A case management program to prevent recurrent homelessness in people with severe mental illness leaving shelters, hospitals, or other institutions.
The Critical Time Intervention (CTI) seeks to prevent recurrent homelessness in people with severe mental illness leaving shelters, hospitals, or other institutions. People with such illness are estimated to comprise one-fifth of the U.S. homeless population (U.S. Department of Housing and Urban Development, 2017). CTI’s approach is to (i) strengthen the individual’s long-term ties to services, family, and friends; and (ii) provide emotional and practical support during the critical time of transition back to the community.
The nine-month program is delivered to each participant by a single caseworker – a bachelor or master’s level person trained in CTI and supervised by a mental health professional.
Phase one (“transition to the community”) covers the period before and after the client’s discharge from the institution. In this phase, the caseworker gets to know the client (starting before discharge), assesses the client’s needs, and implements a transition plan intended to link the client to services and supports in the community. The plan typically includes home visits and other meetings with the client, the client’s caregivers, and community service providers, designed to teach crisis-resolution skills, provide support and advice, and mediate any conflicts. In phase two (“try out”), the caseworker monitors and adjusts the systems of support that were developed during phase one. This phase involves fewer meetings with the client, as the caseworker encourages the client to problem-solve with the help of community resources and family members, and intervenes only if the client is receiving inadequate support or if a crisis occurs. In phase three (“transfer of care”), the caseworker helps the client develop and implement a plan to achieve long-term goals (e.g., employment, family reunification) and finalizes the transfer of responsibilities to caregivers and community providers. Each CTI caseworker typically works with 10-15 clients at a time.
CTI costs $6,633 per participant (in 2017 dollars).