SAN FRANCISCO (CBS SF/AP) — Thousands of mental health workers at Kaiser Permanente offices across the state walked off the job Monday — the first day of a week-long strike over staffing levels and pay.

Outside Kaiser Permanente hospitals and clinics in the San Francisco Bay Area dozens of workers marched Monday holding signs that read “Kaiser, Don’t Deny My Patients Mental Health Care,” and “Care Delayed is Care Denied.”

About 4,000 psychologists, therapists, social workers, psychiatric nurses and other medical professionals represented by the National Union of Healthcare Workers say they will picket through Friday.

Elita Fielder, a spokeswoman for Kaiser Permanente, said during the walkout some non-urgent mental health and other appointments may need to be rescheduled but anyone in need of urgent mental health or other health care will receive the services they need.

“They’ve canceled appointments for these five days, but there’s a critical situation every day of the year,” Sal Rosselli, the union’s president, told the East Bay Times.

Rosselli said patients have to wait a month or more for follow-up appointments because of inadequate staffing.

Fielder said Kaiser Permanent has added more than 500 mental health care therapists and invested $175 million to expand mental health care offices since 2015, when the threat of an open-ended strike was averted after the union and Kaiser agreed to a contract.

Rosselli said negotiators are seeking pay increases as well as benefits packages equal to those given to other medical professionals.

Kaiser has hired hundreds more mental health professionals but patient care and access has stayed the same or worsened as the health care provider has expanded its client base significantly and some caregivers have left, Rosselli said.

The union claims at the current work force levels there is one clinician for every 3,000 patients.

Michelle Gaskill-Hames, the regional chief nurse executive for Kaiser Northern California said the holiday season is often providers see spikes in depression and mental health challenges. “It affects us all, our families, and so we find it really irresponsible that [the union has] made this decision,” said Gaskill-Hames.

Patients who feel they need mental health care should be sure to call their provider, said Gaskill-Hames; do not wait for the strike to be over.

Kaiser says it has brought in additional staff to cross the picket line and pick up shifts, keeping all of their facilities open. They say this time of year is critical for mental health and they aren’t taking any chances.

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