Critical Time Intervention for Mental Health Challenges

(CTI-YAMH Trial)

Overseen By Yadira Cortez

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Houston

Disqualifiers: Age 25+, Non-English, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 15

60 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assist young adults experiencing homelessness and mental health challenges as they transition into supported housing. It tests an approach called Critical Time Intervention (CTI), which provides structured case management and support from mental health specialists and peers. Participants will receive either this specialized intervention or usual housing support without additional mental health assistance. Young adults aged 18-24 who qualify for rapid rehousing and have ongoing mental health symptoms such as depression, anxiety, or bipolar disorder might be suitable candidates. As an unphased trial, this study offers a unique opportunity to receive specialized support that could significantly enhance mental health and housing stability.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that the Critical Time Intervention for Young Adults with Mental Health conditions is safe?

Research has shown that Critical Time Intervention (CTI) is generally manageable for individuals. A review of studies found that CTI reduces the risk of homelessness and other negative outcomes by providing support during critical transitions, such as moving from homelessness to stable housing.

Studies on mental health conditions have reported no major negative effects. CTI has been used safely with various groups, including those leaving psychiatric facilities or experiencing housing instability. This suggests that CTI can be safely adapted for young adults facing mental health challenges as they transition to stable housing. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Critical Time Intervention for Young Adults with Mental Health (CTI-YAMH) because it offers a unique approach to supporting young adults facing mental health challenges. Unlike typical treatments that might focus solely on therapy or medication, CTI-YAMH combines personalized intervention with rapid rehousing support, addressing both mental health and housing stability. This dual focus aims to create a more stable environment, which can significantly improve mental health outcomes by reducing stress and providing a supportive foundation for recovery. By integrating housing assistance with mental health care, CTI-YAMH has the potential to offer more comprehensive support than traditional methods, which often address these issues separately.

What evidence suggests that the Critical Time Intervention for Young Adults with Mental Health conditions could be effective for mental health challenges?

Research has shown that Critical Time Intervention (CTI), which participants in this trial may receive, can positively impact mental health. One study found that CTI lowered the chances of early psychiatric hospital readmissions and improved satisfaction with care. Another study discovered that CTI enhanced overall health and quality of life. While results can vary, many people have experienced significant benefits from this approach. CTI provides structured support during critical transitions, making it potentially helpful for young adults moving from homelessness to stable housing. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

This trial is for young adults aged 18-24 who are on a housing list, experiencing mental health challenges like depression, anxiety, bipolar or psychotic disorders with ongoing symptoms. They must speak English and be eligible for rapid rehousing based on their priority score.

Inclusion Criteria

You have exhibited psychological distress on the Kessler-6 scale, or have been diagnosed with depression, anxiety, bipolar disorder or a psychotic disorder and are still experiencing symptoms.

Exclusion Criteria

I am 25 years old or older.

Not eligible for rapid rehousing based on housing priority score

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pilot Feasibility Phase

Recruit and enroll a sample of 8 participants to refine enrollment and intervention procedures

3 months

Baseline interview via Zoom or phone

Intervention Phase

Participants receive the CTI-YAMH intervention in conjunction with rapid rehousing supports

6 months

Baseline, midpoint (3 months), and end of intervention (6 months) surveys

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

Follow-up survey at 12 months

What Are the Treatments Tested in This Trial?

Interventions

• Critical Time Intervention for Young Adults with Mental Health conditions

Trial Overview The study tests an intervention called Critical Time Intervention (CTI-YAMH), which provides structured case management and support from mental health professionals to young adults transitioning into supported housing. Participants will either receive CTI-YAMH or standard housing supports.

How Is the Trial Designed?

Group I: Intervention Condition, CTI-YAMH Experimental Treatment 1 Intervention

Participants receive the CTI-YAMH intervention in conjunction with rapid rehousing supports for the 6 month intervention

Group II: Treatment as Usual Condition Active Control 1 Intervention

Participants will be assigned to a housing program at another agency that provides rapid rehousing with usual supports

Critical Time Intervention for Young Adults with Mental Health conditions is already approved in United States for the following indications:

Approved in United States as Critical Time Intervention for:

• Homelessness prevention and support for individuals with mental health conditions

Who Is Running the Clinical Trial?

University of Houston

Lead Sponsor

Trials

155

Recruited

48,600+

Published Research Related to This Trial

Critical Time Intervention (CTI) is an effective case management approach that provides intensive, time-limited support to patients with serious mental illness, helping them connect to long-term care systems.

CTI is particularly beneficial for patients who are new to psychiatric care and may struggle to engage with services due to complex issues like homelessness or social skills deficits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Engaging patients with serious mental illness in care services by Critical Time Intervention]. van der Plas, AG., Abdoelbasier, S., van Hemert, AM.[2010]

The brief three-month critical time intervention (B-CTI) significantly improved continuity of psychiatric outpatient care for 135 veterans with serious mental illness after discharge from inpatient treatment, leading to fewer days until their first outpatient service visit.

Participants in the B-CTI group had more outpatient visits and reported better support in managing appointments and community connections, indicating that this intervention effectively enhances postdischarge care continuity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of a critical time intervention to promote continuity of care after psychiatric inpatient hospitalization. Dixon, L., Goldberg, R., Iannone, V., et al.[2022]

Early identification and treatment of serious mental illnesses, which often begin before age 20, is crucial for reducing long-term impacts on youth.

Despite advancements in understanding and treating children's behavioral health, significant barriers such as insurance gaps and public misconceptions still hinder timely access to necessary services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reflection health means hope: 2013 is the year of the children. Rosenberg, L.[2021]

A study involving 1,062 youth and young adults aged 11 to 25 showed significant reductions in depression symptoms after participating in remote intensive outpatient programming, with over half of the participants crossing below the clinical cutoff for major depressive disorder by discharge.

The remote treatment model was effective across diverse subgroups, including those defined by gender identity and sexual orientation, indicating it may help address mental health disparities among marginalized youth who often face greater barriers to care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treating Depression in Adolescents and Young Adults Using Remote Intensive Outpatient Programs: Quality Improvement Assessment. Evans-Chase, M., Solomon, P., Peralta, B., et al.[2023]

Adolescence is a critical period for mental health, with 50% of adult mental disorders starting before age 16, highlighting the need for effective early intervention services.

Current youth mental health services, which separate care between child and adult systems at ages 16-18, are inadequate; a pilot program in Birmingham, Youthspace, demonstrates that a redesign of these services is both necessary and achievable to improve young people's experiences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Youth services: meeting the mental health needs of adolescents. Vyas, NS., Birchwood, M., Singh, SP.[2022]

Young men aged around 18.8 years face significant barriers to seeking mental health care, including societal expectations of masculinity and unfamiliarity with talk therapy, as identified in interviews with 25 young males and 4 service providers.

Facilitators that could improve help-seeking behaviors include positive initial contact with services, partnerships between different sectors, the presence of male practitioners, and targeted messaging that resonates with young men.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Young men's access to community-based mental health care: qualitative analysis of barriers and facilitators. Rice, SM., Telford, NR., Rickwood, DJ., et al.[2018]

The Youth Mental Health First Aid Program significantly improved adults' ability to recognize mental health issues like schizophrenia and depression, as well as their confidence in providing help, based on an evaluation of 246 participants over six months.

The program has successfully trained 318 instructors who have taught over 10,686 individuals across Australia, and it has expanded internationally to countries like Canada and Singapore, indicating its effectiveness and broad acceptance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Youth mental health first aid: a description of the program and an initial evaluation. Kelly, CM., Mithen, JM., Fischer, JA., et al.[2023]

The Critical Time Intervention (CTI-BR) did not show significant advantages over regular care in improving social performance and quality of life for individuals transitioning from long-term psychiatric hospitalization.

Despite the lack of overall benefit from CTI-BR, participants reported improvements in social functioning and self-perception of mental health, suggesting that elderly patients can successfully reintegrate into community living with appropriate support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Deinstitutionalization of long stay patients in a psychiatric hospital in Rio de Janeiro. Silva, PRFD., Carvalho, MCA., Cavalcanti, MT., et al.[2018]

The Critical Time Intervention (CTI) significantly improved family contact and satisfaction with family relationships among 150 individuals with serious mental illness over an 18-month follow-up period after hospital discharge.

Improvements in family relationship quality were found to modestly mediate the reduction in psychiatric rehospitalization, suggesting that strengthening family ties can be beneficial during the transition from hospital to community living.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mediation analysis of critical time intervention for persons living with serious mental illnesses: assessing the role of family relations in reducing psychiatric rehospitalization. Tomita, A., Lukens, EP., Herman, DB.[2022]

Critical Time Intervention (CTI) effectively helps prevent recurrent homelessness in individuals with severe mental illness by improving continuity of care during their transition from institutional settings to community living.

The model has shown promise in real-world applications, as illustrated by a case example of a homeless woman successfully transitioning from a shelter to stable housing, highlighting its potential for broader adaptation and implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Critical Time Intervention: an empirically supported model for preventing homelessness in high risk groups. Herman, D., Conover, S., Felix, A., et al.[2022]

Citations

1. withpower.com withpower.com/trial/phase-mental-disorders-8-2023-1090f

Critical Time Intervention for Mental Health Challenges This trial is for young adults aged 18-24 who are on a housing list, experiencing mental health challenges like depression, anxiety, bipolar or psychotic ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9832072/

A Systematic Review of Critical Time Intervention - PMC Three experimental studies reported mixed results in the impact of CTI on mental health outcomes. Lako et al. (2018) reported significantly ...

3. pilotfeasibilitystudies.biomedcentral.com pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-025-01677-7

Charge Up! Feasibility Study: Homeless to Housing Adaptation Charge Up! is a 6-month, phased support intervention that utilizes a team-based approach to connect young adults to community and mental health support.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8811242/

Evaluating the Impact of a Critical Time Intervention ... This particular model has been shown to decrease early psychiatric readmission rates, improve perceived quality of care, improve health and quality of life ...

5. criticaltime.org criticaltime.org/cti-model/research-hidden/

Research Hidden This first randomized trial of the nine-month CTI model assessed its effectiveness in preventing homelessness among 96 men with serious mental disorder being ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT05945277

NCT05945277 | Critical Time Intervention-Peer Support CTI-PS is a time-limited, 9-month long intervention, provided at the critical time when a person is discharged from an inpatient psychiatric treatment facility.

7. omh.ny.gov omh.ny.gov/omhweb/adults/cti_team_program_guidance.pdf

Adult Critical Time Intervention Teams (CTI) Program Guidance CTI Teams must use data from Regional Health Information ... CTI services provided by New York State Office of Mental Health licensed or authorized adult.