Preventing Recurring Homelessness Among Mentally Ill Men Using a Critical Time Intervention (CTI)

An Evidence-Based Practice

This practice has been Archived and is no longer maintained.


Critical Time Intervention (CTI) is a strategy to prevent homelessness by improving the continuity of care from institutional to community living. One of the goals of CTI is to strengthen the individual’s long-term ties to key services, family, and friends. Another major goal is to provide emotional and practical support during the transition time. The increased risk of homelessness among the mentally ill has been attributed to a lack of continuity in mental health services during the deinstitutionalization process; CTI works to meet this need.

CTI works with patients with severe mental illness who have recently been discharged from a psychiatry program. A CTI worker is paired with each patient and provides support services sich as meeting with family members, attending appointments with the patient and providing advice during times of crisis.

Goal / Mission

The goal of this Critical Time Intervention (CTI) is to prevent recurring homelessness in the mentally ill.

Results / Accomplishments

A randomized study among 96 men recently released from a New York State Psychiatric Institute was conducted to assess the effectiveness of the CTI intervention. Participants were assigned either to an intervention group and received the CTI intervention in addition to usual services for 9 months, followed by 9 more months of usual services, or a control group who received usual services only for 18 months. In-person assessments were completed with the participants every 30 days to determine where they had spent each night.

The study found that participants in the intervention group spent significantly fewer homeless nights than those in the control group over the course of the 18-month period (p=0.003). It was also found that significantly fewer men in the intervention group were homeless at the end of the study (p=0.05). In addition, extended homelessness (defined as more than 54 nights) occurred significantly less frequently in the intervention group (p=0.045).

About this Promising Practice

Primary Contact
Ezra Susser, MD, DrPH
Columbia University/New York State Psychiatric Institute
722 W. 168th Street, Box 24
New York, NY 10032
Economy / Homelessness
Health / Mental Health & Mental Disorders
Health / Access to Health Services
Columbia University and New York State Psychiatric Institute
Date of publication
Feb 1997
Date of implementation
Geographic Type
New York City, NY
For more details
Target Audience
Adults, Men, Racial/Ethnic Minorities
Additional Audience
homeless, mentally ill