Spartanburg subject matter experts report that the state’s behavioral health system is in crisis. Although the state is required by statute to provide a statewide system for delivering mental health services, budget cuts have led to reductions in the number of psychiatric beds in state-run mental health facilities. Community-based services are inadequate and there is significant concern regarding the lack of parity between treatment for medical issues and treatment for mental illness.  The shortage of facilities for long-term treatment of mental illness has resulted in increased burden on jails, EMS, law enforcement agencies, emergency rooms, and short term inpatient units ill-equipped to treat chronic major mental illness.

Depressive disorders ranked 17th of the top diagnostic groups for self-pay patients visiting the emergency room at Spartanburg Regional Medical Center from July 2006 to June 2007, constituting 323 visits. Patients have remained in hospital emergency rooms for days or weeks waiting for psychiatric beds to become available in appropriate facilities.  Most patients presenting with psychiatric disorders at the emergency room, however, are discharged to their homes. Five years ago, most of these patients would have been admitted for behavioral health treatment (see Table 7).