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Centre for Evidence-
Based Medicine

Therapy: Clinical Scenario

You are responsible for the provision of psychiatric services to the local homeless people in an inner city area. Many of your patients suffer from schizophrenia. Although the outpatient clinic you run in a local hostel seems to help stabilise their symptoms, you find that resettling the patients from the hostel to alternative accommodation is difficult and often results in failure. You want to know if there is a model of service that will make it more likely for resettlement to be successful . You formulate the clinical question: "In homeless patients with schizophrenia, is there an intervention that will reduce the rates of homelessness following resettlement?

You go to the Centre for Evidence-Based Mental Health website and search through the titles. You find an abstract and commentary looking at the effectiveness of a "critical time" intervention that looks promising and you decide to get the original article Am J Public Health 1997 Feb; 87: 256-62.

Read the article and decide:

  1. Is the evidence from this randomised trial valid?
  2. If valid, is this evidence important?
  3. If valid and important, can you apply this evidence in caring for your patient?

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