A complaint filed by the National Union of Healthcare Workers to California's Department of Managed Health Care (DMHC) describes a process that a Kaiser insurance patient might go through when experiencing anxiety or depression: log onto kp.org, answer a series of multiple-choice questions, then receive a treatment recommendation — which could be an online health education class or a self-care app — with no evidence that licensed staff reviewed the answers before results were sent out.
No call from a doctor—only a questionnaire and a link to a self-care app.
From screening teams to automated questionnaires
Before 2023, Kaiser operated screening teams consisting of licensed clinical staff who interviewed patients by phone to assess urgency. According to the complaint, the new system — combining unlicensed office staff and an automated e-visit tool — began implementation in 2023 and now handles most initial screening work. This was confirmed as the first complaint targeting a health insurer related to algorithm and artificial intelligence use in mental health care in California. Kaiser, by contrast, asserts it does not use AI to diagnose or make clinical decisions, and that office staff are trained to immediately refer urgent cases to clinical personnel.
The two sides disagree on actual consequences. An internal Kaiser survey from 2025 that The Guardian obtained shows more than one-third of mental health staff in Northern California said the company deployed AI or other technology they worried would negatively impact their work or quality of care, and nearly half felt uncomfortable with introducing AI tools into clinical practice. The union in Northern California documented over 70 cases of adverse care outcomes since January 2025 due to the new screening system.
Who is affected, and how many
The issue directly affects a specific professional group: therapists and social workers who are part of approximately 2,400 mental health specialists that the union represents in Northern California. On the patient side, the scale is even larger: San Francisco alone and other public agencies paid Kaiser $508 million in insurance premiums over the past year to cover more than 39,000 employees and retirees — many of whom may depend on the very screening system now under scrutiny.
Precedent and what to watch
Kaiser is no stranger to regulatory oversight: the company is operating under a Corrective Action Plan with DMHC, extended until October 2026 following an agreement signed in 2023. Kaiser has also agreed to settlements totaling more than $231 million since 2023 related to delays in accessing mental health and addiction treatment, including a $200 million payment in 2023 and 31 million USD earlier this year. Meanwhile, Kaiser states it has invested over $2 billion since 2020 to expand its mental health care network, and reported net income of $9.3 billion over the past year — a context that makes questions about cutting clinical staff to save costs particularly sensitive. Workers in Sonoma County voted to strike with 92% support earlier this year, reflecting discontent that extends beyond a single facility.
What readers can do
If you or a loved one uses Kaiser insurance and ever received a mental health treatment recommendation through e-visit without a phone call or in-person appointment with a doctor, that is the process now under challenge. You have the right to request an in-person visit with a licensed clinical staff member, and can file a complaint with DMHC if you feel you experienced unreasonable delays in care. DMHC confirms it has received the complaint and is conducting an investigation.