Behavioral Health Encounters and Clients
Terms and Definitions
Encounter Month
For both the “Encounters” and “Unique Clients” data visualizations, users are able to filter by the month in which the behavioral health intervention occurred, going back from the present to April of 2023. Adjusting the sliders will select only encounters or clients during the range specified. The number of encounters recorded is often variable due to the number of behavioral health staff employed at the detention center at a given time and is not necessarily reflective of the needs of the incarcerated population or related to the total number of persons held in the detention center during the selected period.
Type of Encounter
The Behavioral Health team conducts two main types of interventions in the detention center: Behavioral Health Therapy and Care Coordination. Behavioral Health Therapy interventions are conducted by a therapist or licensed addiction counselor and include crisis stabilization, de-escalation, and therapeutic interventions. Care Coordination activities are conducted by the case manager or education and transition coordinator and include assisting individuals in determining benefit eligibility, completing housing applications, arranging treatment placements, and making referrals to continued behavioral health services upon release.
Diagnosis Categories
For each behavioral health intervention delivered in the detention center, staff make a record of what diagnosis is being treated. These diagnoses may be self-reported by the client or determined by a licensed therapist. However, not all staff know a person’s diagnosis, and it may not be recorded as part of a specific encounter. This is especially common in Care Coordination encounters where staff may not be directly working with a client on a mental health issue. Because not all persons treated have a known diagnosis, there is a high proportion of encounters in which there is an “unspecified” diagnosis.
Categories shown are a combination of diagnosis types requested by state agencies and the collapsing of ICD-10 diagnosis codes that were written in by staff. Staff were instructed to select only one diagnosis at the time of the intervention; therefore, these represent the primary diagnosis known to staff. The table below shows the generic categories of diagnosis types along with specific disorders that fall within them.
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Examples of Disorders within Categories
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Anxiety & Trauma-related disorders
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Generalized anxiety disorder, social anxiety disorder, agoraphobia, separation anxiety disorder, post-traumatic stress disorder, acute stress disorder, adjustment disorder, traumatic brain injuries
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Developmental/Behavioral disorders
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Autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disabilities, cerebral palsy, Tourette's syndrome, conduct disorders
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Depressive disorder, bipolar, seasonal affective disorder, prolonged grief disorder
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Borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, obsessive compulsive disorder, paranoid personality disorder
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Schizophrenia, delusional disorder, psychotic disorder, substance-induced psychotic disorder
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Alcohol dependence, cannabis use disorder, opioid dependence, amphetamine and other psychostimulant dependence
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This category was specifically requested by state agencies for tracking purposes and is not associated with a specific disorder or diagnosis
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This category includes all cases in which the client had an unspecified or unknown diagnosis
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Unique Clients
The dashboard view for unique clients includes demographic details of persons who receive behavioral health therapy or care coordination interventions during the most recent month of their stay in the detention center. There are low counts of persons who identify as transgender or non-binary and receive services each month; therefore, they are excluded from the dashboard to protect confidentiality. For many clients, housing status and education level were unknown, as these data were not pertinent to an encounter and not recorded prior to or at the time of the intervention. The behavioral health team is actively working to improve data quality and the collection of these variables, having instituted new procedures as part of the informed consent process to ask about these characteristics at intake and record them as part of each intervention in the same way that other demographic information, such as gender and age, is recorded.
Housing Status
Categories related to someone’s housing status prior to incarceration were collapsed for analysis. Clients who were living as a dependent—either as a child or other dependent—in a private home were grouped into a category of “Private - dependent”. Those who were living in foster care, institutional settings, other correctional facilities, or in residential care were grouped into the category of “Institutional” housing.