Joty Sikand, PsyD
The Hume Center
Joty Sikand has been president of the Hume Center in Concord, Calif., since 2004 and has worked toward success not just for the changing market of today, but also to lay the groundwork for the future. Specifically, she has created a training program to ensure an influx of new professionals to serve the local community as well as a program evaluation and research department to study outcomes for the benefit of clinical improvement and financial sustainability. Outcomes measurement will increasingly be a business imperative for behavioral health.
“We took a proactive stance to be able to create a program that was mainly focused on a reduction in institutional care and then we were providing high intensity outpatient care at the community level, and it was useful to tie it into program evaluation,” she says.
The Hume Center was able to leverage an Alameda County grant dedicated to Medi-Cal (California’s Medicaid program) to support the appointment of a dedicated program evaluator who could help the center develop measures and review outcomes for research, working collaboratively with the program manager and chief psychologist. Sikand says the goal was to strengthen the statistics for measuring effectiveness of the services her teams provide. The grant provided nearly $600,000 a year for three years.
She says there is no control group in the research but rather it’s designed to show progress for the future.
“As I paid attention to the county needs and what their strategic plan is, I also paid attention to the additional needs of this new program and from the beginning developing outcome measures to demonstrate that these services are effective to support ongoing funding for such services,” Sikand says.
About 16% of California’s adults have some degree of mental illness, and less than half received treatment, according to a 2009 study by the state. In fiscal year 2012-2013, Medi-Cal spending on mental health totaled $1.6 billion in federal funds, $206 million in state funds and $1.4 billion in county funds, according to the California HealthCare Foundation. Clearly there are unmet needs coupled with finite resources. Becoming more effective and efficient is one way to better serve the community.
Sikand says with the implementation of the Hume Center’s intensive community outpatient program—funded by Alameda County Behavioral Health Care Services (ACBHCS)—the community was able to see results. More Hume Center clients avoided county-level crisis services and emergency department use, for example. In fact, overall client use of county services dropped by 95%, she says.
But the need for professionals to provide targeted services remains. In 10 years, the Hume Center has gone from just a few trainees to an educational track for more than 40 doctoral-level trainees per year, who can gain experience with the center’s clinical services, which have grown from just four programs to 12 under Sikand’s leadership.
“Our identity is a training center,” she says. “Not only do we provide mental health services, we also train a diverse group of graduate students in psychology and social work,” she says. “So we have a natural recruitment process.”
That process helps to bring professionals onboard with the language backgrounds that reflect the local community’s culture. The languages represented by staff currently are English, Cantonese, Czech, Dari, Farsi, Gujarati, Hindi, Hokkian, Japanese, Malay, Mandarin, Punjabi, Romanian, Slovakian, Spanish, Tamil, Telugu and Urdu.
Sikand says trainees are often promoted to become employees at the center, and from the business perspective, the center is able to draw funding for specific capabilities related to diversity, language barriers and underserved communities. And the funding helps support the continuation of their service. Beyond just the Hume Center, Sikand says she is able to collaborate with other organizations to lobby at the state level for legislation that supports funding for diverse communities. She says there’s a lot of momentum in California to support culturally appropriate service and outreach, some of which dates back to the California Mental Health Services Act of 2004, which she advocated for as part of a stakeholder group.
“There’s a lot of effort to move in that direction and support professional staff who can deliver services in unique languages and have that cultural understanding,” she says.
This year, the Hume Center is expected to serve more than 2,000 individuals from many cultures and many communities.