Global Assessment of Functioning 

Color-coded, enhanced content GAF scale with free online training.

The Global Assessment of Functioning scale or GAF is a scale intended to represent the continuum of Mental Health to Mental Illness.

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Routine
91-100
81-90
71-80

Urgent 
61-70
51-60
41-50

Emergent
31-40
21-30
11-20
1-10

0 - Not 
enough info

Suicidal  

  41-50 ideation 

31-40  Progressively more 

21-30 preoccupation 

11-20 attempt without expectation of death  

1-10 attempt with expectation of death

Depression
61-70 mild 

51-60 moderate 

41-50 severe

Psychosis   

  31-40 some psychosis

21-30 behavior influenced by delusions or hallucinations

11-20 some danger because of delusions or hallucinations

1-10 persistent danger because of delusions or hallucinations

Communication  

51-60 mild thought disorder; circumstantial, tangential

41-50 none noted

31-40 moderate thought disorder; sometimes illogical

21-30 severe thought disorder; sometimes incoherent

11-20 complete inability to communicate; generally incoherent or mute

Additional Info

e. g. dysfunction; suicide risk; differentiation between Routine/Urgent/Emergent

Routine

The range from 71-100 is one that represents "normal" symptoms and functioning.  These individuals are actively and effectively involved with the world around them.  If there are issues, they are short lived and effectively coped with.  Treatment is not called for, but guidance and reassurance can be helpful.

The severity begins to shift from routine to urgent at this point.  

Urgent

61-70    Mild Depression; Insomnia; Some truancy or household theft

51-60  Moderate Depression; flat affect; panic attacks; few friends; trouble with peers/co-workers

41-50  Severe Depression; suicidal ideation; severe obsessive rituals; frequent shoplifting; no friends, can't keep a job

Emergent

This is the transitional point where you decide if you have an Emergency.  The decision is especially difficult because you must decide if the individual's functioning is stabile enough to to allow the individual to stay in the community or warrants imposing safety controls, even if against their will.

31-40   Occasional psychotic symptoms; Impairment in reality testing; Speech is sometimes illogical, obscure or irrelevant;  Multiple impairment might be a depressed man avoiding family and friends while being unable to work or a child who is having school, peer and family difficulties.

21-30  Hallucinations and delusions influence behavior; sometimes incoherent, acts grossly inappropriately, suicidal preoccupation; An individual who is without a home, job or friends who spends all day in bed.

11-20   Some danger due to hallucinations or delusions; Suicide attempts without clear expectation of death; frequently violent; manic; an individual who smears feces or may be generally incoherent or mute.

1-10    Persistent danger due to hallucinations or delusions; This individual is a persistent danger to self/others;  completely unable to take care of themselves. Suicidal act with clear expectation of death.

GAF Sub-Scales (indicated by color)  Psychological & Social/Occupational 

(e.g depression, psychosis, suicidal ideation, communication disorders; school problems for children, can't keep a job, fights, poor personal hygiene)

Routine

91-100 No Symptoms; Superior in all areas  

81-90    Absent or minimal symptoms; Good; just "every day" problems

71-80    Limited or expectable reactions; No more than slight impairment

Urgent

61-70    Mild symptoms; Some difficulty but functioning pretty well

51-60    Moderate symptoms; Moderate difficulty

41-50    Serious symptoms; Serious impairment

Emergent

31-40    Some impairment in reality testing or communication; Major impairment in several areas such as work, school, family relationships

21-30    Behavior is considerably influenced by delusions or hallucinations OR serious impairment in communication or judgment; Inability to function in almost all areas.

11-20    Some danger of hurting self or others; Occasionally fails to maintain minimal personal hygiene

1-10    Persistent danger of severely hurting  of self or others; Persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death.

The significance of an accurate GAF score cannot be overrated.  Color-coding and enhanced content are designed to assist the rater in consistently organizing and categorizing information with the intended outcome being a more valid rating.   The online training can help the rater better understand this strategy.

I've  made modifications and added my professional comments to GAF format and description information from the DSM IV ( pg. 32) and an article by Michael First, MD.  I recommend that raters get GAF training. Mark R. Marquez, LCSW, MSW, EdD