Officals: High number of mentally ill strain system

For many years, South Carolina residents with mental illnesses have been treated for their conditions within their own communities.

But medical officials say the large number of mentally ill patients are straining the system — a system that doesn’t have the proper funding or the hospital space to treat them.

“It is a time of crisis for mental health all over the United States, as well as here in South Carolina, and has been for sometime,” said Pat Godbold, administrator for McLeod Regional Medical Center Behavioral Health Services.

Mental health programs compete against public education and other programs for state support, Godbold said. And when there are state budget cuts, she said, mental health care programs are the first to suffer.

Long-term facilities

In 2004, the South Carolina State Hospital in Columbia was closed as part of a national deinstitutionalization program.

At the same time, the amount of bed space was decreased at other state-operated facilities — such as G. Werber Bryan Psychiatric Hospital in Columbia, which is the primary long-term care provider for patients from the Pee Dee, Godbold said.

“They were thinking that what they could do is bring the mentally ill back into the communities,” she said. “This is a wonderful idea, but the infrastructure to care for the patients was never developed on a community level.”

Such state-operated facilities as the Pee Dee Mental Heath Center in Florence provide outpatient treatment and medication to residents with mental illnesses. But chronically ill patients often have to wait weeks to be admitted to a long-term inpatient facility.

Florence Probate Court Judge Kenneth Eaton said he issues court orders of involuntary treatment for the mentally ill and often discovers no hospitals have space for the patient.

“What do I do with (a) patient who’s sitting next door?” he asked. “Do I tell them to go home and be a good boy or girl and we’ll call you back in 10 days or two weeks when a bed becomes available? Is that a real option?”

Patients who have disregarded previous court orders for treatment can be jailed for contempt of court, Eaton said.

“I don’t send mentally ill patients to jail for contempt, I don’t think that’s proper,” he said. “Nobody elects to be mentally ill. We should never forget that.”
Other options

The remaining option is to have law enforcement officers escort that person to an emergency room — a place Eaton said might not be equipped to deal with chronic mental illness.

“The public doesn’t know that any day or night, a person that’s a threat to themselves and others are waiting in hospital emergency rooms,” he said. “Suppose that person acts out or has an episode and becomes very violent? The potential for something catastrophic is very great.”

Having severely mentally ill patients waiting for days in an emergency room isn’t uncommon, Godbold said.

“It’s an everyday thing. In every emergency department in every city in the entire state,” she said. “There’s not a single hospital in the state of South Carolina that would say they do not have psych patients holding. Every hospital has this trouble.”

McLeod has specially trained doctors who work with Pee Dee Mental Health staff to evaluate patients, Godbold said.

“Safety is the No. 1 priority. You keep the patient safe and you keep other people safe,” she said.

McLeod has a nonprofit 23-bed facility in Darlington for psychiatric patients, but it’s only designed to provide short-term care and it isn’t a permanent fix for the lack of state beds, Godbold said.

Bryan has about 250 patient beds to provide for the large number of psychiatric patients, said Dennis Sullen, Pee Dee Mental Heath Director of crisis and emergency services.

Addressing the problem

The problem could be alleviated if there were a local state-supported crisis center to service those who need immediate help, Sullen said.

This would unclog the emergency departments and free up space at Bryan hospital, Sullen said.

“There are some crisis centers in the state, but just not in the Pee Dee,” he said. “Columbia has one connected to one of their hospitals. We could get people stabilized quickly and get them back in the community.”

State Sen. Hugh Leatherman, R-Florence, said $5.4 million was appropriated this year for statewide critical outpatient mental health services.

New state funds also will pay for a mental health professional to be in hospital emergency rooms for crisis intervention services, Leatherman said. That person, however, will only be available on weekends because the state can’t afford to staff someone during the week.

Florence will receive additional funds for crisis stabilization teams that will respond to existing adult clients and stabilize their situation before they have to enter a hospital emergency room, Leatherman said.

Eaton said he’s grateful Leatherman and other lawmakers are trying to do something about the situation. But quick action and more funds still are needed.

“When I read in the paper where we have found some how to provide ... money for a bean museum, and the Okra Strut ... (and) all these festivals, that bothers me a little bit,” Eaton said. “Where are your priorities?”