COLUMBIA, S.C. — The federal government has initiated legal action against the state of South Carolina, claiming inadequate support for individuals with severe mental health issues. The lawsuit, filed recently, asserts that the state is in violation of the Americans with Disabilities Act by allowing individuals to remain in group homes, where they lack autonomy over aspects of daily life such as meal choices, roommates, employment opportunities, and participation in community events.
This legal challenge follows a 2016 lawsuit highlighting similar concerns. Federal officials reiterated these issues in a detailed report last May, warning the state of potential legal repercussions if no action was taken to improve the situation, according to filings from the U.S. Justice Department.
Kristen Clarke, an assistant attorney in the Justice Department’s Civil Rights Division, emphasized the importance of providing services in private homes for those with disabilities instead of isolating them in institutional settings.
Governor Henry McMaster of South Carolina, expressing skepticism about the lawsuit’s timing as it coincides with the latter weeks of the Biden administration, is nonetheless seeking solutions to the outlined problems. His spokesperson, Brandon Charochak, mentioned a proposal to merge the Department of Mental Health with the Department of Disabilities and Special Needs. This newly formed agency would operate within the governor’s cabinet, enhancing accountability and efficiency in mental health services.
Federal officials recommend increased funding and ensuring the Medicaid program offers sufficient reimbursements for assertive community treatment programs. These programs involve multidisciplinary teams that engage with individuals suffering from serious mental illnesses in their homes. The teams typically comprise a psychiatrist, psychiatric nurses, and specialists in employment and substance abuse, among others.
Research illustrates that such teams can effectively avert mental health crises. Furthermore, they can swiftly deploy crisis intervention teams to address urgent issues and prevent complications that might lead to police encounters or psychiatric hospital admissions, as found by the Justice Department’s investigation. However, South Carolina only has four such teams located in Columbia, Greenville, and Dillon, and they are insufficiently staffed and lack statewide availability.
Currently, over 1,000 individuals are residing in group homes. Many expressed a desire to live independently but reported facing significant challenges in doing so. Federal investigators conducted thorough research on community residential care facilities, seeking insights from residents, facility administrators, and external treatment providers for those living on their own.
Anonymity was preserved for those providing testimonies, including a resident who noted that living conditions in group homes seemed reminiscent of outdated mental health facilities that offered minimal individualized care and no private accommodations. The resident remarked that they only had the opportunity to leave for infrequent outings and were often confined to their home without means to seek employment due to transportation issues.
The report also highlighted that activities within these homes were mainly confined to internal events like arts and crafts sessions, Bible studies, and games, rather than community engagement. One state employee described the atmosphere within these homes as reminiscent of historical asylums, lacking any forward-thinking approach to independence.
Among the cases examined was that of a 40-year-old man who, after living independently for three years, faced a mental health crisis following a break-in. After being released from a psychiatric hospital, he remained in a group home for over a decade, expressing a desire for independence but receiving no assistance toward that goal.
Another individual, a 43-year-old woman who experienced a mental health crisis in 2020, was admitted to a group home at her parents’ suggestion in hopes of regaining independence. Unfortunately, her parents are now seeking her release due to the absence of help for acquiring essential life skills and other needed support.
The report underscores the complex interplay of mental health and socio-economic factors facing many residents, highlighting their need for assistance with affordable housing and vocational training to foster independence and improved quality of life.