New report calls for big behavioral health changes in South Carolina

The South Carolina Institute of Medicine & Public published a report calling for major changes to the behavioral health system in this state.

Between 2008 and 2012, the South Carolina Department of Mental Health suffered more severe budget cuts than any other mental health department in the country. Now, experts are calling for major change.

The South Carolina Institute of Medicine & Public Health released a report last week recommending that South Carolina transform the way mental health and substance abuse services are provided in this state. Some of the group’s ideas are simple — like extending hours for community mental health clinics and allowing hospitals to convert regular inpatient beds to psychiatry beds without state approval.

Other recommendations, such as developing “supportive housing” for behavioral health patients and their families, would require time to implement and significant money.

The report recommends 20 ideas in all, many of which are already in place in the greater Charleston area.

“The thing that we are excited about is most of the services that they’re talking about are already up and running in some communities,” said Mark Binkley, deputy director for administrative services for the Department of Mental Health, who participated in the task force meetings.

For example, he said, Charleston’s mobile crisis unit, which dispatches mental health professionals into the field when a resident appears to be having a behavioral health crisis, would be useful throughout the state. These professionals often keep patients from winding up in an emergency room or in jail, but the unit is expensive. The South Carolina Department of Health and Human Services has requested $3.6 million to expand “community crisis response and intervention” in the 2016 fiscal year.

“Having enough money for all these different programs is of course going to be expensive, but if you view them as long-term goals ... I don’t know if we can attain it all but it would certainly improve services throughout the state,” Binkley said.

Experts from the Department of Mental Health, the Department of Corrections, the state Medicaid agency, and the Drug and Alcohol Abuse agency, among others, also contributed to the new report.

Patients with behavioral health problems — which includes adults and children with mental health disorders, substance abuse addictions, or both — often end up in an emergency room, jail, prison or a homeless shelter. None of these settings are well equipped to meet their ongoing needs, the report shows, but patients often have nowhere else to turn because South Carolina spends significantly less than the national average on public mental health resources.

In the 2012 fiscal year, South Carolina spent $57.07 per capita on public mental health expenditures. The national average was $127.

“I think we do need to invest more, but I would say that’s not all we need to do,” said Maya Pack, the associate director for research and strategic initiatives for the South Carolina Institute of Medicine & Public Health, who wrote the report.

Her team has no interest in the 74-page document “sitting on a shelf,” she said. The Institute will organize an implementation advisory council to track South Carolina’s progress.

“This is a really strong statement of need that’s laid out here — the need to transform,” she said. “I think with the stature of people involved, like the state agency heads, the Legislature will recognize these issues and hopefully participate with the providers to make some of these recommendations a reality.”

Reach Lauren Sausser at 937-5598.