Mental health care in South Carolina has been a responsibility of government since before the Revolutionary War and the establishment of the United States. The state has z’a rich history of looking out for citizens who have mental health issues,’’ S.C. Department of Mental Health director John H. Magill reminded The Sun News editorial board members recently.
Before 1700, “the Lords Proprietors of South Carolina established that the mentally ill should be cared for at public expense by local governments.’’ That is the initial statement in a department timeline of mental health history.
Today the department, directed by Magill since 2006, operates a comprehensive mental health care system including 42 clinics, four hospitals, three veterans nursing homes and a community nursing home. The veterans nursing homes are unusual -- the only such facilities operated by a mental health agency in the United States. Every night, about 3,500 patients are cared for in some state-supported mental health facility. Compare that to the 1960s when the DMH had an average daily population of more than 6,000 patients.
In the 1960s, mental health care changed dramatically, with a focus on community treatment. In that decade, the federal Community Mental Health Centers Act provided matching federal funds and many mental health centers opened, including the Waccamaw Center for Mental Health in 1967. The Waccamaw Center is one of a network of 17 in the SCDMH. The area center is the largest in the state, 2,901 square miles, and serves Georgetown, Horry and Williamsburg counties. There are clinics in Georgetown, Conway and Kingstree.
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The Waccamaw Center also operates mental health programs in many Horry County schools, notwithstanding a loss of financial support from the HCS district. Moreover, Horry County Council ceased its financial support after fiscal year 2009 when Horry County provided $30,000, a decrease from the $48,000 it contributed in 2007.
In contrast, Magill said, Georgetown County’s current financial support is $68,600 and Williamsburg County contributes more than $11,000. Obviously, something is out of sync -- it’s the geographical size of Horry County that makes the Waccamaw Center’s service area the largest.
The budget now in the works for the fiscal year beginning July 1 includes no mental health funding. The Administration Committee has received a request for $150,000 from the Waccamaw Center but has taken no action on the request. The committee could make a recommendation but the full council has the decision.
It’s worth noting that two decades ago, in FY 1993, the Waccamaw Center received $171,000 from the three counties. One of Magill’s points is the need for more financial assistance from counties. Waccamaw Center executive director Ethel B. Bellamy specifically addressed Horry County financial assistance in a talk to the Rotary Club of Little River, urging members to tell County Council members of the need for county funding. She noted that 56 percent of the Waccamaw Center’s $11 million-plus budget is in Horry County.
For the Department of Mental Health, the Recession of 2008 ultimately meant a loss of close to $90 million -- 40 percent of state financial support. With a more healthy state economy, “We’ll nudge back -- but not $90 million,’’ Magill said. State money is $155 million of a total DMH budget of $345 million, with other revenue coming from fees from Medicare and Medicaid, the Department of Veterans Affairs, various grants, school districts and counties.
Mental health care is absolutely vital. Like other medical treatment, mental health care is an investment in a stronger society that ultimately saves other public expenditures that accumulate when people don’t have the care they need. The Horry County Council -- and the HCS board as well -- should restore mental health funding.