Critical Time Intervention for Frequent Users of the Comprehensive Psychiatric Emergency Programs
Special Projects Fund
August 11, 2008
Frequent users of psychiatric emergency departments (ED) often have complex, unmet needs due to high rates of co-occurring psychiatric and substance use disorders, homelessness, and lack of health insurance.
Their unmet needs result in the use of costly health care resources and contribute to ED overcrowding. Without an appropriate link to outpatient care, patients quickly destabilize upon discharge and return repeatedly to the ED in a psychiatric crisis. Critical Time Intervention (CTI) is a successful model for linking homeless individuals with transitional supports by providing increased support during the critical time of transition. In September 2009, the New York Health Foundation awarded a grant to the Research Foundation for Mental Hygiene, Inc. (RFMH) to adapt the CTI model to provide recovery support services to frequent users of Comprehensive Psychiatric Emergency Programs (CPEP).
Grantee: Research Foundation for Mental Hygiene, Inc.
Grant Title: Critical Time Intervention for Frequent Users of the Comprehensive Psychiatric Emergency Programs
Dates: August 11, 2008–December 21, 2011
Funding: Special Projects Fund
Grant Amount: $436,687
RFMH hoped to achieve the following goals:
- Assess whether the CTI model can succeed at decreasing CPEP utilization while increasing engagement in outpatient treatment among frequent CPEP users.
- Improve engagement in outpatient services by providing recovery support services to frequent users of CPEP at time of discharge.
RFMH accomplished the following:
- Enrolled 75 patients in the CTI model.
- Demonstrated a 63% reduction in ED visits in frequent users using the CTI model, in preliminary analyses comparing number of visits six months prior to and following enrollment. However, decreases in the use of the ED and inpatient services were approximately equal in intervention and comparison groups. Those receiving care through the CTI model were more likely to have substance use histories, receive supplemental social security income, and have more ED visits at baseline.
- Engaged patients in outpatient services by significantly decreasing time to an outpatient visit from an average of 100 days to 27 days. Individuals who received recovery support services from Project Connect were more likely than the comparison group to engage in outpatient services following ED discharge and to maintain a steady level of outpatient service use. Those in the comparison group decreased their outpatient service use by approximately 10% more per month than Project Connect clients.
Grantee Website: http://rfmh.nyspi.org/
Grant ID #: 2405826