Thousands of Kaiser therapists across Northern California went on strike Monday, pushing for improvements in staffing and shorter wait times for clients — a move that left a large number of members without immediate access to mental health resources starting this week.

Workers in San Jose, San Francisco, Sacramento and Fresno picketed at the entrances of Kaiser hospitals, demanding that the health care giant — which serves 4.5 million in the region — adjust its staffing to alleviate what union members claim is a strained workforce. The action comes amid a nationwide reckoning over mental health needs, with California children one of the hardest hit populations in the face of the pandemic.

On Monday, the effects of the strike could already be felt by some Kaiser members.

Walnut Creek resident Laura Bramble had an appointment scheduled for 9 a.m. Monday. But last Thursday, she received a phone call from Kaiser saying it was being canceled because of the looming strike.

“I feel like I’m flying without a net,” said Bramble, who has been using Kaiser’s therapy services since 2015 for anxiety, depression and post-traumatic stress disorder. “They do so much to promote so much about wellness. And yet, if you’re an actual patient with a mental health need, they could not care less.”

Bramble, 53, worries that patients like her will suffer because they lack access to care.

“I know that for me, my anxiety is more heightened because I don’t know when I’m going to see my therapist again,” she said. “I hope to God that nobody hurts themselves.”

It was not clear Monday how many appointments have been canceled in Kaiser’s Northern California region. Union researchers said they estimate up to 20,000 patients per day may be affected, since each clinician can have anywhere from six to 10 patients per day.

Kaiser called the union’s estimate “absolutely false and deliberately misleading.”

“Based on our preliminary data and the fact that a significant number of our therapists are choosing to come to work and see their patients, the union’s claim is not based on any valid measures,” Kaiser said in a statement. When asked for the company’s own estimate, Kaiser spokesperson Karl Sonkin did not provide a figure.

While previous strikes have been set for only five days, Monday’s action was open-ended until negotiators can come to a resolution.

In response to the strikes, Kaiser said it has plans in place to meet the mental health needs of their members, although it has acknowledged in previous statements that “some” appointments have been canceled.

The cancellations have led the National Union of Healthcare Workers — which represents 4,000 Kaiser mental health clinicians — to file a complaint with state regulators. On Monday, California’s Department of Managed Care said in a statement it is monitoring access to Kaiser’s mental health services.

“Ensuring California health plans provide timely access to care is a top priority for the DMHC. The law requires health plans provide enrollees with medically necessary care within timely access and clinical standards at all times, which includes during an employee strike,” said DMHC Director Mary Watanabe.

The estimated 2,000 striking workers include psychologists, marriage and family therapists, chemical dependency counselors and social workers.

During negotiations this past weekend, members of the NUHW and Kaiser reached an agreement over a wage offer, but failed to strike a deal on specific issues related to how many administrative hours Kaiser employees are offered. That time is usually spent on documentation and planning.

Kaiser said Monday that union members are requesting nine “administrative” hours per week, during which they would not see patients, while the health care company has proposed a little over seven. Union members say that more hours spent treating patients has left them working overtime and stretched thin.

The company says that members “cannot afford a proposal that significantly reduces time available to care for our patients and their mental health needs.” Kaiser is facing a 30% increase in demand for its therapy services, the company said in a statement on Monday, though it didn’t offer a specific time frame for the surge.

That demand is creating long waits for his clients, said Joseph Crivello, who has been a psychological associate with Kaiser for just under a year. Crivello said that patients are waiting months just to start with a therapist.

Crivello was one of about 60 workers who showed up at Kaiser’s San Jose location on Cottle Road on Monday in 90-degree heat. Wearing red shirts with their union’s name emblazoned across the front, Kaiser workers chanted through bullhorns and held up picket signs that said “Patient Health Not Corporate Wealth.”

“There’s no reason why they can’t make mental health a top priority,” said Crivello. “Every day (a colleague) is leaving because they are just burned out. It’s not what they envisioned doing as a health care provider. The current system is basically broken.”