SOP 508.23-att-7: Specialized Mental Health Treatment Unit (SMHTU) Discharge Summary
Summary
Key Topics
- SMHTU discharge
- Behavioral Therapy Unit
- mental health treatment unit
- discharge summary
- treatment team
- inmate mental health
- psychiatric discharge
- follow-up care
- mental health documentation
- treatment disposition
Full Text
SOP 508.23
Attachment 7
04/27/18
# Georgia Department of Correction Institution: _______________________ Name: _________________________ GDC ID#: ______________________ Date: __________________________ Date of Birth: ___________________ Race: _____________ Sex: ________ SPECIAL MENTAL HEALTH TREATMENT UNIT(SMHTU)
DISCHARGE SUMMARY
Behavioral Therapy Unit Counselor ____________________________ Printed/Typed Name
Admit Date: ____________________ / Discharge Date: ____________________________
Admitting Diagnosis: ____________________________________
Reason for Admission: _______________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Final Diagnosis (if different from above): ________________________________________
Summary of Stay (SMHTU Course and Outcome): ________________________________
___________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Disposition Changes (Including medications, treatments and justification for level of
classification at discharge.): ____________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Level Changed: [ ] Yes [ ] No Why? _____________________________________________
Plan: Recommended Follow-Up Appointments:
____________________________________________________________________________
____________________________________________________________________________
Page 1 of 2
Retention Schedule: Completed forms shall be placed in the offender’s mental health file (section 1). At the end of the offender’s need for mental
health services and/or sentence, the mental health file shall be placed within the offender’s health record and retained for ten (10) years.
SOP 508.23
Attachment 7
04/27/18
Approved by the Treatment Team:
Attending SMHTU Counselor ____________________________ (Signature)
Activity Therapist
____________________________________ ___________________________
Signature Printed/Typed Name
Multifunctional Correctional Officer:
____________________________________ __________________________
Signature Printed/Typed Name
Clinical Director: _________________________________ __________________________
Signature Printed/Typed Name
Psychiatrist: ____________________________________ __________________________
Signature Printed/Typed Name
Others:
Title: ______________________
____________________________________ __________________________
Signature Printed/Typed Name
Title: ______________________
____________________________________ __________________________
Signature Printed/Typed Name
Title: ______________________
____________________________________ __________________________
Signature Printed/Typed Name
Title: ______________________
____________________________________ __________________________
Signature Printed/Typed Name
Page 2 of 2
Retention Schedule: Completed forms shall be placed in the offender’s mental health file (section 1). At the end of the offender’s need for mental
health services and/or sentence, the mental health file shall be placed within the offender’s health record and retained for ten (10) years.