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Cost-effectiveness of critical time intervention to reduce homelessness among persons with mental illness
Nathan S. Kline Institute for Psychiatric Research.
Charles P. Felton National Tuberculosis Center, NYC.
University of Michigan.
Nathan S. Kline Institute for Psychiatric Research.
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2003 (English)In: Psychiatric Services, ISSN 1075-2730, E-ISSN 1557-9700, Vol. 54, no 6, p. 884-890Article in journal (Refereed) Published
Abstract [en]

Objectives: Cost-effective programs are needed to assist homeless persons with severe mental illness in their transition from shelters to community living. The authors investigated the cost-effectiveness of the critical time intervention program, a time-limited adaptation of intensive case management, which has been shown to significantly reduce recurrent homelessness among men with severe mental illness. Methods: Ninety-six study participants recruited from a psychiatric program in a men's public shelter from 1991 to 1993 were randomly assigned to the critical time intervention program or to usual services. Costs and housing outcomes for the two groups were examined over 18 months. Results: Over the study period, the critical time intervention group and the usual services group incurred mean costs of $52,374 and $51,649, respectively, for acute care services, outpatient services, housing and shelter services, criminal justice services, and transfer income. During the same period, the critical time intervention group experienced significantly fewer homeless nights than the usual care group (32 nights versus 90 nights). For each willingness-to-pay value - the additional price society is willing to spend for an additional nonhomeless night - greater than $152, the critical time intervention group exhibited a significantly greater net housing stability benefit, indieating cost-effectiveness, compared with usual care. Conclusions: Although difficult to conduct, studies of the cost-effectiveness of community mental health programs can yield rich information for policy makers and program planners. The critical time intervention program is not only an effective method to reduce recurrent homelessness among persons with severe mental illness but also represents a cost-effective alternative to the status quo.

Place, publisher, year, edition, pages
2003. Vol. 54, no 6, p. 884-890
Keywords [en]
adult, article, clinical trial, community care, controlled clinical trial, controlled study, cost effectiveness analysis, criminal justice, disease severity, evaluation, health care cost, health care planning, health care policy, health care utilization, health program, homelessness, housing, human, income, major clinical study, male, mental disease, mental health care, mental health service, outcomes research, outpatient, randomized controlled trial, technique, Community Psychiatry, Cost-Benefit Analysis, Crisis Intervention, Homeless Persons, Humans, Mental Disorders, New York City, Program Evaluation, Progressive Patient Care, Social Class
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Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-38570DOI: 10.1176/appi.ps.54.6.884Scopus ID: 2-s2.0-0038012569OAI: oai:DiVA.org:hig-38570DiVA, id: diva2:1659599
Available from: 2022-05-20 Created: 2022-05-20 Last updated: 2022-05-20Bibliographically approved

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Holter, Mark

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