# Adapting Critical Time Intervention to Support Inpatient Medical Care Transitions

> **NIH NIH P50** · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · 2020 · $178,103

## Abstract

PROJECT SUMMARY – PROJECT 2
For adults with schizophrenia, the transition from hospital inpatient to outpatient care poses substantial risks of
treatment disengagement. Traditional case management approaches for patients with schizophrenia have
involved telephonic follow-up after discharge from inpatient mental health care and have yielded poor results.
Much less information exists regarding outcomes for patients with schizophrenia discharged following inpatient
medical care. Given that these patients often have difficulty accessing and adhering to medical treatments,
patients with schizophrenia who are admitted to a hospital for treatment of a medical condition are especially
vulnerable to failed care transitions. Intensive interventions involving home visits, social support, motivational
interviewing, and accompanying patients to outpatient appointments have shown positive results for patients
discharged following inpatient mental health care, and may therefore be effective for patients with
schizophrenia discharged following inpatient medical care. Critical Time Intervention (CTI) is a novel evidence-
based time-limited intervention that involves ongoing community-based contacts with patients from trained care
managers to facilitate connections to aftercare providers and community and support systems following
hospital discharge. This pilot study will adapt CTI for use with patients with schizophrenia who are admitted to
one of 2 safety net hospitals in Bronx, New York, for treatment of ambulatory care sensitive conditions (medical
conditions for which appropriate ambulatory care should limit the need for inpatient treatment). We will
randomize 80 eligible inpatients to receive either: 1) treatment as usual (TAU) (n=40); or 2) CTI and TAU
(n=40). During a 3-month period prior to randomization, an Adaptation Team of research and hospital staff will
review data from qualitative interviews of clinical staff and patients to identify factors likely to facilitate and
impede CTI implementation. The team will then adapt the CTI to increase the likelihood of successful
implementation. In the randomization phase, participants assigned to CTI will meet with a CTI care manger
during their inpatient stay and over a 3-month period following hospital discharge. CTI care managers will
assess and address patient needs and barriers to outpatient medical and mental health care and provide
support and assistance with medical and mental health care management. For quantitative analyses, the
primary outcome measures will be all-cause hospital readmissions at 7 and 30 days following discharge.
Secondary outcomes will include follow-up with medical and mental health outpatient care at 7 and 30 days
following hospital discharge. Patients receiving CTI will also be assessed to evaluate satisfaction with CTI
services, psychiatric symptoms, community function, and involvement in medical care decisions. The proposed
study will test whether a time-limited novel interventio...

## Key facts

- **NIH application ID:** 9841456
- **Project number:** 5P50MH115843-03
- **Recipient organization:** NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
- **Principal Investigator:** THOMAS E SMITH
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $178,103
- **Award type:** 5
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9841456

## Citation

> US National Institutes of Health, RePORTER application 9841456, Adapting Critical Time Intervention to Support Inpatient Medical Care Transitions (5P50MH115843-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9841456. Licensed CC0.

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