Research

Currently underway

CTI for Men with Mental Illness Leaving Prison (NIMH R01 MH076068)
Jeffrey Draine, PI
University of Pennsylvania
An estimated 100,000 people with mental illness are released to communities from prison each year, many with little or no assistance in helping them make effective transitions to community living. Not surprisingly, homelessness and other adverse outcomes are common. This randomized trial is testing an adaptation of CTI with persons with severe mental illness following discharge from prison. Approximately 350 men leaving prison for Camden County, NJ will be randomized, half to receive CTI and half to receive an enhanced reentry planning intervention. The implementation and effectiveness of the intervention will be assessed by interviews at 1, 3, 6, 9, and 18 months post release, collecting clinical data as well as data on treatment engagement and community integration. The study also aims to test the mediating role of growth in resources from community connections.

Mental Illness and Community Reentry in a Multi-Ethnic Population of Female Inmates (NIMH R34 MH082186)
Cathleen E. Willging, PI
Behavioral Health Research Center of the Southwest
The percentage of female inmates in U.S. federal and state correctional facilities is increasing at an alarming pace with racial and ethnic minority women disproportionately overrepresented in the rising numbers. A growing body of research strongly suggests that psychiatric disorders, including substance abuse and dependence, are vitally important in explaining female offending. However, access to mental health services that address the needs of female offenders, both within and outside prison settings, is strikingly limited. Female inmates in the predominantly rural state of New Mexico exemplify the plight of an invisible population. Within rural social networks and community settings more generally, stigma and cultural ideals of self-reliance deter access and utilization of the few professional treatment options that may be available. This project has three specific aims: to assess the role of mental illness in community reentry among Hispanic, Native American, and White women moving to rural environments from prison; to examine the role of social support in the reentry process, and determine strategies to strengthen and sustain the women’s community connections and access to formal and informal helping resources; and finally to adapt and refine CTI to address mental health and community reentry needs and to decrease recidivism within this population.

US Veterans’ Administration Special Needs Grant for Chronically Mentally Ill CTI Program
Robert Rosenheck, PI & Wes Kasprow, Co-PI
Veterans Administration Northeast Program Evaluation Center
This research demonstration project is being implemented at multiple locations in the US. CTI teams are working with community-based residential providers to provide services to homeless veterans with severe mental illness. Training in CTI and other evidence-based approaches is provided by the ACT Center of Indianapolis. This work follows an earlier research demonstration project with homeless adults following discharge from inpatient psychiatric care in eight VA sites.

Evaluation of the Effectiveness of Project Connect for Frequent Users of the Psychiatric Emergency Room
Ilana Nossell, PI
New York State Psychiatric Institute Division of Services and Policy Research
Project Connect is a pilot program of New York State Psychiatric Institute’s Washington Heights Community Service adapting CTI for frequent users of the New York-Presbyterian Hospital’s Comprehensive Psychiatric Emergency Program (CPEP). CTI is being delivered by trained peer workers operating under professional supervision. Secondary service use data from the hospital and Medicaid claims data will be used to evaluate the impact of the intervention. Two comparison groups will be employed: (1) historical controls and (2) frequent users who do not participate in Project Connect due to the limited capacity of the pilot program.

ACT Transition Pilot Project
Molly Finnerty, PI
New York State Office of Mental Health
The New York State Office of Mental Health has launched a project intended to develop and test an approach to identifying and effectively transitioning selected clients from ACT to less intensive (and expensive) sources of treatment and support in the community. This project involves staff from state and city mental health authorities and New York City-based provider agencies in a collaborative effort to design and implement a specific transition model, adapted from CTI.  Once the model is specified, several ACT providers will identify appropriate service recipients from their caseloads and then work with them in the process of transition to less intensive sources of ongoing support.  Process and outcome evaluation data will be collected as part of this multi-year pilot study.

CTI Netherlands Shelter Study
Judith Wolf, PI
Radboud University Nijmegen Medical Centre, Netherlands
The Netherlands Center for Social Care Research at Radboud University Nijmegen Medical Centre, with funding from the national government, has launched two randomized controlled trials to assess the effectiveness of CTI in Dutch services for homeless people and victims of domestic violence.  The studies investigate whether combining CTI with the typical strengths-based social work approach is more effective than the strengths-based methodology alone in improving housing and other outcomes.  The homeless sector trial will include adult clients of nine shelters, examining whether CTI leads to fewer days of homelessness (primary outcome measure). The trial in the women’s shelter sector targets adult female clients of eight facilities who have experienced violent abuse and examines how CTI affects their quality of life (primary outcome measure).  Teams have been trained in the interventions and data collection is set to begin shortly.  The study is led by Dr. Judith Wolf with collaborators Renee de Vet, Danielle Lako, and Marielle Beijersbergen.

CTI for Severely Mentally Ill Released Prisoners: A Randomised Control Trial (CrISP)
Jenny Shaw, PI
University of Manchester
The aim of this project is to see if Critical Time Intervention can help people released from prison stay in contact with community services and possibly reduce reoffending. The investigators will also see whether it is cost effective compared to how services are usually provided.  This project will take place in three male prisons in England.Funded by the British National Institute for Health Research.  Further details are available here.