Critical Time Intervention
An Evidence-Based Practice
Description
Critical Time Intervention (CTI) is designed to prevent recurrent homelessness and other adverse outcomes among persons with severe mental illness. It aims to enhance continuity of care during the transition from institutional to community living. The intervention, which lasts roughly 9 months following institutional discharge, involves two components: (1) strengthening the individual's long-term ties to services, family, and friends; and (2) providing emotional and practical support during the transition. Postdischarge services are delivered by workers who have established relationships with patients during their institutional stay. CTI is intended to be used with individuals leaving institutions such as shelters, hospitals, and jails. The intervention is delivered in three main phases: (1) transition to the community, which focuses on providing intensive support and assessing the resources that exist for the transition of care to community providers; (2) tryout, which involves testing and adjusting the systems of support that were developed in the first phase; and (3) transfer of care, which completes the transfer of care to community resources that will provide long-term support.
Goal / Mission
The goal of the Critical Time Intervention is to prevent homelessness among people with severe mental illness.
Impact
Evaluations of this program have found sizable reductions (24-67%) in average number of nights spent homeless over the 18-month follow-up period and more than a 60% reduction in likelihood of being homeless in the final weeks of the 18-month follow-up. Cost offsets and savings have been shown.
Results / Accomplishments
One randomly controlled trial reported a 67% reduction in homeless nights during the 18 month study period, and a 64% reduction in the likelihood of being homeless during the final month of the trial.
A second randomly controlled trial reported a 24% reduction in homeless nights, a 72% reduction in the likelihood of being homeless during the final 18 weeks of the program, a 24% percent reduction in nights spent in a psychiatric hospital during the 18 month trial, and a 27% reduction in the likelihood of psychiatric hospitalization in the 18 month period.
The cost of this program is $6,290 per person in 2013 dollars to deliver program services. This cost was mostly offset in one study by savings of $5,326 per person in other government/community expenditures, and more than offset in another study by savings of $24,000 per person.
Other studies have also shown that CTI participants experienced a significant decrease in negative symptoms of psychopathology. There was also a significant increase in both frequency of family contact and satisfaction with family relationships.
A second randomly controlled trial reported a 24% reduction in homeless nights, a 72% reduction in the likelihood of being homeless during the final 18 weeks of the program, a 24% percent reduction in nights spent in a psychiatric hospital during the 18 month trial, and a 27% reduction in the likelihood of psychiatric hospitalization in the 18 month period.
The cost of this program is $6,290 per person in 2013 dollars to deliver program services. This cost was mostly offset in one study by savings of $5,326 per person in other government/community expenditures, and more than offset in another study by savings of $24,000 per person.
Other studies have also shown that CTI participants experienced a significant decrease in negative symptoms of psychopathology. There was also a significant increase in both frequency of family contact and satisfaction with family relationships.
About this Promising Practice
Organization(s)
The Center for the Advancement of Critical Time Intervention (CACTI)
Primary Contact
Topics
Health / Mental Health & Mental Disorders
Economy / Housing & Homes
Economy / Housing & Homes
Organization(s)
The Center for the Advancement of Critical Time Intervention (CACTI)
Source
SAMHSA's National Registry of Evidence-Based Practices and Programs (NREPP)
Date of publication
Aug 2006
Date of implementation
1991
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