The Bernalillo County, NM, Detention Center uses the services of a licensed counselor and psychiatric nurse to ensure that inmates with mental illnesses receive needed care and also to ensure their safety, including safety from self-destructive behaviors during times of personal crisis. The counselor or nurse may refer cases of severe mental illness to the Psychiatric Services Unit for evaluation, treatment and counseling. One of the most challenging tasks facing mental health clinicians is an inmate's threat to commit suicide. They must determine whether it reflects a death wish, is a serious threat arising from the current but temporary situation, a ruse to obtain better treatment or better living arrangements, or a symptom of deeper and more serious problems. The mental health professionals try to positively affect behavior and outcome in an environment that inherently has no therapeutic benefit, but is, in fact, depressing, hostile and dangerous. The outcome of their treatment of a patient is stability, not wellness.