My very first hospitalization I was given a GAF of 3. I often scored under 20 those first few years. Then I did better but not great. Back then they would tell me my score partly to explain my need of a hospital and why if I didn't go voluntary I would be put on a hold. As I got better it wasn't mentioned as much when I moved to TX about 15 years ago it's never been mentioned. Don't know if it's a regional thing or if it's been phased out.