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

Am J Public Health. 1997 Feb;87(2):256-62. doi: 10.2105/ajph.87.2.256.


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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Community Mental Health Services / methods*
  • Educational Status
  • Follow-Up Studies
  • Homeless Persons*
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / therapy*
  • New York City
  • Outcome and Process Assessment, Health Care