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Centre for Evidence-
Based Medicine

Homelessness - "Critical Time" intervention decreased risk

Clinical Bottom Line

A "critical time" time intervention decreased homelessness in mentally ill men.


Susser E, Valencia E, Conover S, et al. Preventing recurrent homelessness among mentally ill men: a 'critical time' intervention after discharge from a shelter. Am J Public Health 1997 Feb; 87: 256-62.

Clinical Question

In a mentally ill homeless person, does a "critical time" intervention prevent extended homelessness?

Search Terms

"homelessness" in Evidence-Based Mental Health

The Study

Randomised controlled trial with intention-to-treat analysis. Patients discharged from an on-site psychiatry programme in a New York City men's shelter

Control Group:
(N = 48; 48 analysed): usual services only

Experimental Group:
(N = 48; 48 analysed): "critical time" intervention - an intervention aimed at strengthening an individual's ties to services, family and friends and providing emotional and practical support during transition from hostel to alternative accommodation.

The Evidence

Outcome Time to Outcome CER EER RRR ARR NNT
Extended homelessness (>54 days) 18 months 0.40 0.21 0.47 0.19 5
95% Confidence Intervals: 1 to 73 3 to 100
Control mean Exp mean Difference between the means 95% CI
Days homeless 18 months 91 30 61 19 to 105

Appraised By

Geddes 1999

Expiry Date