Mental health professionals at Rogers Behavioral Health in West Philadelphia have formed a union, citing increased workloads and business changes that diminished patient care.
The nonprofit mental healthcare provider last year transitioned from individual patient sessions to a group care model, said Tiffany Murphy, a licensed professional counselor and therapist at the facility. Some workers there were also moved from salaried to hourly positions then forced to reduce hours, their union has said.
Some patients and workers have left amid the changes, says Murphy, estimating that 22 of her colleagues have quit in the past year.
“A lot of us sort of put our jobs on the line by [unionizing], because we believe in the organization, but more so, we believe in our patients. We wanted to provide the best patient care that we possibly could for them,” said Murphy.
The 19 West Philadelphia Rogers employees, including therapists and behavioral specialists, filed their petition last month to unionize with the National Union of Healthcare Workers. Rogers voluntarily recognized the union, according to NUHW, marking the union’s first unit in Pennsylvania.
NUHW represents some 19,000 healthcare workers, primarily in California.
Sal Rosselli, NUHW president emeritus, said the union is pleased that Rogers accepted the petition. “All too often, employers do the opposite and put together very anti-union campaigns, spending all kinds of patient care dollars to prevent their workers from organizing,” he said.
The Philadelphia metro area, which also includes Camden and Wilmington, has the fifth-highest number of working therapists among U.S. metros, according to the Bureau of Labor Statistics. This region employs just over 500 therapists, with average salary of $79,510.
A spokesperson for Rogers declined to comment on employees’ organizing efforts and remarks on workplace changes.
Rogers provides addiction treatment and mental healthcare with facilities in 10 states. In Philadelphia, the nonprofit offers outpatient treatment and partial hospitalization, treating patients with depression, anxiety, and obsessive-compulsive disorder.
In recent years, Rogers workers in California also unionized with NUHW. Their recently forged union contract includes caseload limits and a cap on how many newly admitted patients can be assigned to each therapist or nurse.
Thousands of healthcare workers in the Philadelphia area have moved to unionize in recent years.
Within the past few years, residents at Penn Medicine and the Rutgers University health system finalized their first contracts with their health systems, and attending doctors at ChristianaCare became the first group of post-training physicians in the region to unionize. Residents at Temple University Hospital, Thomas Jefferson University Hospitals, ChristianaCare, and Jefferson’s Einstein Healthcare Network also voted to unionize in early 2025. Residents at Children’s Hospital of Philadelphia narrowly voted against joining a union.
The organizing push means that about 81% of the city’s resident physicians are unionized.
What do workers want?
When Murphy first started working at the Rogers facility in Philadelphia 4½ years ago, she said there was “a really good work-life balance.”
At the time, clinicians had four patients per day, provided individualized care, and led group sessions. As the organization moved toward group counseling, she said, caseloads have grown, with up to 12 patients in each group.
The organization hired behavioral specialists to support therapists, said Murphy, but “it was difficult to provide the patients with the care that they really needed and deserved with the new structure.”
Some patients and staff left because of the new model, said Murphy.
This year, some salaried workers were switched to hourly, and Rogers started sending workers home due to low patient demand, leaving the rest with larger workloads, according to the union. That meant some used paid time off to avoid going without pay, said Murphy.
When Philadelphia Rogers employees heard their colleagues in California were unionizing, “That became a bit enticing to us,” said Murphy, noting the workplace had become challenging and sometimes “unbearable.”
Now, she says, the union members want more manageable caseloads — or pay increases to account for the larger caseloads — and a return to the old pay model for those who were switched to hourly work.
“We are unionizing to have a voice at work that will allow us to promote a healthier work-life balance as well as high-quality sustainable patient care,” therapist Sara Deichman said in a union news release.
Where else have mental health workers unionized?
The organizing in Philadelphia comes as the U.S. faces a shortage of mental healthcare professionals, and in the wake of a demand surge from the pandemic.
“The industry is forcing fewer providers to care for more and more patients because the focus is on the bottom line,” said Rosselli.
Staffing concerns plague the healthcare industry generally, said Rebecca Givan, an associate professor at Rutgers University’s School of Management and Labor Relations.
“If the facility wants to hold down costs, it tries to keep staffing levels as low as possible,” said Givan. “In the case of mental health providers, it can be about shortening appointment times or increasing caseloads so that each provider has a very large number of cases or clients.”
She says there’s not “a huge amount of union representation” in stand-alone behavioral health facilities, but some public hospitals are unionized.
Private practice mental health workers can’t unionize because they’re self employed, Givan noted, but “one could argue that they might benefit from collectively negotiating, for example, with the insurance companies that determine their reimbursement rates.”
NUHW is leading efforts to organize independent providers. The goal, Rosselli says, is to “establish an employer for them so that they can have leverage against insurance companies to increase pay and increase access to patient care issues.”
The union has already done this in the home care industry in California, Rosselli noted.
Staff reporter Aubrey Whelan contributed to this article.
