MUSC's New Initiatives Bring Hope Amid South Carolina's Mental Health Crisis

The pandemic brought to the forefront the prevalence of mental health challenges and acutely exposed the disconnect between the urgent need for mental health services and access to care.

Adult-Geriatric Psychiatrist LalithKumar Solai M.D., explains how, despite the alarming rise in mental health issues and suicide rates, this is a time of hope in South Carolina.

What is your top concern about mental health right now?

Access to clinical services. There are so many barriers to getting the right help in mental health. Even if you find a provider, it can take weeks or even months to get an appointment. There are many reasons for this, but it’s driven by a lack of funding at the federal and state levels – although I’m happy to report that this is changing in South Carolina.

A lack of a trained workforce to provide mental health services is another big challenge. Since we do not have the proper infrastructure to provide basic mental health services – including outpatient services to provide counseling and medication management – often a patient’s challenges will build into a crisis, and these end up flooding our emergency departments and inpatient beds.

Though COVID threw our country’s mental health care system into crisis mode, you are hopeful that things are improving.

Yes, COVID emergency funding allocated resources to the states, including significant dollars for behavioral health, and this has broadened our ability to treat mental health conditions. Because of this state funding, we have been able to revamp many of our programs and services at MUSC Health and are taking a lot of initiatives.

So while it’s true that mental health issues have been increasing over the last decade nationwide, particularly in young people including adolescents, things are slowly taking a turn for the better in South Carolina. I am significantly hopeful that things will improve as services become more accessible.

What are some initiatives that are having or will have an impact?

School-based mental health services

One of the ways we’re able to improve access is by shifting to community-based care so that minor conditions do not become major health concerns. MUSC Health is building on its community-based services, including school-based mental health services. Children and youth spend most of their time during the day at school, so this is a targeted way to reach and treat them. Our teams (psychotherapy counselors and child psychiatrists via in-person and telehealth) are currently in more than 20 schools in the Charleston County school district; by next year, we will be in 100 schools across the state. This is in addition to the robust school-based behavioral health services provided by the SC Department of Mental Health and other agencies. We are currently exploring opportunities to further provide higher levels of mental health services in schools.

Children can access these school-based mental health services for regular ongoing care as well as in a crisis, so we can see them right away in their own environment, avoiding a trip to the emergency department.

A cautionary note to parents:

When talking about the mental health of children and adolescents, I want to caution parents and caregivers. Much of our social structures have fallen apart with the advent of smartphones, especially social interactions. Many kids today interact with their smartphones rather than with their support systems. That means they’re using social media to communicate any stress they are experiencing. This has led to more and more isolation, and the forced isolation of the pandemic brought this to the forefront.

There is also a heightened sense of idealism in social media. Teens don’t yet have the world experience to judge what is real and what is not. They go by the worldview they see in social media and can easily aspire to and go in the wrong direction.

My advice? Try to limit smartphone usage to a maximum of two hours daily. Make sure children and youth are eating a healthy meal, sleeping well, and that they have in-person social and physical interactions (playing with friends outside, riding bikes, swimming, etc.). These activities help release endorphins and feel-good hormones.

Emergency Psychiatric Assessment, Treatment, and Healing (EmPATH) units

I am also very excited and hopeful about another new statewide initiative in mental health services. Not everyone who is in a mental health crisis requires a hospital stay—often patients simply need counseling, medication adjustments, treatment, or other mental health services to be able to go back to their daily lives. This is where emergency psychiatric assessment, treatment, and healing (EmPATH) units come in.

EmPATH units provide rapid behavioral health assessments and treatments in calming environments. As crisis centers within hospitals, they serve as urgent care-like centers for psychiatric patients and provide the option of a 24- to 48-hour stay.

MUSC Health is among the many health care systems within our state that received funds from the SC Department of Health and Human Services to build these EmPATH units. This is a significant advancement in access for patients who would normally have to wait to get into a hospital for mental health treatments.

Most EmPATH patients receive services over a short stay and then transition to community-based treatments. Thirteen EmPATH programs are funded across the state in different phases of development. MUSC Health has four sites with EmPATH units, including MUSC Health University Medical Center, MUSC Shawn Jenkins Children’s Hospital, MUSC Health-Orangeburg, and MUSC Health Kershaw Medical Center.

More Hope on the Horizon: Jean and Hugh K. Leatherman Behavioral Care Pavilion

The Jean and Hugh K. Leatherman Behavioral Care Pavilion, expected to open in October 2025, will serve as a much-needed regional behavioral health center in Florence County. The Pee Dee region has very few mental health resources, so this new pavilion is expected to fill a crucial need. Patients will gain access to services including triage, crisis stabilization units, telehealth, outpatient, and inpatient services.

Built-in collaboration with McLeod Regional Medical Center and other local agencies, including the SC Department of Mental Health, Hope Health, and Circle Park, the pavilion will serve outpatient adults and children and offer mental health, addiction, and therapy services. It will include 16 adult and four adolescent beds for crisis services to rapidly stabilize patients as well as a 63-bed inpatient psychiatric unit to treat patients needing more acute care.

While these important new services offer improved access, this is a first step in building an infrastructure of community- and outpatient-based services within the state. The COVID funding has allowed us to create newer models that will continue to offer improvements in both access and care. That is why I am so hopeful and expectant of positive change.”

To schedule an appointment or learn more, visit MUSC Behavioral Health or call 843-792-9888.