The Department of Behavioral Health and Developmental Disabilities (BHDD) Office of Mental Health is dedicated to supporting the recovery of people with mental illnesses. As South Carolina’s public mental health system, it is one of the largest hospital and community-based systems of care in South Carolina. Its numerous programs, services, and divisions are designed to ensure that South Carolinians in need receive the right treatment, at the right place, at the right time from a robust, interconnected, evidence-based system of care.

From the Beginning

The Department of Behavioral Health and Developmental Disabilities (BHDD) Office of Mental Health (BHDD Office of Mental Health) traces the beginning of its history to December 20, 1821, the date on which the South Carolina State Legislature passed a statute-at-large approving $30,000 to build the South Carolina Lunatic Asylum and school for the deaf and dumb. The Mills Building — which still exists at the corner of Bull Street and Calhoun Street in Columbia — was completed and became operational in 1828.

Even before December of 1821, South Carolina had a history of providing care at public expense for those suffering from what we would recognize today as mental illnesses. In 1694, the Lords Proprietors of South Carolina established that destitute individuals disabled by physical or mental impairments should be cared for by local governments. The concept of “Outdoor Relief,” based upon Elizabethan Poor Laws, affirmed that the poor, sick and/or disabled should be taken in or boarded at public expense. In 1762, the Fellowship Society of Charleston established an infirmary for the indigent disabled. However, 1821 is the year that funds were appropriated at the State level in South Carolina to care for individuals with psychiatric disabilities.

Since the 1820’s, South Carolina’s state-run hospitals and nursing homes have treated approximately one million patients and provided over 150 million bed days of care to citizens in need of care.

In the 1920’s, treatment of persons with a mental illness began to include outpatient care as well as institutional care. The first outpatient center in South Carolina was established in Columbia in 1923.

The 1950’s brought the discovery that some severe symptoms of mental illness could be successfully treated with the use of medications. Phenothiazine’s, such as Thorazine and Mellaril, were hailed as “miracle drugs,” and enabled many State Hospital patients to be discharged, reducing the need for prolonged hospitalization.

With the passage of the Mental Health Act of 1952, South Carolina recognized the importance of community-based care and provided for the creation of publicly funded community mental health centers, 11 years before the federal Community Mental Health Services Act was passed. The Act provided that any community wishing to establish a local mental health program for the prevention, diagnosis and treatment of mental illness could apply to the Mental Health Commission for a grant for the establishment and operation of such program, and subject to available funds, the Commission could provide grants to fund up to 2/3rds of the cost of such clinics, subject to the community funding the other 1/3rd of the cost. The Centers so established were subject to the policies promulgated by the Commission. This was the beginning of one of the few integrated public mental health systems which exists in America today.

The Mental Health Commission itself was also created by the 1952 Mental Health Act. The Commission was vested with all of the powers and responsibilities of the previous Board of Regents of the South Carolina State Hospital. The Board of Regents had existed continuously since 1827, when the State General Assembly created the Board to oversee the operation of the soon-to-be-completed Asylum. [Over the years, the Asylum went through a couple of different name changes reflecting society’s changing understanding of mental illness, and eventually was renamed the South Carolina State Hospital.]

Although the Department of Mental Health (BHDD Office of Mental Health) was not created by statute until 1964, its jurisdiction, mission and resources were those of the South Carolina Mental Health Commission,

There is hereby created the State Department of Mental Health which shall have jurisdiction over all of the State’s mental hospitals, clinics and centers, joint State and community sponsored mental health clinics and centers and facilities for the treatment and care of alcohol and drug addicts … All the powers and duties vested in the South Carolina Mental Health Commission immediately prior to March 26, 1964 are hereby transferred to and vested in the Department of Mental Health. All records, files and other papers belonging to the South Carolina Mental Health Commission shall be continued as part of the records and files of the Department of Mental Health.

The Mental Health Commission continued in the role of the Governing Body of the Department. After the creation of the Department, one of the Commission’s principal responsibilities was the selection of a “State “Commissioner of Mental Health” (later changed to State Director) to serve as the “Chief Executive of the Department of Mental Health.”

Federal financial support and spending on mental health treatment dramatically increased in the 1960’s. The federal Community Mental Health Act of 1963 authorized substantial grant funds for the construction of local mental health centers as well grants to support the operation of mental health centers once established.

In 1967, the Columbia Area Community Mental Health Center was recognized as the first comprehensive community mental health center in the South. Since their inception, the Department’s community mental health centers have served more than three mil-ion patients, and provided more than 42 million clinical contacts.

Today, BHDD Office of Mental Health operates a network of 16 community mental health centers, with a combined total of 61 clinic locations, with at least one clinic in all 46 of South Carolina’s counties. BHDD Office of Mental Health also operates three hospitals, three veterans’ nursing homes, one community nursing home, a Forensic Program, and a Sexually Violent Predator Treatment Program (SVPTP). BHDD Office of Mental Health is one of the largest hospital and community-based systems of care in South Carolina.

In response to community needs, BHDD Office of Mental Health has developed multiple innovative blue-ribbon programs, two of which are its School-based program and its Telepsychiatry program. As of August, 2015, BHDD Office of Mental Health’s School-based program has mental health professionals embedded in approximately 500 public schools and serves 13,000 children per year. The Telepsychiatry program, which utilizes state of the art equipment that allows doctors to see, speak with, and evaluate patients from re-mote locations, is currently located in 23 emergency departments and has provided more than 25,000 consults.

The Department of Behavioral Health and Developmental Disabilities (BHDD) Office of Mental Health bicentennial is a meaningful and historic milestone in our state. December 8, 2021 is officially the 200th anniversary of when the Department of Mental Health was established in South Carolina.

Our bicentennial also kicks off a year long celebration in celebration of mental health initiatives in South Carolina. While we may not all be together in person for some, we are a strong community—perhaps never more so than during these challenging times.

Together, we recognize generations of progress and how our state leaders helped create a dynamic support structure in our communities.

Happy Bicentennial, BHDD Office of Mental Health.