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Summaries of RCT Grants

Expansion and Randomized Controlled Evaluation of Critical Time Intervention

Critical Time Intervention (CTI) is a case-management program designed to prevent homelessness in adults with serious mental illness.

Grant Recipients: University of Chicago Health Lab 

Principal Investigators: David Meltzer, Ph.D., MD, University of Chicago and Harold Pollack, Ph.D., University of Chicago

Term:
20212027

Funding: $2,514,240

Summary: Critical Time Intervention (CTI) is a case-management program designed to prevent homelessness in adults with serious mental illness. When evaluated in two well-conducted randomized controlled trials (RCTs) in New York City, CTI was found to reduce the likelihood of homelessness by more than 60%, 18 months after random assignment, and to produce sizable cost savings in government/​community expenditures that nearly (in one RCT) or completely (in the second RCT) offset the program’s cost.

Under this project, the grantee will oversee – in partnership with The Center for the Advancement of Critical Time Intervention at Hunter College, City University of New York (CACTI) – CTI implementation in Chicago, IL. CTI will be delivered to approximately 200 individuals over a three year period.

Additionally, the grantee will conduct a two-site RCT of CTI, which will take place in Chicago, IL, and in a five-county region in Mississippi (in partnership with Madison-Rankin-Simpson Mental Health Commission Region 8). The RCT will determine whether the sizable impacts found in prior RCTs of CTI can be reproduced on a larger scale in diverse settings and implementation conditions.

The study will track homelessness and other outcomes for approximately 700 study participants over a two-year period after random assignment. The study’s primary outcome will be the number of nights spent homeless in a 24-month follow-up period. The study will also measure important secondary outcomes, including rates of psychiatric hospitalizations, criminal justice involvement and mortality. Outcomes will be measured using data from each site’s Homeless Management Information System (HMIS), Departments of Public Health and County Sheriff’s Offices. 

The study’s pre-specified analysis plan is linked here. The project is also associated with an expansion and replication grant to Madison-Rankin-Simpson Mental Health Commission Region 8 and a technical assistance grant to the Research Foundation of the City University of New York.