Critical Time Intervention

Critical Time Intervention (CTI) is a care management service for adults with serious mental illness. This approach is used during a “critical time” of transition in their lives. CTI Teams coordinate the services and supports that help people return to their community. Services include outreach and engagement with people in care settings like inpatient hospitals and crisis units, as well as in the community.

BENEFITS OF CTI

Critical Time Intervention helps people develop strong ties to their support systems during and after transition periods. It addresses key social care needs at an individual level. CTI uses a nonjudgmental and person-centered approach that meets people where they are and focuses on their strengths. This model supports:

• community integration
• self-advocacy
• access to ongoing support

The goal is to build connections and strengthen supports that will remain in place after the intervention ends.

WHO IS ELIGIBLE?

1. Individuals who are at least age 18-years-old (*see Young Adult Exception below)
2. Individuals with complex mental health conditions
3. Individuals who need transition in care, including but not limited to:
• Individuals discharged from an inpatient psychiatric hospital, with long-stay admissions or multiple admissions.
• Individuals discharged from the Emergency Room (ER)/ Comprehensive Psychiatric Emergency Program (CPEP) or other crisis services – who are not otherwise engaged, returning to ER/CPEP multiple times, and who lack community support.

*Young Adult Exception: Some adult CTI Teams can serve young adults ages 16+ who need support during the transition of any existing service in the children’s system to the adult service systems.

HOW IT WORKS

Critical Time Intervention includes four (4) phases:

Pre-CTI Early Engagement Phase - CTI teams conduct outreach (before discharge when possible) to develop a trusting relationship with the individual.

• Receive referrals and conduct outreach with local hospitals, including inpatient psychiatric units, emergency departments, and CPEPs.

Phase 1 Initiate Linkages – Provide support & begin to connect the individual to people and agencies that will be the main source of support.

• Conduct in-person home/community visits
• Engage in collaborative assessments
• Identify and meet with existing supports
• Introduce the individual to new positive supports and providers/resources in the community

Phase 2 Try Out - Monitor and strengthen the support network and individual’s skills.

• Observe the established support network
• Address issues as needed
• Help adjust the network as needed
• Encourage the client to take more responsibility to build independence

Phase 3 Final Transfer of Support - End CTI services once the support network is in place.

• CTI providers step back to ensure that the individual can function independently
• Hold a meeting with the individual and support(s) to mark the final transfer of care
• Meet for the last time to review progress made

RESOURCES FOR CTI TEAMS

Critical Time Intervention Manual (2002)

CTI Manual for Workers and Supervisors (2021)

CTI Team Program Guidance (2024)