The Critical Time Intervention (CTI) program at the UNC Center for Excellence in Community Mental Health will continue its services this year as it undergoes an important expansion. Funded with recent contracts from the state, the program’s growing team will serve around 90 individuals with severe mental illness at high risk of homelessness each year in five counties across North Carolina.
CTI was originally an evidence-based program developed in New York City, where there was a persistent need to relocate individuals from massively overcrowded homeless shelters into long-term, affordable housing. In adapting to the specific needs of North Carolina, the Center’s CTI program maintains this focus on the housing first principle, assisting individuals with mental illness as they transition from institutions, such as prisons, shelters, and hospitals, to the community.
Janice Bainbridge, MSW, LCSW, team leader of CTI, explains the program’s method of outreach: “To qualify for the program, an individual needs to have a serious mental illness, be experiencing a critical transition, to have functional impairments that impede their ability to act effectively in their own best interest, and to have a need for assertive outreach efforts. We reach out to most of our clients after they have been referred by members of the community or institutions and begin to build a relationship with them.”
For people who are homeless, the program aims first to find affordable, sustainable housing for its clients, but much of the progress after that involves a continuum of care and emotional support. CTI works with clients for nine months, linking individuals with medical and psychiatric care, helping them earn income and apply for benefits and strengthening their long-term emotional ties to family and friends. Evidence shows that individuals participating in the CTI program have reductions in inpatient and emergency departments care, fewer encounters with the criminal justice system, decreased homelessness and improved housing stability.
“The program is split into three phases,” explains Bainbridge. “For the first three months, we work intensively with the client to meet his or her more immediate individual treatment, housing or other needs. For the next three months, we focus on helping them successfully connect to various community-based services and benefits, such as Medicaid and food stamps, medical and psychiatric treatment, and we continue efforts to secure income and housing. In the final stage, we try to step back and enable the client to live independently.”
Not only does CTI aid in these critical transitions in which individuals are at imminent risk of homelessness, but it also helps sustain their participation in both their own self-care and in their communities by providing practical support and education in independent living skills. “By teaching our clients important skills such as budgeting,” says Bainbridge, “we are enabling them to have control over their lives and to be productive members of their communities.”
Initially funded by a three-year Kate B. Reynolds Charitable Trust grant and serving Orange and Chatham counties, CTI will now expand to Alamance, Person and Caswell counties with the help of the local managed care organization Cardinal Innovations Healthcare Solutions. Bainbridge is confident about the future of the program and speaks highly about its past successes. “There is a huge lack of affordable housing in our communities,” she says, “and many of the people that we work with would be living outside with no connection to their families and no medical attention without our help.”