As a clinical social worker at the University of California San Francisco (UCSF), I am deeply concerned about the disparities in mental health care that my employer perpetuates, contributing to the ongoing crisis in our city. Despite UCSF’s partnership with public agencies to address this public health crisis, the lack of accountability from state and local governments leaves many questions unanswered. Recently, the San Francisco Board of Supervisors passed a nonbinding resolution acknowledging the disparity in mental health services, but this alone is not enough to initiate meaningful change.
My journey into social work stems from my personal experiences with community violence. As a Black woman and a mother, I understand the importance of mental health support, especially for those who have faced trauma. At the Trauma Recovery Center (TRC), I work as a “Campus Clinical Social Worker” (CSW), providing trauma-informed care to survivors of violent crimes, such as sexual assault and shootings. My role often involves meeting clients in the emergency room or our clinic, helping them navigate the complex aftermath of their experiences.
However, my commitment to supporting survivors is challenged by the systemic oppression I encounter within UCSF. While I am dedicated to addressing the mental health crisis on the ground, I find myself simultaneously battling the inequalities that affect my clients. The disparity in compensation between Campus CSWs and “Medical Center CSWs” is particularly disheartening. Despite having similar qualifications and responsibilities, Campus CSWs earn, on average, 32 percent less than their Medical Center counterparts. This pay gap not only leads to high turnover and chronic understaffing but also hampers our ability to provide timely care to the most vulnerable populations.
Data shows that the disparities in treatment outcomes often seen among survivors—based on age, education, and housing status—can be significantly mitigated by accessing care at a TRC. Unfortunately, the inequity in pay diminishes morale among Campus CSWs, leading to burnout and further exacerbating the issues we are trying to address. This situation is not only unjust but directly impacts our ability to deliver the quality of care expected by the community.
Earlier this year, other UC workers highlighted similar issues when optometrists represented by the Union of Professional and Technical Employees held an unfair labor practice strike, underscoring UC’s neglect of employee rights and the chronic challenges faced by healthcare providers.
UCSF is not financially incapable of rectifying these disparities. The university manages substantial public resources and has accumulated around $26.9 billion in reserves, along with billions in long-term investments. Despite these resources, the university’s recent acquisition of nearly a dozen new hospitals further illustrates its focus on expansion rather than addressing the inequities in its existing workforce.
While we appreciate the San Francisco Board of Supervisors for their recent resolution condemning the two-tiered system of mental health care, it is crucial to recognize the structural limitations we face. The University of California, by virtue of state law, is exempt from certain public oversights, complicating efforts to hold it accountable.
As negotiations between UC and thousands of healthcare staff—myself included—progress, we are advocating for the reinvestment of profits back into our services. However, we face numerous unfair labor practices pending against UC due to the same bad-faith negotiations that previously sparked the optometrist strike.
The impact of turnover and vacancies continues to hinder our ability to deliver essential care to the community’s most vulnerable members. The urgency of addressing San Francisco’s mental health crisis cannot be overstated. The Department of Public Health has entrusted UCSF with critical responsibilities, and my colleagues and I possess the necessary skills and passion to fulfill this mission. What we lack are the adequate resources and support to be present for those experiencing their worst moments.
I am committed to focusing my efforts on the clients who need me most, but if the University of California fails to provide the accountability necessary for change, we may have no choice but to take to the picket line to ensure our voices are heard. Our community deserves better, and it is time for UCSF to recognize its responsibility in supporting both its employees and the vulnerable populations we serve.
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