee Concerns
The NUHW’s strike was partly motivated by a complaint filed with the California Department of Managed Health Care, alleging that Kaiser’s new patient screening system is illegal. A similar complaint was filed by NUHW in Southern California in 2025.
In an internal survey conducted in 2025, over one-third of Kaiser’s mental health workers in Northern California reported that they were aware of AI or other technologies being rolled out that could negatively impact their work or patient care. Nearly half of the employees expressed discomfort with the introduction of AI tools into their clinical practice, raising concerns about transparency and data retention policies associated with AI software.
Impact on Mental Health Professionals
Kristi Reimer, a licensed psychologist who previously conducted mental health triage assessments at Kaiser’s Walnut Creek facility, left her position due to the drastic changes in the mental health assessment system. She cited a sense of foreboding about the future of her role and the care patients would receive.
Harimandir Khalsa, a triage worker at Kaiser in Walnut Creek, reported that her team has been reduced by two-thirds over the past two years. Despite her love for the work and the impact she has on patients, she shares the anxiety of her colleagues regarding job security and the encroachment of clerical staff and questionnaires into their professional responsibilities.
The Importance of Licensed Therapists
The initial point of contact for patients seeking mental health care is crucial. Licensed therapists bring years of training, experience, and clinical judgment that are essential for accurately assessing and treating mental health conditions. The shift to a system that relies on clerical staff and automated questionnaires raises significant concerns about the quality of care patients receive.
As the healthcare landscape continues to evolve with the introduction of new technologies, it is vital to ensure that patient care remains a priority. Mental health professionals argue that human interaction and clinical assessment cannot be replaced by automation or clerical work.
Conclusion
The changes in Kaiser Permanente’s patient screening process have sparked significant debate among mental health professionals, raising questions about the quality of care and the future of licensed therapists in the healthcare system. As concerns grow about the potential risks associated with these changes, it is essential for healthcare organizations to prioritize patient safety and the integrity of mental health care.
Note: The information in this article is based on reports and statements from various sources and may be subject to change as new developments arise.
