The complex problem of how we handle mentally ill defendants — how we preserve their right to a fair trial, help them get the care they need and keep the rest of us safe — affects all 50 states, as readers of The Post and Courier’s Caught in the Cycle investigative series have no doubt learned. This report thoroughly documents the mental health crisis in South Carolina’s county jails and details its heartbreaking impact on too many lives.
The question is what we can and should do better.
The tragic stories in the series are far from the sole fault of those who work in jails and prisons; there is plenty of other fault to go around. We likely need to add state psychiatric beds, move more expeditiously in identifying those in the most need of care and increase support for programs that divert more of those with mental illness away from our jails.
As the report concludes, change won’t occur without a concerted effort by all parties, including law enforcement, prosecutors and defense lawyers, judges, mental health agencies and our state and local officials who determine how our tax dollars are spent. No, this challenge won’t be solved by simply throwing money at it, but we won’t improve things without a concerted effort to pay for the most promising changes to the status quo.
Take the example of South Carolina’s competency restoration process, which now has an average wait of eight months between a judge’s order and the Office of Mental Health completion. The strain leaves South Carolina exposed to the legal risk that has dragged other states into court battles they ultimately lost.
Last year, Mental Health took a positive step and urged public defenders to request that their clients be screened to see if they really need a mental competency exam or could be served better by some other service. That has helped free up resources for those who really need the exam, but this is a partial solution at best. It has prevented an increase in waiting times for restoration treatment, but the waits are still long.
State lawmakers voted in 2022 to allow jail-based treatment programs, which are designed to provide restoration treatments for mentally ill defendants deemed too ill to stand trial, but did not fund them. Four years later, only one such program is fully open, and that is simply unacceptable. They should be funded, as a sensible first step, especially in those counties farther from Columbia.
This is by no means a new problem. Only two years ago, a 51-year-old inmate in Bamberg County’s jail languished for five months without medicine for his schizophrenia or diabetes until he eventually died, after he was found incompetent to stand trail but unable to move to an open bed. Dozens of South Carolina’s county jails were struggling then with systemic problems involving the treatment they provide (or don’t provide) to mentally ill inmates. They struggle still.
That The Post and Courier was able to shine new light on this life-and-death problem was partly a fluke: Reporters obtained unexpected access to a trove of court records, including more than 200 psychiatric examinations of defendants in Charleston County. While this information was released due to a court error, it serves as an example of the public benefit information normally kept private can provide if it’s shared with the public, by broadening the discussion into problems in our government that we should work together to solve.