Solano County Mental Health Crisis: SEIU 1021 Takes On Understaffing

Union leaders believe Solano County’s mental health care system is failing to meet community needs because chronic understaffing and noncompetitive pay have left roughly 200 Health and Social Services positions vacant, driving dangerous waitlists for Medi-Cal patients. Service Employees International Union Local 1021 and three other unions responded with a two-day, 2,000-worker strike to force the county to bargain over staffing, wages, and working conditions to retain qualified clinicians and other essential public workers. 

Clinician Sarah Soroken warns that the consequences are not abstract: delayed health care access can worsen illness, increase long-term public costs, and, in extreme cases, contribute to preventable loss of life. This underscores why union-driven staffing demands are a public health issue, not just a workplace dispute.

The Solano County Staffing Crisis

• The Vacancy Gap: Over 200 vacant positions in Health and Social Services.

• The Strike: 2,000 workers (nurses, clinicians, social workers) walked out on Jan. 13–14, 2026.

• The Human Cost: Solano County currently ranks 15th out of 58 California counties for suicide rates.

• The Demand: SEIU 1021 is calling for competitive pay and manageable workloads to stop “moral injury” and patient neglect.

Solano County, Calif. — A system stretched past capacity

Solano County’s behavioral health workforce is not describing a future risk. They are describing a present-tense emergency.

On this edition of the America’s Work Force Union Podcast, Sarah Soroken, a licensed marriage and family therapist employed by Solano County Health and Social Services and SEIU Local 1021 member, laid out what frontline clinicians say happens when public systems cannot hire and keep enough staff: waitlists grow, care becomes fragmented and preventable crises escalate.

Soroken has spent more than 15 years in the field across county mental health departments and major institutions, including Kaiser Permanente and UCLA’s Student Counseling Center. Today, she provides therapy to children and teens at a pediatric clinic serving Medi-Cal patients.

Her message was direct: Solano County is not short on need. It is short-staffed, and the shortage is driven by compensation and working conditions that fail to attract and retain qualified workers.

“The problem… is about our county board of supervisors' unwillingness to provide the salaries and benefits that will attract and retain the needed workforce to actually provide essential behavioral healthcare services.” —Sarah Soroken

Union Rights: SEIU Local 1021 and the public workforce push back

Soroken’s comments come amid a broader labor dispute in Solano County that extends beyond behavioral health.

She said roughly 2,000 county workers across four unions recently walked out in a two-day strike on Jan. 13-14. The coalition included a wide range of essential classifications: child welfare social workers, 911 dispatchers, animal control officers, nurses, mental health clinicians and even doctors and dentists.

The strike was not framed as a single-issue protest. It was a collective warning about the county’s ability to function, Soroken said.

Chronic understaffing, Soroken argued, is not a narrow workplace complaint. It is a public-service failure that hits residents at their most vulnerable moments.

Ed “Flash” Ferenc, host of America’s Work Force, noted SEIU Local 1021’s size and influence. The Local represents about 60,000 members and has become increasingly vocal as staffing crises spread through public agencies.

Soroken described the two-day strike as a deliberate escalation, a “last resort” tool used when bargaining stalls.

“We actually held a two-day strike and about 2,000 people… were out on the picket lines January 13th and 14th… We got a lot of local media, and we’re continuing to try to engage the county to bargain with us.” —Sarah Soroken

SEIU 1021, Solano County and the cost of vacancies

Solano County’s staffing gap is not hypothetical. Soroken said there are approximately 200 vacant positions within Health and Social Services alone.

Vacancies create a predictable chain reaction: remaining staff absorb more work, burnout rises, turnover accelerates, and the system becomes even less capable of meeting legal and clinical standards.

Soroken said filling those vacancies would immediately change the day-to-day reality for workers and patients.

“That would mean that the workload that the current staff are facing would become lighter. They’d be able to actually be more effective at their jobs.” —Sarah Soroken

She also challenged the premise that the county lacks resources.

According to Soroken, one of the unions conducted a “deep dive” into county finances and concluded that the county’s public claims of a financial crisis do not align with the savings generated by unfilled positions and the consistent overestimation of spending.

In labor terms, it is a familiar pattern: austerity rhetoric paired with vacancy-driven “savings” that are achieved by pushing more work onto fewer workers.

Labor Legislation 2026: Mental health parity laws and timely access

The staffing crisis is colliding with legal requirements.

Soroken pointed to mental health and substance use disorder parity laws, noting that California has strong standards for timely access to care. Yet she said Solano County is “routinely not able to meet those requirements,” a failure that can put lives at risk.

This is where the labor dispute becomes a policy question. When a public employer cannot meet parity standards because it cannot retain staff, the issue is no longer just wages. It becomes a matter of compliance, accountability and the state’s obligation to ensure that residents can access medically necessary care.

Looking ahead to potential legislative changes, the policy stakes are likely to intensify nationally as lawmakers debate how to enforce parity, fund Medicaid behavioral health networks, and address workforce shortages across public systems.

Soroken also described California’s Behavioral Health Services Act, previously known as the “millionaires tax,” as a critical funding stream supporting mental health and substance use treatment. While she said she is not an expert on all details, she emphasized that the state relies on this funding to supplement Medicaid reimbursement.

But funding alone does not deliver care if local employers do not hire.

Union Rights and moral injury: what clinicians see when care is delayed

Soroken described the human cost of waitlists in terms that go beyond statistics.

She explained how she transferred internally from Solano County’s behavioral health department, which serves residents with acute needs, including severe mental illness, homelessness and substance use disorders. The reason she switched was not a change in mission. It was burnout and “moral injury,” the distress clinicians experience when they cannot provide the standard of care they know patients need.

She challenged a common misconception that medication alone can stabilize serious mental illness.

Evidence-based care, she said, is a team approach that includes therapy and wraparound support.

The most devastating consequences emerge when the system fails at the first step: timely access.

Soroken cited California Department of Public Health data showing Solano County ranks 15th out of 58 counties for suicide rate. She also shared a case that underscores what “delayed care” can mean.

“One of the… devastating experiences I had… was seeing how a teen had ended their life after they were experiencing an extended wait for an initial appointment.” —Sarah Soroken

She called it “an injustice” that early intervention is not consistently available, especially when research shows timely treatment can prevent escalation and disability for conditions such as schizophrenia.

SEIU Local 1021 strategy: bargaining, public pressure and the strike toolbox

Asked what comes next, Soroken said another strike remains possible, but she emphasized it will be a last resort.

In the near term, she described a strategy centered on sustained pressure: speaking at Board of Supervisors meetings, engaging local media and pushing the county’s bargaining team to negotiate rather than simply reject proposals.

Her framing is pragmatic: a functioning county requires a stable workforce, and a stable workforce requires fair pay and manageable workloads.

Patients and families, she noted, are often least able to advocate publicly, especially in a county system serving residents living day to day.

That reality, Soroken argued, increases the responsibility on clinicians and public workers to speak.

What this fight signals for Union Rights and public services

Solano County’s labor dispute is a case study of a broader national problem: public systems are asked to solve crises without the staffing levels required to do so.

When mental health care is rationed through waitlists, the costs do not disappear. They shift.

They show up in emergency rooms, in law enforcement calls, in school crises, in family breakdowns and in the quiet suffering that never makes headlines.

Soroken argues that investing in staffing is not only ethical but also fiscally rational.

“Pay me now or pay me later,” Ferenc summarized.

For SEIU Local 1021 and its coalition partners, the question is whether county leadership will treat staffing as a budget line to minimize or a public obligation to meet.

As bargaining continues, the unions representing workers say the stakes are clear: the well-being of public employees and the residents who rely on them.

The Fight for Public Health Doesn’t End Here

The crisis in Solano County can be a wake-up call for public services nationwide. When they underfund caregivers, they undermine the community's safety. Sarah Soroken and the members of SEIU 1021 are on the front lines, ensuring that “moral injury” doesn't become the standard of care.

Want to stay informed on the front lines of labor? The struggle for fair staffing, living wages and mental health parity is happening across the country. From healthcare to public works, see how SEIU members are holding leadership accountable and winning for their communities.

Explore more SEIU stories and strike updates on the America’s Work Force Union Podcast.