Glossary

A behavioral health model focused on early intervention for adolescents and young adults showing signs of serious mental illness (often psychosis). Services may include:

• Medication
• Therapy
• Family education
• Life skills training

ETP aims to reduce long-term disability by providing support early in the illness course.

A treatment approach in behavioral health that uses scientifically validated methods shown to improve outcomes. EBP combines:

• Best available research
• Clinical expertise
• Patient preferences

The most severe form of Fetal Alcohol Spectrum Disorders (FASDs), caused by alcohol use during pregnancy. Symptoms include:

• Growth deficiencies
• Facial abnormalities
• Intellectual disabilities
• Behavioral challenges
• Attention and memory problems

Early diagnosis and support services can improve long-term outcomes.

Arizona’s First Episode Centers provide early intervention services for young people experiencing their first episode of psychosis. These centers use the Coordinated Specialty Care (CSC) model to improve recovery outcomes and reduce long-term disability.

Eligibility Criteria:

• Age Range: Typically 15 to 25 years old (some programs extend to age 32)
• Symptom Onset: Experiencing psychotic symptoms—such as hallucinations, delusions, or disorganized thinking—that began within the past 2 to 5 years
• Diagnosis: Schizophrenia spectrum disorder, schizoaffective disorder, bipolar disorder with psychotic features, or other early psychosis diagnoses
• Voluntary Participation: Willing to engage in treatment services, including therapy and supportive programs
• Family Support: At some centers (e.g., UA EPICenter), at least one family member or support person must participate in family education and support
• Geographic Access: Must be able to travel to the center location (e.g., Phoenix or Tucson)

Core Services:

• Comprehensive psychiatric and clinical evaluations
• Individual and group therapy (e.g., CBT for psychosis)
• Family therapy and psychoeducational
• Medication management (as clinically appropriate)
• Supported employment and education services
• Peer support and recovery coaching
• Social skills and life skills development
• Care coordination and community integration

Refers to the first occurrence of psychotic symptoms such as:

• Hallucinations
• Delusions
• Disorganized thinking or speech
• Severe behavioral changes

Early intervention programs provide:

• Rapid psychiatric treatment
• Therapy
• Family support
• Life skills training

Goal: Reduce long-term disability and promote recovery through early, coordinated care.

An adaptation of the ACT model for individuals with SMI who are also involved in the criminal justice system. FACT teams:

• Integrate behavioral health care and legal coordination
• Provide 24/7 services
• Reduce recidivism
• Help individuals maintain housing, follow court mandates, and stay out of institutions

Describes behavioral health services provided to individuals with:

• Non-SMI mental health concerns (e.g., anxiety, depression)
• Substance use disorders

Services Include:

• Assessment and diagnosis
• Counseling and therapy
• Recovery support
• Education and relapse prevention

GMH/SA care supports emotional wellness and healthy lifestyle change.

A legal and clinical designation for individuals with serious mental illness who are unable to meet basic personal needs (food, clothing, shelter, or medical care) due to their condition.

This term is often used in civil commitment and guardianship proceedings.

A person appointed by a court to make decisions for someone legally deemed incapacitated due to:

• Mental disorder
• Intellectual or developmental disability
• Physical illness
• Chronic substance use
• Other conditions impairing their ability to make informed decisions

Guardian responsibilities may include:

• Consenting to treatment
• Managing housing or healthcare decisions
• Advocating for the individual’s well-being

Guardians must act in the person’s best interest and under court supervision.

A federal law that protects the privacy and security of individuals’ medical records, including behavioral health data.

HIPAA ensures:

• Confidentiality of mental health diagnoses and treatment
• Limits on how protected health information (PHI) is shared
• Secure communication among authorized providers to improve patient care

A behavioral health professional who works with individuals experiencing complex and chronic mental health challenges.

Responsibilities:

• Develop and coordinate intensive care plans
• Connect clients to resources (housing, legal, health)
• Monitor treatment progress
• Serve clients with co-occurring conditions, homelessness, or legal involvement

The goal is long-term stability and improved quality of life.

A core component of psychiatric evaluation. It documents the onset, progression, and characteristics of a patient’s current symptoms.

Elements may include:

• Timing, duration, and severity
• Triggers or alleviating factors
• Associated symptoms
• Impact on daily functioning
• Treatment history
• Substance use and family history

A federal program that assists low-income individuals and families—including those with behavioral health needs—in securing safe, affordable housing.

Key Features:

• Vouchers subsidize rent in privately owned housing
• Tenants typically pay 30–40% of their income toward rent and utilities
• The U.S. Department of Housing and Urban Development (HUD) covers the remainder

Stable housing is essential for recovery and long-term mental health stability.

A federal Medicaid policy (established in the 1965 Social Security Act) that prohibits the use of federal Medicaid funds for adults (ages 21–64) in IMDs.

Purpose:
Originally intended to promote community-based treatment.

Current View:
Often seen as a barrier to necessary inpatient care for individuals with SMI.

Workarounds:
States can seek federal waivers or use alternative state funding sources.

A residential facility with more than 16 beds that primarily provides psychiatric care for individuals with Serious Mental Illness (SMI).

Examples:

• Psychiatric hospitals
• Residential treatment centers
• State mental health facilities

IMDs provide structured care for individuals needing intensive behavioral health support.

A collaborative group of professionals from various disciplines working together to create and implement a coordinated care plan for individuals with complex behavioral health needs.

Team Members May Include:

• Psychiatrists
• Psychologists
• Nurses
• Social workers
• Substance use counselors
• Peer support specialists
• Case managers

The goal is to provide holistic, integrated care addressing medical, psychiatric, and social needs.

Antipsychotic medications administered via injection at scheduled intervals (e.g., every 2, 4, or 12 weeks).

Benefits Include:

• Improved medication adherence
• Reduced risk of relapse or hospitalization
• Steady therapeutic effect

LAIs are often used for individuals with schizophrenia or bipolar disorder who struggle with daily oral medication.

Now known as Valleywise Health, MIHS is the Phoenix area’s only public teaching health system. Founded in 1877, it provides:

• Hospitals and health centers across Maricopa County
• Inpatient and outpatient behavioral health care
• Assertive Community Treatment (ACT) teams
• First Episode Psychosis (FEP) intervention
• Integrated behavioral health services in primary care

MIHS/Valleywise plays a key role in serving the uninsured and Medicaid populations.

Defined as a substantial disorder of a person’s emotional processes, thoughts, cognition, or memory.

Exclusions (unless comorbid with a mental disorder):

• Substance abuse
• Intellectual disability
• Personality disorders
• Terminal illness-related cognitive decline

This legal definition is used to determine eligibility for court-ordered treatment in Arizona.

A specialized court program that diverts individuals with Serious Mental Illness (SMI) who are involved in the criminal justice system into treatment rather than incarceration.

Program Features:

• Individualized treatment plans
• Close judicial supervision
• Community-based behavioral health services
• Coordination with case managers and probation officers

Goals:

• Reduce recidivism
• Improve mental health outcomes
• Promote public safety and recovery

A structured assessment used by clinicians to evaluate a person’s current cognitive, emotional, and psychological functioning.

Areas Assessed:

• Appearance and behavior
• Mood and affect
• Speech and thought processes
• Orientation (person, place, time)
• Memory and attention
• Insight and judgment

The MSE informs diagnosis, treatment planning, and monitoring over time.

Founded in 2014 as the Regional Behavioral Health Authority (RBHA) for Maricopa County, MMIC integrated physical and behavioral health services for individuals with SMI.

Timeline:

• In 2018, MMIC transitioned to Mercy Care, a nonprofit Medicaid managed care organization.
• As of October 1, 2022, Mercy Care operates under the AHCCCS Complete Care — RBHA (ACC-RBHA) model.

Services Include:

• Crisis intervention
• SMI coordination
• Integrated physical and behavioral health
• Housing and recovery supports
• Collaboration with community providers

Mercy Care is sponsored by Dignity Health and Ascension Health.

The number of psychiatric inpatient beds needed per 100,000 people depends on a community’s needs and outpatient resources.

Recommended Benchmarks:

• Absolute Minimum: 30 beds per 100,000
• Optimal Range: 40–60 beds per 100,000
• Predictive Model Estimate: 34.9 beds per 100,000 (95% CI: 28.1–41.7)

As of 2022, the U.S. averaged only 18 beds per 100,000, contributing to:

• Emergency department overcrowding
• Longer wait times
• Higher incarceration rates among individuals with SMI

Addressing this shortfall requires investment in both inpatient and community-based behavioral health services.

1. Intellectual Disability
Characterized by limitations in reasoning, learning, problem-solving, and adaptive behavior.

2. Autism Spectrum Disorder (ASD)
A neurodevelopmental condition affecting social interaction, behavior, and communication.

3. Cerebral Palsy
A group of disorders affecting movement, muscle tone, and posture, often caused by brain injury before or during birth.

4. Epilepsy
A neurological disorder marked by recurrent seizures; when severe, it can impact learning and development.

5. Down Syndrome
A genetic disorder caused by an extra chromosome 21, associated with intellectual disability and distinct physical traits.

6. Fetal Alcohol Spectrum Disorders (FASD)
Caused by prenatal alcohol exposure; may involve cognitive, behavioral, and physical challenges.

7. Fragile X Syndrome
A genetic condition resulting in intellectual disability, behavioral challenges, and features of ASD.

A recurrent, intrusive, and unwanted thought, image, or urge that causes significant anxiety or distress.

Commonly associated with Obsessive-Compulsive Disorder (OCD), obsessions may include fears of contamination, harm, or inappropriate behavior.

Key Characteristics:

• Person attempts to ignore or suppress the thought
• May lead to compulsive behaviors as coping
• Can interfere with daily functioning if untreated

An evidence-based model that combines affordable housing with voluntary supportive services for individuals with:

• Serious Mental Illness (SMI)
• Substance Use Disorders
• Chronic medical or social needs

Key Features:

• Long-term, stable housing
• On-site or mobile case management
• Behavioral health services
• Life skills training

PSH improves housing stability, health outcomes, and community integration.

A legal and clinical term (especially in Arizona) describing individuals with serious mental illness who:

• Cannot meet their basic needs
• Are at risk of significant harm without intervention

Persistently disabled = long-term impairment

Acutely disabled = immediate, severe impairment

Used in decisions about civil commitment and court-ordered treatment.

A formal written request submitted to a court to initiate legal action related to a person’s mental health care.

Types Include:

• Court-Ordered Evaluation (COE)
• Court-Ordered Treatment (COT)

The petition must provide clinical evidence that the individual meets criteria such as:

• Danger to self/others
• Persistently or acutely disabled
• Gravely disabled

An initial clinical review conducted before filing a court petition for involuntary evaluation (COE).

Purpose:

• Assess if legal criteria are met
• Review symptoms and risk factors
• Ensure voluntary treatment has been considered
• Avoid unnecessary legal action when alternative interventions are appropriate

A healthcare professional (e.g., physician, nurse practitioner, or physician assistant) who serves as the first point of contact for general medical needs.

In Behavioral Health:

• Screens for mental health and substance use disorders
• Prescribes basic psychiatric medications
• Coordinates care with behavioral health specialists
• Helps integrate physical and mental health services

PCPs are essential for early identification and holistic treatment planning.

Facilities that provide immediate walk-in mental health services for individuals experiencing acute psychiatric symptoms.

Services May Include:

• Suicide or crisis intervention
• Stabilization for severe anxiety, depression, or psychosis
• Medication evaluation and short-term treatment
• Referrals to long-term care

Key Providers in Arizona:

1. MIND 24-7 (Phoenix & Mesa)

• Open 24/7 for children and adults
• Crisis stabilization, express care, ongoing treatment

2. Connections Health Solutions (Phoenix)

• 23-hour observation and crisis stabilization

3. Valleywise Behavioral Health

• Locations in Maryvale, Mesa, Phoenix, Avondale
• Inpatient, outpatient, and emergency services

4. Community Bridges, Inc. (CBI)

• Crisis stabilization and detox in Avondale and Mesa

5. RI International — Recovery Response Center (Peoria)

• Crisis stabilization and urgent psychiatric care

These centers help divert individuals from ERs and jails, offering timely behavioral health intervention.

Changes in physical movement often associated with mood disorders, especially bipolar disorder or major depression.

• Agitation: Restlessness, pacing, hand-wringing, or inability to sit still
• Retardation: Slowed movement, speech, or reaction times

These symptoms are linked to brain chemistry and can signal manic or depressive episodes.

A condition where a person loses touch with reality. Symptoms may include:

• Hallucinations (seeing/hearing things not present)
• Delusions (false beliefs)
• Disorganized thinking or behavior

Psychosis is a symptom, not a diagnosis—it can occur in:

• Schizophrenia
• Bipolar disorder
• Major depression
• Substance use
• Brain injury or extreme trauma

Treatment may involve medication, therapy, and support services.

Organizations contracted by the Arizona Health Care Cost Containment System (AHCCCS) to manage publicly funded behavioral health services in specific geographic regions.

Responsibilities Include:

• Coordinating care for individuals with SMI, GMH/SA, or substance use disorders
• Managing crisis services and housing support
• Ensuring integration of physical and behavioral health services
• Monitoring provider performance and quality

As of 2022, Arizona’s RBHAs:

• Mercy Care RBHA — Central Region (e.g., Maricopa County)
• Arizona Complete Health RBHA — Southern Region
• Care1st / Steward Health Choice Arizona RBHA — Northern Region

RBHAs ensure access to a full continuum of services, including treatment, crisis intervention, and recovery supports.

A structured evaluation of a person’s potential for:

• Self-harm (e.g., suicide)
• Harm to others (e.g., aggression or violence)
• Neglect of basic needs due to impaired mental functioning

Conducted by clinicians, it involves:

• Reviewing past behavior and medical history
• Assessing current symptoms, substance use, stressors
• Identifying protective factors (support system, coping skills)

Used to determine the level of intervention needed (e.g., crisis response, hospitalization).

A type of supportive housing where individuals with behavioral health needs live in independent rental units throughout the community, rather than a single facility.

Benefits:

• Promotes autonomy and community inclusion
• Tenants sign their own leases
• Support services are provided flexibly based on need
• Encourages recovery in non-institutional settings

In Arizona, an adult (18+) may be designated as having SMI if, due to a mental disorder as defined in A.R.S. §36-501, they experience:

• Severe and persistent functional limitations
• Difficulty with daily living (e.g., self-care, interpersonal relationships, housing, employment)
• A long-term need for treatment and support

SMI designation qualifies individuals for specialized services including case management, housing, supported employment, and Assertive Community Treatment (ACT).

1. SSDI – Social Security Disability Insurance

• For people who’ve worked and paid into Social Security
• Includes Medicare eligibility after 24 months

2. SSI – Supplemental Security Income

• For low-income individuals with a disability (any age)
• No work history required
• Automatically qualifies for Medicaid

3. DAC – Disabled Adult Child

• For adults disabled before age 22
• Based on a parent’s work history (deceased, retired, or disabled)
• Treated similarly to SSDI

4. SSI for Children – Childhood Disability

• For individuals under 18 with disabilities
• Family income and assets must meet program limits
• Often used for autism, SED, or physical/developmental disabilities

Established in 1988, Arizona’s State Housing Fund supports the development of affordable permanent and transitional rental housing for low-income individuals and families.

Funding Sources:

• Unclaimed property deposits
• Interest on unexpended funds
• Loan repayments and recaptured funds

Annual Funding: Approximately $2.5 million, with potential increases based on legislative priorities.

These funds often support housing programs for individuals with behavioral health needs, including the SMI population.

A medical and behavioral health condition where an individual repeatedly uses alcohol or drugs in a way that causes significant problems in life.

Symptoms May Include:

• Loss of control over use
• Cravings
• Tolerance and withdrawal
• Continued use despite harm

Treatment May Include:

• Medication-assisted treatment (MAT)
• Counseling and behavioral therapy
• Peer support
• Recovery coaching and housing supports

SUD can range from mild to severe and often co-occurs with mental illness (dual diagnosis).

A service model that helps individuals with SMI, SUD, or developmental disabilities find and maintain competitive employment in the community.

Support Services Include:

• Resume building and interview coaching
• On-the-job support
• Skills training
• Coordination with employers
• Long-term follow-up

Employment is viewed as a key component of recovery and community integration.

An AHCCCS initiative that provides incentive payments to healthcare providers who integrate:

• Physical health care
• Behavioral health care
• Social support services

Goals:

• Improve health outcomes for high-need populations (e.g., SMI, SUD, complex medical needs)
• Reduce costs through care coordination
• Enhance patient-centered models of care

Refers to the federal Medicaid program under Title XIX of the Social Security Act. In Arizona, this is administered by AHCCCS and covers:

• Physical and behavioral health care
• Long-term care services
• Substance use treatment
• Services for adults and children

Primary funding source for many behavioral health services in Arizona.

Refers to the Children’s Health Insurance Program (CHIP) under Title XXI of the Social Security Act. In Arizona, this is known as KidsCare.

Eligibility:
Children in families who earn too much for Medicaid but still need affordable coverage.

Services Include:

• Behavioral health care (therapy, psychiatric services)
• Preventive care and medications
• Substance use treatment

A major provider of behavioral health services in Maricopa County, operated by Valleywise Health (formerly MIHS).

Campuses and Services:
1. Valleywise Behavioral Health Center – Maryvale (Phoenix)

• 192 inpatient beds
• 24/7 emergency psychiatric services
• Primarily serves court-ordered patients
• Reopened in 2019 following a major renovation

2. Valleywise Behavioral Health Center – Mesa

• Outpatient psychiatric care
• Adolescent psychosis programs
• Integrated behavioral health services
• 14-bed adolescent inpatient unit

3. Valleywise Behavioral Health Center – Phoenix

• Inpatient and outpatient behavioral health services
• Crisis stabilization and SMI-focused care
• Integrated physical and behavioral health services

Total Licensed Beds Across Facilities: 433

Valleywise is one of Arizona’s largest providers of inpatient mental health services and plays a key role in public and court-ordered care.