For persons with severe mental illness, the transition from assertive community treatment (ACT) to less intensive services is a vulnerable period during which enhanced support is especially vital. The ACT Transitions Model, adapted in part from CTI, is a framework designed to enhance the coordination and continuity of care of service recipients who are moving from ACT to less intensive services. A workgroup of stakeholders developed the model to be delivered in the following three phases over a nine-month period: (1) Transition Planning, (2) Try-Out, and (3) Fine Tuning, Transfer of Care and Follow-up. The stakeholder workgroup included ACT staff and consumers as well as representatives of the New York State Office of Mental Health and the New York City Department of Health and Mental Hygiene. The model will be piloted and evaluated over the next two years. The project is a New York State Office of Mental Health initiative funded by the Bristol-Myers Squibb Foundation (PI, Molly Finnerty, M.D.) For further information, contact Jennifer Manuel at coevjim@omh.state.ny.us or 212.543.5164.
April 3, 2009
Lisa Dixon of the University of Maryland and colleagues have published a new experimental study assessing the effectiveness of a brief three-month adaptation of CTI in enhancing continuity of outpatient psychiatric treatment for persons with serious mental illness following discharge from inpatient care. Among the findings were that, compared with the control group, persons assigned to receive the intervention had significantly fewer days between their hospital discharge and their first outpatient service. The authors conclude that the intervention successfully promoted post-discharge continuity of care, but caution that the limited association between improved continuity and improved patient outcomes requires further study.
April 2, 2009
CTI has been added to the Best Practices Portal for Health Promotion and Chronic Disease Prevention. The portal, maintained by the Public Health Agency of Canada, is intended to improve policy and program decision-making by enabling access to the best available evidence on chronic disease prevention and health promotion.
April 2, 2009
Dan Herman of the Columbia University Mailman School of Public Health and New York State Psychiatric Institute gave an invited presentation on CTI at the 2009 meeting of the NIMH Outreach Partnership Program in Charlotte, North Carolina on March 30. The program partners with national and state organizations, including local branches of NAMI and mental health associations to strengthen the public health impact of research by disseminating the latest scientific findings; informing the public about mental disorders, alcoholism, and drug addiction; and reducing the associated stigma and discrimination.
March 31, 2009
A collaboration between the New York State Office of Mental Health, the Center for Urban Community Services and the Columbia Center for Homelessness Prevention Studies will develop and test a modified version of CTI to enhance continuity of treatment, housing and community supports for adolescents being discharged from residential treatment facilities. These programs, which provide longterm residential care to children and adolescents with severe emotional disorders, hope to improve their capacity to develop effective discharge plans and coordinate post-discharge supports. Based on input from providers and service recipients, the pilot project will first adapt the model to meet the needs of the target population and then train a small number of transition coordinators assigned to several residential treatment facilities. The project also aims to evaluate the impact of this training on selected client outcomes including housing placement and retention. For further information, contact Susan Thaler at oncysct@omh.state.ny.us or Madeline Zivian at oncymxz@omh.state.ny.us
March 11, 2009
New Mexico has become the first state to issue a request for proposals calling specifically for new programs using CTI to assist persons with mental illness in the transition from institutions, treatment programs, and other high-cost transitional programs to sustainable long term supportive living in the community. Value Options, Inc., the organization responsible for managing public behavioral healthcare services in the state issued the RFP on January 26 with a deadline of 2/27/09.
February 21, 2009
Conceptualizing discharge from psychiatric emergency rooms (ER) as a “critical time” of transition, researchers at New York State Psychiatric Institute have launched Project Connect, a pilot program that adapts CTI for frequent users at New York Presbyterian Hospital, home to one of New York City’s busiest psychiatric emergency departments. In evaluating Project Connect, the research team will compare outcomes of persons receiving CTI services with those receiving usual care in order to determine whether the model decreases psychiatric ER visits and increases engagement in outpatient care among participants. A particularly innovative aspect of the study is its use of specially trained peer workers to deliver the CTI intervention. The project is supported with a grant from the New York State Health Foundation. For further details, contact Dr. Ilana Nossel who heads the study at irn1@columbia.edu
February 21, 2009
CTI is now being implemented in Harris County, Texas with adults with SMI following discharge from the county jail. The project is being carried out by the mental health unit of the county sheriff’s office in collaboration with the local county Mental Health Association with training and consultation provided by the Center for Urban Community Services. Further details here.
February 14, 2009
German researchers based at Ulm University are conducting a multi-site randomized trial testing a brief intervention intended to ehance continuity of care for high utilizers of psychiatric services following discharge from inpatient treatment. Although the research team notes that the study was partially inspired by CTI, the model they are employing differs from CTI in its emphasis on discharge planning and follow-up monitoring rather than provision of direct staff support during the post-discharge period. The researchers hope that the intervention will lead to a reduction in future inpatient stays and better quality of life and clinical outcome. Details on the study design were reported recently in BMC Health Services Research.
January 16, 2009
The Center for Social Innovation (formerly the Institute on Homelessness and Trauma) has launched a new initiative to provide online training for social workers on evidence-based practices. Funded by the National Institute of Mental Health, this innovative effort will reach social workers who might not otherwise be able to access training, and improve care by equipping them with the knowledge and skills to provide services that are supported by strong research evidence. Their efforts will begin with CTI. In collaboration with a team from the Columbia University Mailman School of Public Health, they will develop web-based CTI training and implementation support materials and test the materials with social workers in the field. The initial round of pilot training began in March, 2009. If successful, CSI and the Columbia team hope to offer training more broadly in 2010. For further information, contact Tara Vary at CSI at tvary@center4si.com.
January 15, 2009
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