Time-limited case management for homeless mothers with mental health problems: Effects on maternal mental health

Objective: In this study we test the effect of a time-limited case management model targeting homeless mothers who are experiencing mental health problems. Adapted from an empirically informed intervention to prevent recurrent homelessness among individuals, the Family Critical Time Intervention (FCTI) supports mothers with children for a 9-month period as they move from homeless shelters into affordable housing. The case management team uses a structured intervention to encourage mothers to create and maintain necessary connections in the community for key family supports. Method: We use a longitudinal randomized controlled trial (N = 210) to test whether homeless mothers referred to FCTI experience greater declines in psychopathology compared with those receiving homeless services-as-usual. All families receive access to affordable housing. Hierarchical linear models examine changes in symptomatology at shelter entry and 3, 9, and 15 months later. Results: Results suggest all homeless mothers report significant and clinically meaningful declines in mental distress over time, regardless of intervention condition. Treatment effects do not vary by prior homelessness experiences or receipt of mental health services. Conclusions: Homelessness presents acute stress for mothers that diminishes over time after families rehouse. In addition, improvements in maternal mental health fail to explain prior findings that associated FCTI with benefits in child and adolescent behavior. Taken together, FCTI with connection to affordable housing provides a useful approach with homeless families; however, additional research needs to articulate mechanisms involved in the intervention.