Preventing recurrent homelessness among mentally ill men: a "critical time" intervention after discharge from a shelter.

TLDR

The study examined whether a bridge between institutional and community care prevents homelessness among severely mentally ill individuals. Ninety‑six men with severe mental illness were randomized to receive nine months of a critical‑time intervention plus usual services or usual services alone, and the mean number of homeless nights over 18 months was compared using survival curves. During 18 months, the intervention group had an average of 30 homeless nights versus 91 in the control, and the advantage persisted beyond the nine‑month intervention period, suggesting critical‑time strategies can reduce recurrent homelessness.

Abstract

OBJECTIVES: This study examined a strategy to prevent homelessness among individuals with severe mental illness by providing a bridge between institutional and community care. METHODS: Ninety-six men with severe mental illness who were entering community housing from a shelter institution were randomized to receive 9 months of a "critical time" intervention plus usual services or usual services only. The primary analysis compared the mean number of homeless nights for the two groups during the 18-month follow-up period. To elucidate time trends, survival curves were used. RESULTS: Over the 18-month follow-up period, the average number of homeless nights was 30 for the critical time intervention group and 91 for the usual services group. Survival curves showed that after the 9-month period of active intervention, the difference between the two groups did not diminish. CONCLUSIONS: Strategies that focus on a critical time of transition may contribute to the prevention of recurrent homelessness among individuals with mental illness, even after the period of active intervention.