Policy Synthesis

Mental Health Services in Georgia Department of Corrections

Synthesized from 30 SOPs · 27 directly cited · updated May 2, 2026

The Georgia Department of Corrections maintains an extensive written framework governing mental health services across its facilities, covering intake screening, a five-level continuum of care, crisis stabilization, suicide prevention, psychotropic medication management, and discharge planning. Multiple overlapping SOPs — originating from both the Health Services Division (Mental Health) and the Health Services Division (Physical Health) — establish specific timelines, staffing requirements, and procedural safeguards for offenders with serious mental illness. Significant gaps and potential conflicts exist around coverage at non-mental-health-mission facilities, the scope of telehealth, and the practical adequacy of crisis-bed capacity.

Overview and Organizational Structure

The GDC's mental health system is governed by SOP 508.01 (Mental Health Organization and Administration, effective 7/27/2023), which establishes that "a system is in place to facilitate the effective and efficient delivery of treatment services to offenders with serious mental illness." Central office mental health administration — headed by a Statewide Mental Health Director — provides "oversight, support, and technical assistance" to facility-based Mental Health Programs. At the facility level, a Clinical Director (a contract-vendor psychologist) provides clinical direction, and a Mental Health Unit Manager (MHUM), defined as a master's-level professional, handles administrative oversight. The policy also establishes a dedicated Suicide Prevention Specialist position, a GDC-employed psychologist who oversees suicide prevention activities and psychological autopsies.

"Serious Mental Illness" is defined consistently across SOP 508.01, SOP 508.16, SOP 508.15, SOP 508.20, and SOP 508.33 as "a substantial disorder of thought or mood that significantly impairs judgment, behavior, capacity to recognize reality or cope with the ordinary demands of life within the correctional environment." SOP 507.04.50 notably expands this definition to explicitly include PTSD, gender dysphoria, and any disorder involving suicidal or self-injurious behavior.

Weekly interdisciplinary staff meetings are mandated by SOP 508.02, chaired by the MHUM and including security staff, with the Warden invited to attend. Meeting minutes documenting attendance and topics discussed must be retained.

Intake Screening and Mental Health Evaluations

Two parallel SOPs govern initial mental health screening, originating from different divisions but referencing each other:

SOP 508.14 (Mental Health Reception Screen, applicable to facilities with diagnostic units) requires that "on the day of arrival at a diagnostic facility, a Qualified Mental Health Professional will complete the Mental Health Reception Screen (form M30-0101) on all newly arriving offenders." Referral triggers include suicidal ideation, recent suicide attempts, history of abuse as a victim, inability to function in general population due to mental illness, and receipt of mental health treatment or psychotropic medication within the last six months. Offenders flagged must be placed on the mental health caseload or transferred to an appropriate mental health facility within five business days. Comprehensive evaluations must be completed within 14 calendar days; emergency evaluations within 24 hours.

SOP 507.04.50 (Mental Health Evaluations, applicable to all facilities including private and county prisons) requires that "a mental health evaluation of all offenders will be performed by qualified mental health personnel upon admission to the GDC or when clinically indicated." The admission screening includes specific inquiry questions: present suicidal ideation, history of suicidal behavior, current psychotropic medication use, current mental health complaints, history of inpatient/outpatient treatment, and substance use history. Disposition options include placement in general population, general population with referral, or emergency referral.

SOP 508.15 (Mental Health Evaluations, Health Services Division Mental Health) adds that all mental health referrals from the reception screening process are routed to the MHUM for assignment, and that the resulting mental health classification level is entered into the Scribe computer tracking system.

SOP 507.04.19 (Receiving Screening, Physical Health) further specifies that offenders presenting with signs or symptoms of suicidal behavior at intake "should be immediately referred to a mental health professional," and that if no mental health services are available at the intake facility, the offender must be transferred to one that has them. The referral must occur the same day signs are noted, with evaluation no later than 14 days after admission.

Levels of Care

SOP 508.16 (Mental Health Levels of Care, effective 5/9/2018) is the central policy governing the care continuum. Offenders are assigned to levels based on treatment need:

Level I: No mental health services needed.
Level II (Outpatient): Services provided in general population or non-clinical settings. Individualized Treatment Plans (ITPs) are required. The offender receives mental health counselor contact at defined intervals.
Level III (Supportive Living Unit / SLU): Special intermediate-care housing for Seriously Mentally Ill offenders "unable to live and function effectively in the general prison population due to the nature of their mental illness." SLUs are separate from general population but allow for reintegration when clinically appropriate. A "therapeutic milieu with a spectrum of programming" is required.
Level IV (Crisis Stabilization Placement): Offenders in crisis are placed in an Acute Care Unit (ACU) or Crisis Stabilization Unit (CSU) cell. Facilities without ACU/CSU cells must place the offender in an observation cell and arrange transfer. Offenders with repeated severe crises who cannot be stabilized may be transferred to a forensic psychiatric hospital.
Level V (Crisis Stabilization Unit): Governed separately by SOP 508.31 (see below).

Mental health classification levels are entered into Scribe and govern transfer eligibility: per SOP 508.33 (Transfer of Offenders with Serious Mental Illness), an offender on the mental health caseload "may only be transferred to a GDC facility with an equivalent or higher level of mental health care."

Acute Care Unit (ACU) — SOP 508.30

SOP 508.30 (Mental Health Acute Care Unit, effective 12/9/2019) governs ACUs, which provide intensive short-term mental health services for offenders who are "extremely agitated but not posing an overt danger to self or others," experiencing abrupt behavioral change, or needing diagnostic clarification — but who do not require the intensive medical attention of a CSU.

Key operational requirements:

ACU placement is not a choice: "Offenders may refuse mental health treatment, but they may not refuse ACU placement."
A physician's admission order is not required, but a mental health evaluation from a privileged provider with psychiatrist/APRN/psychologist consultation is required prior to or immediately after placement.
The ACU Stabilization Team (psychiatrist, mental health nurse, mental health counselor) makes rounds Monday–Friday; a qualified nurse covers weekends and holidays.
Length of stay "should rarely exceed 14 days."
The ACU Discharge Summary Form (M70-01-02) must be completed upon discharge.

Crisis Stabilization Unit (CSU) — SOP 508.31

SOP 508.31 (Mental Health Crisis Stabilization Unit, effective 12/9/2019) establishes CSU as "a level of care (Level V) requiring intensive mental health services," provided only in "designated GDC prison infirmaries located at facilities with a mental health mission." The CSU provides 24-hour monitoring by professional staff.

Admission criteria include: extreme agitation with self-harm or harm to others; need for mental health observation due to abrupt behavioral change; suicidal preoccupation or active self-injury with history of lethal acts; and need for restraints as a last resort. A psychiatrist is on-call 24 hours per day. CSU Nurses cover seven days per week on all shifts.

Average length of stay is approximately five days, with flexibility based on clinical justification. Juveniles in crisis are designated to Augusta State Medical Prison (males) or Lee Arrendale State Prison (females) for CSU services (SOP 508.31; SOP 211.05).

Suicide Prevention and Crisis Management

SOP 508.28 (Managing Potentially Suicidal, Self-Injurious, and Assaultive Behavior, applicable to all facilities including county and private prisons) requires that "offenders who are potentially suicidal, self-injurious, and/or homicidal will be identified and referred for further evaluation and/or appropriate stabilization/management." When a mental health crisis is suspected, the offender must be evaluated at a facility with a mental health unit.

SOP 508.29 (Suicide Precautions) requires that "if any staff determines that an offender may be suicidal or self-injurious, the offender will be referred at once to the mental health staff for further assessment and disposition." All observations must take place in a Hardened Cell — a cell certified by GDC Central Office of Health Services to contain no device usable for self-harm. Mental health observations include continuous observation, one-on-one observation, and irregular 15-minute watches.

SOP 507.03.11 (Health Related Training for Correctional Officers) mandates that all correctional officers receive training in "procedures for suicide prevention" and "recognizing signs and symptoms of mental illness" during Basic Correctional Officer Training (BCOT), with refresher training at least every two years.

SOP 508.03 (Death Notification, Critical Incident Notification, and Investigation) requires a Psychological Autopsy for any offender who commits suicide, regardless of mental health caseload level, and a Clinical Peer Review for all suicides, unusual deaths, and critical incidents involving mental health offenders. Clinical Peer Review is confidential and non-discoverable under O.C.G.A. § 31-7-133.

Psychotropic Medication Management

SOP 508.24 (Psychotropic Medication Use Management, effective 8/15/2022) is the governing document for all aspects of psychiatric prescribing. Key requirements:

Psychotropic medications "will be prescribed when medically indicated and used in a manner consistent with current pharmacological knowledge."
Informed consent is required, documented "in a language understood by the offender."
A DSM-current diagnosis or diagnostic impression must exist prior to initiating any psychotropic medication.
The psychiatrist or APRN must rule out organic/physical causes of mental illness symptoms before prescribing.
Psychotropic medications may not be used for disciplinary purposes — this prohibition is stated explicitly in SOP 508.24 and is cross-referenced in SOP 508.01.
Regular monitoring for clinical response and side effects is required.
SOP 508.24 applies specifically to "all GDC facilities with a mental health mission," not all GDC facilities.

Psychiatric Hospitalization

SOP 508.25 (Psychiatric Hospitalization, effective 8/2/2022, applicable to all facilities including private and county prisons) governs transfer of offenders to inpatient Prison Psychiatric Facilities. Transfer is appropriate when an offender with serious mental illness "presents a great risk of danger to themselves or others, or who are unable to care for their own physical health and safety, creating a life-endangering crisis" and "cannot be safely managed in a less restrictive environment."

A Due Process Hearing is required before any involuntary transfer, held before a three-member Due Process Committee (a deputy warden of care and treatment/designee, a clinical mental health staff member, and a medical staff member). An Offender Advocate — a mental health counselor or technician who is not the offender's assigned clinician — must be appointed to assist the offender. The "least restrictive alternative" principle governs facility selection.

Mental Health in Restrictive Housing

SOP 508.20 (Mental Health Rounds in Restrictive Housing Units, effective 8/2/2022) mandates weekly mental health rounds on all offenders in restrictive housing (segregation, isolation, protective custody) at facilities with a mental health mission. Offenders receiving mental health services placed in restrictive housing must receive a mental health screen within two working days of placement. A monthly individual counseling session is also required based on the offender's mental health level.

SOP 209.06 (Administrative Segregation) cross-references SOPs 508.20 and 508.28–508.29, confirming that mental health services are to be maintained during segregation.

Specialized and Extended Programs

SOP 508.23 (Specialized Mental Health Treatment Units) establishes seven SMHTUs — secure therapeutic units serving populations with serious and persistent mental illness, severe personality disorders, dementia/traumatic brain injury, severe impulse control disorders, cognitive delays, violent behavior with mental illness, and a reentry-focused unit. Admission requires mental health services enrollment, clinical need, and multi-level approval (Warden, Statewide Mental Health Director, Facilities Division Director).

SOP 508.44 (Integrated Treatment Facilities) governs nine-month residential programs for offenders with co-occurring mental health and substance use disorders, using a Therapeutic Community model with four treatment phases. Eligibility requires a documented serious substance use disorder (score of 9 or above on the Next Generation Assessment) and a mental illness.

SOP 508.43 (Tele-Mental Health Services) permits delivery of mental health services via videoconferencing, provided care quality is "at least equivalent to the quality of any other type of care." Psychiatry services delivered via telehealth must be supplemented by an in-person visit at least every six months. All staff providing tele-mental health services must be fully licensed in their discipline.

Discharge Planning

SOP 508.35 (Discharge Planning for Mental Health Offenders, effective 8/2/2022) requires that discharge planning begin 30 to 60 days before release for any offender on the mental health caseload with a confirmed parole or discharge date. The mental health team must coordinate with the Department of Behavioral Health and Developmental Disabilities (DBHDD) and Department of Community Supervision (DCS). A final psychiatric evaluation must be scheduled as close as possible to the release date, and the prescribing psychiatrist or APRN must provide at least a 30-day supply of blister-packed medications at discharge for offenders on psychotropic medications.

Quality Assurance and Oversight

SOP 508.11 (Mental Health Continuous Quality Improvement) requires facility-level and statewide CQI committees to meet at least quarterly, with facilities submitting annual CQI plans to central office by January 31. Mandatory quarterly CQI audit topics include: restraints, CSU/ACU admissions, emergency medications, involuntary medications, psychotropic medication non-adherence, self-injurious and assaultive behavior, facility mortality reviews resulting from suicides, suicide prevention committee meetings, and post-stabilization restrictive housing assessments.

SOP 508.12 (Mental Health Audits and Evaluations) requires the central office audit team to review each mental health program at least annually using standardized audit tools. Facilities must conduct one self-audit within six months of the comprehensive audit. Any deficiencies (scores of 70% or less, or areas of concern) require a written Corrective Action Plan submitted within one month.

Key Findings

SOP 508.14 requires a mental health reception screen to be completed on the day of arrival at a diagnostic facility, with placement on the mental health caseload or transfer to an appropriate facility within five business days and comprehensive evaluations within 14 calendar days; emergency evaluations must occur within 24 hours.
SOP 508.16 establishes a five-level continuum of mental health care (Level I through Level V/Crisis Stabilization), with Level III requiring Supportive Living Unit housing for Seriously Mentally Ill offenders who cannot function in general population, and Level V requiring 24-hour inpatient monitoring in a designated infirmary CSU.
SOP 508.24 explicitly prohibits the use of psychotropic medications for disciplinary purposes, requires a current DSM diagnosis prior to prescribing, mandates informed consent in a language the offender understands, and requires ruling out organic/physical causes before initiating psychiatric medication.
SOP 508.25 requires a formal Due Process Hearing before any involuntary transfer to an inpatient Prison Psychiatric Facility, with an independent three-member committee and an Offender Advocate appointed to represent the offender's interests.
SOP 508.29 requires that any staff member who determines an offender may be suicidal or self-injurious must refer that offender immediately to mental health staff, and all suicide-precaution observation must occur in a GDC-certified Hardened Cell containing no device usable for self-harm.
SOP 508.20 mandates weekly mental health rounds on all offenders in restrictive housing, an initial mental health screen within two working days of restrictive housing placement, and monthly individual counseling sessions for mental health caseload offenders in segregation.
SOP 508.33 prohibits transferring an offender on the mental health caseload to a facility with a lower level of mental health care than indicated on the offender's mental health profile in the Scribe tracking system.
SOP 508.35 requires discharge planning to begin 30–60 days before release for mental health caseload offenders, including coordination with DBHDD and DCS, a final psychiatric evaluation near release, and provision of at least a 30-day supply of blister-packed psychotropic medications at discharge.
SOP 508.03 requires a Psychological Autopsy for every offender who commits suicide regardless of mental health caseload level, and a confidential Clinical Peer Review (non-discoverable under O.C.G.A. § 31-7-133) for all suicides, unusual deaths, and critical incidents involving mental health offenders.
SOP 507.03.11 requires all correctional officers to receive training in suicide prevention and recognition of mental illness signs during Basic Correctional Officer Training, with refresher training at least every two years.

Gaps & Conflicts

Where SOPs contradict each other, leave standards ambiguous, or fail to address something the broader policy framework would suggest they should.

Coverage gap for non-mental-health-mission facilities: SOP 508.24 (psychotropic medication management), SOP 508.16 (levels of care), SOP 508.20 (restrictive housing rounds), and SOP 508.14 (reception screening) all apply only to 'GDC facilities with a mental health mission.' SOP 507.04.50 (mental health evaluations) and SOP 508.28 (suicidal/self-injurious behavior) apply to all facilities including private and county prisons, but the full suite of mental health services — including weekly restrictive housing rounds, CSU/ACU access, and formal levels-of-care assignment — is not guaranteed at non-mental-health-mission facilities.
Definitional inconsistency for Serious Mental Illness: SOP 507.04.50 explicitly includes PTSD, gender dysphoria, and any disorder involving suicidal or self-injurious behavior in the definition of Serious Mental Illness, while SOPs 508.16, 508.15, 508.20, and 508.33 use a narrower functional definition without these explicit inclusions. This inconsistency could affect caseload eligibility determinations across facilities.
Telehealth in-person requirement gap: SOP 508.43 requires in-person psychiatric visits at least every six months for offenders receiving tele-psychiatry, but no SOP specifies the minimum frequency of in-person contact for offenders in remote facilities receiving all mental health services via telehealth, nor does any SOP specify what happens when the six-month in-person requirement cannot be met due to facility location or staffing.
CSU bed capacity not standardized: SOP 508.31 states that the number of CSU beds per infirmary 'will be specific, but there will be flexibility to expand or reduce the number of beds according to need.' No SOP establishes minimum bed ratios, waiting list procedures, or what happens when a facility's observation cells are full and transfer cannot immediately occur.
ACU weekend coverage gap: SOP 508.30 specifies that the full ACU Stabilization Team (psychiatrist, mental health nurse, and counselor) makes rounds Monday–Friday, with weekend/holiday coverage provided only by 'a qualified nurse.' No psychiatrist or counselor weekend round requirement is specified, creating a potential gap in clinical oversight during weekends and holidays.
Transitional Center mental health services hand-off is time-limited but not guaranteed: SOP 508.34 states that GDC will ordinarily provide psychiatric services for the first 30 days at a Transitional Center, after which the local Community Service Board takes over. No SOP addresses what occurs if the Community Service Board is unavailable, refuses, or has a waiting list, nor what standards apply to those community psychiatric services.
Conflict between SOP 508.29 and SOP 508.28 on cell terminology: SOP 508.29 defines the observation cell used during suicide precautions as a 'Hardened Cell' (reviewed and certified by GDC Central Office of Health Services), while SOP 508.28 uses the term 'Suicide Resistant Cell' for the same concept. These are functionally equivalent but the inconsistent terminology across SOPs could cause confusion about which certification standard applies.
Discharge medication supply is specified only as 'at least 30 days' blister-packed: SOP 508.35 requires a minimum 30-day supply but no SOP specifies what occurs when a prescription cannot be filled locally, when a medication is not available in blister-pack form, or when the release date is uncertain, leaving a practical gap in continuity of psychiatric medication post-release.
CQI and audit obligations apply only to 'state institutions' or 'mental health mission' facilities: SOP 508.11 applies to 'all state institutions providing mental health services' and SOP 508.12 to 'all GDC facilities with a mental health mission.' Private and county prisons housing GDC offenders are not explicitly subject to the same CQI audit and corrective action plan requirements, even though those facilities are subject to intake screening and some crisis management SOPs.

SOPs Cited in This Page

SOP 508.15: Mental Health Evaluations Health Services Division (Mental Health)

SOP 508.16: Mental Health Levels of Care Health Services Division

SOP 508.24: Psychotropic Medication Use Management Health Services Division (Mental Health)

SOP 507.04.50: Mental Health Evaluations Health Services Division (Physical Health)

SOP 508.31: Mental Health Crisis Stabilization Unit Health Services Division (Mental Health)

SOP 508.14: Mental Health Reception Screen Health Services Division (Mental Health)

SOP 508.20: Mental Health Rounds in Restrictive Housing Units Health Services Division (Mental Health)

SOP 508.11: Mental Health Continuous Quality Improvement Health Services Division (Mental Health)

SOP 508.25: Psychiatric Hospitalization Health Services Division (Mental Health)

SOP 508.30: Mental Health Acute Care Unit Health Services Division (Mental Health)

SOP 508.29: Suicide Precautions Health Services Division (Mental Health)

SOP 508.35: Discharge Planning for Mental Health Offenders Health Services Division (Mental Health)

SOP 508.28: Managing Potentially Suicidal, Self-Injurious, and Assaultive Behavior Health Services Division (Mental Health)

SOP 508.23: Specialized Mental Health Treatment Units Health Services Division

SOP 508.18: Mental Health Discipline Procedures Health Services Division (Mental Health)

SOP 508.43: Tele-Mental Health Services Health Services Division (Mental Health)

SOP 508.44: Integrated Treatment Facilities (ITFs) Health Services Division (Mental Health)

SOP 508.03: Death Notification, Critical Incident Notification, and Investigation Health Services Division (Mental Health)

SOP 508.34: Clearance for Transitional Programs Health Services Division (Mental Health)

SOP 507.03.11: Health Related Training for Correctional Officers Health Services Division (Physical Health)

SOP 507.04.19: Receiving Screening Health Services Division (Physical Health)

SOP 508.02: Mental Health Staff Meetings Executive Division

SOP 508.12: Mental Health Audits and Evaluations of Mental Health Services Health Services Division (Mental Health)

SOP 508.22: Mental Health Management of Suspected Sexual Abuse or Sexual Harassment Health Services Division

SOP 508.09: Mental Health Records

SOP 209.06: Administrative Segregation Facilities Division

SOP 211.05: Procedures for Housing Offenders Under 18 Years Of Age (Juvenile) In GDC Custody Facilities Division