About 25 percent of the prisoners in Georgia Department of Corrections (GDC) facilities are classified as part of the GDC's mental health population. That figure comes from the state's own data -- and it makes Georgia's prison system, by its own accounting, one of the larger mental health treatment settings in the state.
GDC's mental health care operates under Standard Operating Procedure 508.16 (Mental Health Levels of Care), which establishes the classification levels, housing units, and treatment requirements for prisoners with mental illness. It defines four distinct housing categories from general population outpatient services to crisis stabilization. One of the more unusual policy features in the series: Georgia Administrative Rule 125-4-5 explicitly prohibits charging inmates, their families, or other individuals for the cost of mental health treatment.
GDC works closely with the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD), which operates five state hospitals that provide forensic and inpatient psychiatric services for GDC prisoners who need hospital-level care. In 2023, DBHDD funded five pilot "jail in reach" programs where full-time counselors and forensic peers work with prisoners near release to help them plan their return to the community.
There is no active federal class action against GDC specifically for mental health care at this time.
What Georgia Prisoners Are Entitled To
Under Estelle v. Gamble (1976), GDC SOP 508.16, and Georgia Administrative Rule 125-4-5:
- Mental health screening at intake at a GDC reception center.
- Classification into a mental health level of care based on assessed need.
- An Individualized Treatment Plan (ITP) for each prisoner receiving mental health services.
- Housing in an appropriate mental health unit (Supportive Living Unit, Acute Care Unit, or Crisis Stabilization Unit) when general population is not appropriate.
- Transfer to a DBHDD hospital for inpatient care if needed.
- Mental health services in all State Prisons and Probation Detention Centers.
- No charge to the prisoner, their family, or others for mental health treatment.
Mental Health Screening at Intake
All inmates are screened at a GDC reception center after intake from a county jail. The screening determines current medical, dental, and mental health care needs, including assessments for auditory, mobility, and vision disabilities and the need for specialized mental health treatment.
GDC receives prisoners after they have been processed through a county jail. If your person has a psychiatric history, provide documentation to the GDC reception center at intake -- prior hospitalizations, diagnoses, and active medications.
Mental Health Levels of Care (SOP 508.16)
GDC Standard Operating Procedure 508.16 defines the mental health classification system and associated housing and treatment requirements. The primary levels:
Outpatient Services: Mental health services provided in general population or any other non-clinical setting at a GDC facility. The clinician assists the prisoner with overall adjustment in the correctional environment and provides treatment for specific needs as identified in an Individualized Treatment Plan. This is the broadest level, covering the largest number of GDC prisoners in the mental health population.
Supportive Living Unit (SLU): Special intermediate care mental health housing designed to serve the needs of Seriously Mentally Ill (SMI) prisoners who are unable to live and function effectively in the general prison population due to their illness. The SLU provides more structured mental health support, housing, and programming than outpatient services but is less intensive than acute crisis care.
Crisis Stabilization: For prisoners who are in acute psychiatric crisis. Crisis-level prisoners are placed in an Acute Care Unit (ACU) or Crisis Stabilization Unit (CSU) cell. At facilities without ACU or CSU cells, the prisoner is placed in an observation cell until transfer to a facility with ACU/CSU capacity can take place. Prisoners with repeated severe crises who cannot be stabilized in an ACU/CSU may be referred to a higher level of care -- including transfer to a DBHDD hospital.
The Supportive Living Unit
The SLU is the key intermediate mental health housing unit in Georgia's prison system. It is designed specifically for SMI prisoners who cannot safely function in general population -- not because of disciplinary problems per se, but because of the nature of their mental illness. The SLU provides a structured therapeutic environment within the GDC facility.
If your person has a serious mental illness and is in general population without SLU placement, and they are struggling to function, a referral to SLU evaluation can be requested through the facility's mental health department.
Acute Care Units and Crisis Stabilization Units
ACUs and CSUs are the crisis response housing in Georgia's prison system. When a prisoner is in acute psychiatric crisis, they are placed in an ACU or CSU for stabilization. Not all GDC facilities have ACU or CSU capacity -- when a crisis occurs at a facility without these units, the prisoner goes to an observation cell while transfer is arranged.
This transfer-for-crisis provision means that the speed of crisis response can vary by facility location and the availability of ACU/CSU beds statewide. If your person has experienced a psychiatric crisis, ask whether they were stabilized in an ACU/CSU or held in an observation cell, and how long any transfer took.
The No-Cost Treatment Rule
Georgia Administrative Rule 125-4-5 (GA R&R Subject 125-4-5 Mental Health Services) explicitly states that neither the inmate, their family, nor other individuals shall be required to pay any portion of the fee or expenses for the inmate's mental health treatment.
This is a statutory and regulatory prohibition, not a policy preference. If your person has been billed for mental health treatment, or told that mental health services are conditioned on payment, document this and file a grievance.
Individualized Treatment Plans
SOP 508.16 and GDC mental health policy require Individualized Treatment Plans (ITPs) for prisoners receiving mental health services. The ITP tailors treatment to the specific needs of each prisoner -- it is the document that describes what treatment they are receiving, at what frequency, and what goals are being worked toward.
If your person is receiving mental health services, ask to know what is in their ITP -- specifically: what treatment is being provided, how often they are seen by mental health staff, and what the goals of treatment are.
DBHDD and the State Hospital System
GDC works with the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) for prisoners who need hospital-level psychiatric care beyond what a GDC facility can provide. DBHDD operates five state hospitals with forensic psychiatric services:
- Georgia Regional Hospital at Atlanta (GRHA, Decatur, DeKalb County): 124 forensic beds (Secure 1, Secure 2, Secure 3); serves adults found Incompetent to Stand Trial (IST) or Not Guilty by Reason of Insanity (NGRI) from metro Atlanta counties.
- Central State Hospital (Milledgeville): historic facility; continues to provide some forensic services.
- East Central Regional Hospital (Augusta)
- Southwestern State Hospital (Thomasville area)
- Georgia Regional Hospital Savannah
GDC prisoners who cannot be stabilized at the ACU/CSU level, or who require inpatient psychiatric hospital care, may be transferred to a DBHDD hospital. The forensic units serve people who are referred by the courts (IST, NGRI) as well as people transferred from GDC for clinical reasons.
DBHDD and Pre-Release Support
In 2023, DBHDD funded five pilot "jail in reach" programs. Under this model, a full-time counselor and a forensic peer work with individuals who are incarcerated and need mental health and other social services as they prepare to re-enter the community. The forensic peer is someone who has been incarcerated themselves, has a persistent mental illness but is in recovery, and has specialized training to work with this population.
GDC also places peer mental health counselors in prisons to assist prisoners close to their release date with transition planning -- identifying community mental health providers, coordinating Medicaid enrollment, and developing an aftercare plan.
The West Central Integrated Treatment Facility
The West Central Integrated Treatment Facility (Thomaston, Georgia) is a GDC facility with a dual diagnosis mission: it provides 138 beds for female probation violators with co-occurring mental health and substance abuse disorders, plus 46 beds for female probationers supporting the work mission. The facility provides integrated mental health and substance abuse treatment. It is a distinctive facility in the GDC system -- one of the few specifically designed for the intersection of mental illness and substance use in women.
The GDC Contractor Model
GDC uses a contractor to provide primary health care services (including some mental health care components) within its facilities. The contractor provides the core clinical staffing at each correctional institution, including physicians, nurses, mental health professionals, and dental professionals. This is similar to the private contractor model seen in Alabama, Arizona, and other states in this series.
The identity of GDC's current health care contractor should be confirmed at publish.
What Families Can Do
If your person is in GDC custody and has a mental illness:
Provide psychiatric history at intake. Supply documentation of prior hospitalizations, diagnoses, and active medications at the GDC reception center. Intake screening determines initial mental health classification and whether SLU or other specialized housing is warranted.
Know the no-cost treatment rule. Under Georgia Administrative Rule 125-4-5, mental health treatment cannot be charged to the prisoner, their family, or anyone else. If your person is being denied treatment pending payment or has been billed, file a grievance citing this rule.
Know the SLU. If your person has a serious mental illness and is struggling to function in general population, ask the facility's mental health department whether an SLU evaluation has been conducted. SLU placement is the appropriate intermediate care housing for SMI prisoners unable to function in general population.
Know the ITP requirement. Ask whether your person has an active Individualized Treatment Plan and what it contains: what treatment is being provided, how often they are seen, and what goals are being worked toward.
Know the crisis transfer right. If your person is in acute psychiatric crisis and the facility does not have ACU/CSU capacity, they should be transferred to a facility with those beds. If transfer is being delayed, document this and file a grievance.
Know the DBHDD hospital pathway. If your person's crisis is severe and cannot be managed within the GDC system, they may be eligible for transfer to a DBHDD hospital. Ask whether this referral has been made if conditions warrant it.
Ask about pre-release transition planning. Ask whether your person has been connected with a peer mental health counselor or the "jail in reach" program if they are approaching release.
File a grievance. GDC has an administrative grievance process. File formal grievances for: failure to conduct mental health screening, denial of mental health classification, failure to provide SLU placement when warranted, billing for mental health treatment, failure to provide an ITP, delayed crisis transfer, and medication interruption.
Contact Disability Rights Georgia. DRGa (disabilityrightsga.org) is the federally mandated Protection and Advocacy organization for Georgia and monitors conditions for people with mental illness and disabilities in GDC facilities.
Seek legal help. If your person has a serious mental illness and has been denied SLU placement, billed for mental health treatment, held in an observation cell without crisis care for an extended period, or denied access to DBHDD hospital care when warranted, consult a prisoner rights attorney with experience in Georgia's federal courts (Northern, Middle, and Southern Districts of Georgia).
Frequently asked questions
How does Georgia screen prisoners for mental illness?
All GDC inmates are screened at a reception center after intake from the county jail. The screening assesses current medical, dental, and mental health care needs, including disabilities and the need for specialized mental health treatment. The screening determines initial mental health classification and whether specialized housing (such as a Supportive Living Unit) is warranted. Provide documentation of psychiatric history at the reception center -- prior hospitalizations, diagnoses, and current medications.
What mental health levels does Georgia DOC use?
GDC SOP 508.16 defines three primary mental health levels: outpatient services (in general population, with an Individualized Treatment Plan); Supportive Living Unit (SLU) -- intermediate care housing for SMI prisoners unable to function in general population; and crisis stabilization in an Acute Care Unit (ACU) or Crisis Stabilization Unit (CSU). Prisoners who cannot be stabilized in ACU/CSU may be referred to a DBHDD state hospital for inpatient care.
What is a Supportive Living Unit in Georgia prisons?
The SLU (Supportive Living Unit) is intermediate care mental health housing for SMI prisoners who are unable to live and function effectively in general population due to their mental illness. It provides a more structured therapeutic environment than general population outpatient services while remaining less intensive than acute crisis stabilization. SLU placement is designed specifically for the Seriously Mentally Ill prisoner population that needs specialized housing but not immediate crisis care.
What are ACU and CSU units in Georgia prisons?
ACUs (Acute Care Units) and CSUs (Crisis Stabilization Units) are the crisis response housing in Georgia's prison system. Prisoners in acute psychiatric crisis are placed in an ACU or CSU cell for stabilization. Not all GDC facilities have ACU or CSU capacity. At facilities without these units, prisoners in crisis are placed in an observation cell until transfer to a facility with ACU/CSU beds can be arranged. Prisoners with repeated severe crises who cannot be stabilized may be referred to a DBHDD state hospital.
Can Georgia charge prisoners for mental health treatment?
No. Georgia Administrative Rule 125-4-5 (GA R&R Subject 125-4-5 Mental Health Services) explicitly prohibits charging the inmate, their family, or other individuals any portion of the fee or expenses for the inmate's mental health treatment. This is a regulatory prohibition, not a policy preference. If your person has been billed for mental health treatment or told services are conditioned on payment, file a grievance citing this rule.
What is an Individualized Treatment Plan in GDC?
An Individualized Treatment Plan (ITP) is a required document for each GDC prisoner receiving mental health services. It defines the specific treatment being provided, the frequency of clinical contact, and the goals of treatment -- tailored to the individual's mental health needs. Under SOP 508.16, ITPs are part of the holistic approach to assessment, treatment, and management of mental illness in GDC facilities. Ask whether your person has an active ITP and what it includes.
How does DBHDD support GDC prisoners with mental illness?
DBHDD (Georgia Department of Behavioral Health and Developmental Disabilities) operates five state hospitals (Decatur, Milledgeville, Augusta, Thomasville area, Savannah) with forensic psychiatric units serving people found Incompetent to Stand Trial or Not Guilty by Reason of Insanity, as well as GDC prisoners transferred for clinical reasons. DBHDD also funds "jail in reach" programs (five pilots in 2023) where counselors and forensic peers work with prisoners near release on transition planning.
What is the West Central Integrated Treatment Facility?
The West Central Integrated Treatment Facility (Thomaston, Georgia) is a GDC facility providing integrated mental health and substance abuse treatment for female probation violators with co-occurring disorders (dual diagnosis, 138 beds), plus space for female probationers supporting the facility's work mission (46 beds). It is one of the few GDC facilities specifically designed for the intersection of mental illness and substance use in women, remissioned to its current treatment mission in July 2012.
What can families do if mental health care is denied in GA?
Provide psychiatric history documentation at intake. Know the no-cost treatment rule (Georgia Administrative Rule 125-4-5) -- document any billing or payment conditioning. If your person has SMI and is struggling in general population, ask about SLU evaluation. Know your person's ITP -- ask what treatment is being provided and at what frequency. If crisis care is delayed at a facility without ACU/CSU, document it. File GDC grievances for classification failures, billing violations, ITP failures, and delayed crisis transfers. Contact Disability Rights Georgia (disabilityrightsga.org) for legal advocacy.
Who oversees mental health care in Georgia prisons?
GDC's health services division, under a private health care contractor, manages day-to-day mental health care delivery. GDC SOP 508.16 and Georgia Administrative Rule 125-4-5 set the policy and regulatory framework. DBHDD provides state hospital capacity for inpatient psychiatric care beyond GDC's internal capacity. Disability Rights Georgia (DRGa, disabilityrightsga.org) is the federally mandated Protection and Advocacy organization monitoring conditions for people with mental illness and disabilities in GDC. ---