Development of an Assessment of Functioning Scale for Prison Environments

This paper reports the development of a global assessment of functioning (GAF), modified from the DSM Axis V GAF for the prison environment. Focus groups, which were conducted with 36 correctional officers and clinicians in two prisons, provided descriptions of behavior in prison settings to re-align the GAF scale. Face validity was established. It was found that Habitation/Behavior, Social, and Symptoms emerged as important domains of functioning in prison. Gender differences were noted with regard to cleanliness, relationships and coping strategies. The cut-off score was identified at a score where offenders were unable to participate in a disciplinary process due to their mental illness. The structure of prison alters human functioning, requiring different assessment language and ratings to measure perceived behavioral norms and/or expectations. Front-line staff need the ability to observe and communicate behavioral changes quickly and accurately in a prison environment without undue burden upon their workload. This assessment was modified by front-line staff specifically for the prison environment to document quick and frequent assessments of observed changes over time in the offender population.