Overview
BCSO’s Medical Intake Screening form should include fields regarding past and present treatment or hospitalization for mental health concerns or risk of suicide or suicidal thoughts.
Because BCSO’s Medical Intake Screening form does not inquire about past and present treatment or hospitalization for mental health concerns or risk of suicide or suicidal thoughts, there is a higher-than-acceptable risk that inmates’ mental health issues may not be identified and treated, potentially affecting the health and safety of the inmates in question, other inmates whom they interact with, BCSO employees, and BCSO vendors. While BCSO is providing mental health services to its inmates and reports that it closely monitors inmates who it suspects have mental health conditions, BCSO may not be identifying mental health concerns as early as it possibly could if it were to inquire about past or present mental health treatments in its Medical Intake Screening form.
Authoritative Guidance
BCSO’s “BCSO-100R” policy states,
The findings of the screening shall be recorded in the electronic health record and the form is approved by the Responsible Health Authority. The screening form includes the following items:
A. Inquiry into. . . .
4) Past and present treatment or hospitalization for mental disturbance or suicide.
Reasons for Issue
BCSO was unable to provide an explanation for this issue.
Recommendation
BCSO should update its Medical Intake Screening form to ensure that it includes the inquiry of past and present treatment or hospitalization for mental health concerns or risk of suicide.
Auditee’s Response
The BCSO Medical intake screening form includes the fields “have you ever attempted suicide” and “do you have any suicidal ideations currently” “if yes, please notify the mental health team and shift commander immediately”. The form states, “past or current mental illness, including hospitalization will be included in the mental health screening (SSG). This will include history of or current suicidal ideation”. The medical screening does inquire about suicidal thoughts. BCSO performs an SSG screening on all new arrivals, which may occur prior to the patient being seen by medical staff. Regardless, all patients are screened for their past or present treatment or hospitalizations for mental health concerns, suicide risk and suicidal thoughts.
Auditor’s Reply
While BCSO’s medical intake form does inquire whether an inmate has ever attempted suicide or has suicidal ideation at the time of booking, the form does not inquire whether the inmate has ever received or was receiving treatment or hospitalization for mental illness or suicide, as required by BCSO’s “BCSO-100R” policy. Those discussions may occur, but BCSO’s systems do not require them or document that they have occurred. Because BCSO policy requires these inquiries, we believe it is advisable to document them to protect inmates and BCSO.
We encourage BCSO to consider our recommendations to ensure that the issues identified in this finding do not reoccur. As part of our post-audit review process, we will follow up on this matter in approximately six months.
| Date published: | November 25, 2025 |
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