February 7, 2017: John Magill, State Director of the SC Department of Mental Health (DMH) joined us for our February 7 Meeting. The DMH provides care via an outpatient, community-based system comprising 17 community mental health centers (each with clinics and satellite offices), four psychiatric hospitals, three veterans’ nursing homes, and one community nursing home.
The DMH was founded in 1821, is the third mental health system in the U.S. and one of the oldest government agencies in SC. John Magill is the longest serving mental health director in the US and has treated about 4M people since opening in 1821. To be clear, prior to 1821 the lord’s proprietors had made provisions for mental health care in the 1600s. The mental health systems grew through large hospitals initially but expanded to community mental health centers as money was appropriated in the 1960s. At that time the 2 hospitals housed 6600 patients when care started to move into the communities. Currently much of mental healthcare is privatized and SC is a hybrid of public and private sector care. The state still runs 4 hospitals but also has a large community division with outpatient treatment centers (60) in all counties of the state.
The DMH also has a long-term care division, including nursing homes for veterans which is unique to the state. These are general medical nursing homes, not psychiatric nursing homes. The Forensics Services (240 bed hospital) does competency evaluations, treatment for those who need it to stand trial etc. Given the breadth of services the agency has, many operations are contracted out, however, responsibility cannot be, as with the violent sexual predators civil commitment treatment program, which was given to the agency in the 1990s.Fifty thousand bed days were provided by the agency last year alone and they often have to purchase beds in other systems to accommodate the need.The ER Tele psychiatry program, in place for 7 years, has helped to alleviate the burden on ERs who receive mental health/addiction patients who do not need to take up a bed. Providers can consult in real time to address patient’s needs.
The DMH also has school based mental health care implemented in Dorchester and Charleston County that provide treatment on site to the students in those schools.
Some of the things that need to happen in the future is to establish Crisis Stabilization Centers for police to bring patients without having to bring them to an ER. The first one will be in Charleston. These centers will expand emergency service for mental health needs and relieve the burden on other systems.
State appropriations don’t cover the entire need so the DMH needs to earn money, and receives contributions from the Duke Endowment, Blue Cross Blue Shield and school districts. The DMH will look to philanthropy to be more involved in the mental health system in the future.
— Don Baus, Keyway Committee Chair