Randomized Trial of Critical Time Intervention to Prevent Homelessness After Hospital Discharge
Randomized Trial of Critical Time Intervention to Prevent Homelessness After Hospital Discharge
复制标题
DOI：
10.1176/ps.62.7.pss6207_0713
复制
发表时间：
2011-07-01
影响因子：
3.8
通讯作者：
Susser, Ezra S.
中科院分区：
文献类型：
--
作者：
Herman, Daniel B.;Conover, Sarah;Susser, Ezra S.
目的：本研究评估了先前测试的模型，关键时间干预（CTI）的有效性，在产生持久的减少无家可归的风险的严重精神疾病患者出院的住院精神病治疗设施。研究方法：共有150名以前无家可归的男性和女性患有严重的精神疾病，并从精神病住院治疗出院到医院的过渡住所，他们被随机分配到接受常规护理或常规护理加CTI出院到社区。为期九个月的干预措施旨在逐步将责任移交给社区，以便在干预措施结束后提供持续的支持，从而持久减少未来无家可归的风险。在参与者从过渡住所（停留时间为6至937天）出院后，通过不了解研究条件的采访者收集的参与者自我报告，每六周评估一次他们的住房状况，持续18个月。结果如下：在意向治疗分析中，分配到CTI组的参与者在随访期结束时（最后三个六周间隔）无家可归的情况明显少于分配到对照组的参与者（比值比= 0.22，95%置信区间= 0.06 - 0.88）。结论：对严重精神疾病患者进行的相对简短、重点突出的干预导致无家可归风险降低，这在干预结束后9个月就很明显。这项工作表明，有针对性的，相对较短的干预措施，适用于关键的过渡点，可以提高长期支持的效力，为患有严重精神疾病的人谁是生活在社区。（精神病学服务62：713 - 719，2011）
Objective: This study assessed the effectiveness of a previously tested model, critical time intervention (CTI), in producing an enduring reduction in the risk of homelessness for persons with severe mental illness who were discharged from inpatient psychiatric treatment facilities. Methods: A total of 150 previously homeless men and women with severe mental illness and who were discharged from inpatient psychiatric hospitalization to transitional residences on the hospital grounds were randomly assigned to receive usual care or usual care plus CTI at the point of discharge to the community. The nine-month intervention aims to gradually pass responsibility to community sources for providing ongoing support after the intervention ends, thereby leading to a durable reduction in risk of future homelessness. After participants were discharged from the transitional residence (length of stay six to 937 days), their housing status was assessed every six weeks for 18 months via participant self-report collected by interviewers blind to study condition. Results: In an intent-to-treat analysis, participants assigned to the CTI group had significantly less homelessness at the end of the follow-up period (the final three six-week intervals) than those assigned to the control group (odds ratio=.22, 95% confidence interval=.06-.88). Conclusions: A relatively brief, focused intervention for persons with severe mental illness led to a reduction in the risk of homelessness that was evident nine months after the intervention ended. This work suggests that targeted, relatively short interventions applied at critical transition points may enhance the efficacy of long-term supports for persons with severe mental illness who are living in the community. (Psychiatric Services 62: 713-719, 2011)