In a striking revelation, therapists at Kaiser Permanente are raising alarms about a new patient screening system that they believe compromises the safety of vulnerable individuals seeking mental health care. Ilana Marcucci-Morris, a licensed clinical social worker at Kaiser’s Oakland clinic, expressed deep concern over the increasing number of patients arriving in critical condition—many who, in her view, should have been directed to emergency services long before their appointments. “Thank God they’re still alive,” she remarked, reflecting on the dire situations of some patients who manage to reach her office.
Since the introduction of this new screening process in January 2024, the dynamics of patient assessment have shifted significantly. Previously, licensed professionals were typically the first point of contact for patients with behavioral health issues. The recent changes have led to clerical workers, untrained in clinical assessments, using scripted “yes” or “no” questions to evaluate the urgency of patients’ conditions. This change is compounded by a new system of e-visits, where patients fill out online questionnaires prior to being scheduled with a licensed clinician.
Marcucci-Morris is not alone in her concerns; she recently joined approximately 2,400 mental health professionals in Northern California in a one-day strike to protest these changes. The therapists are particularly worried about the potential for artificial intelligence (AI) to further replace licensed professionals in crucial tasks. “Human function needs to stay with human beings,” she stated firmly.
Concerns Over Delayed Care
Several licensed therapists have reported troubling trends since the implementation of the new patient assessment process. They have observed that patients with higher-risk cases are facing longer wait times for care. Meanwhile, lower-risk patients are sometimes being expedited through the system, leading to a backlog that further strains an already overwhelmed system. Since January 2025, therapists have documented over 70 instances where Kaiser’s mental health screening system has resulted in negative care outcomes. This information was included in an administrative complaint filed with the California Department of Managed Health Care by the National Union of Health Care Workers (NUHW).
Kaiser Permanente has responded to these concerns, asserting that claims made by NUHW are misleading. In an email, Kaiser stated that “AI and clerical staff are not conducting any assessments, making any clinical determinations nor conducting clinical triage.” The organization claims that clerical staff are trained to escalate cases to licensed clinical staff as necessary. However, NUHW representatives argue that the number of triage therapists has significantly decreased, contradicting Kaiser’s assertions of workforce growth.
AI and Clinical Judgment
As the integration of technology increases in healthcare, many Kaiser workers have expressed unease regarding the potential impact of AI on their roles. A 2025 internal survey revealed that more than one-third of Kaiser’s mental health workers believe that the introduction of AI and other technologies could negatively affect their work and patient care. Nearly half of the employees reported discomfort with the use of AI tools in clinical practice. Concerns were especially pronounced regarding transparency and data retention policies associated with AI software, such as Abridge, used for note-taking.
Kristi Reimer, a licensed psychologist who formerly conducted mental health triage assessments at Kaiser, noted that she left her position due to apprehensions about the direction of the mental health assessment system. Similarly, Harimandir Khalsa, who works in triage at Kaiser, indicated that her team has diminished by two-thirds over the past two years. Despite her dedication to helping patients, she shares the anxiety many feel about their future job security amidst these changes.
The Importance of Licensed Assessment
The initial contact a patient has when seeking mental health assistance can significantly influence whether they end up seeing a licensed clinician and the type of appointments they receive. This has amplified the NUHW’s concerns regarding the recent changes in patient assessment protocols at Kaiser. Their complaints suggest that clerical staff are asking patients critical questions about suicidal and homicidal thoughts, inputting responses into a software tool that generates a scoring system to guide scheduling for further care. This practice raises legal concerns, as it could be seen as a violation of state law regarding triage.
Kaiser’s practices have come under scrutiny, as the organization previously faced investigations over delays in mental health service access. In 2023, Kaiser reached a $200 million settlement with California to address these issues, and a more recent settlement with the U.S. Department of Labor for $31 million was too reached concerning similar allegations.
Despite Kaiser’s insistence that it is providing “timely, high-quality care to meet members’ needs,” therapists argue that the current system is inadequate. Many fear that the reliance on unlicensed staff and automated questionnaires could lead to misdiagnoses, delays in care, and a failure to assist those in critical need.
As the healthcare landscape continues to evolve, the implications of these changes are significant. The need for licensed therapists to conduct thorough assessments may be more crucial than ever to ensure patient safety and effective treatment.
For now, Kaiser staff are focused on securing a new contract that addresses these issues and prevents the replacement of licensed social workers with AI. The future of patient care at Kaiser Permanente hinges on finding a balance between technological advancements and the indispensable human element in mental health treatment.
