South Carolina's Department of Corrections (SCDC) operates the Office of Behavioral Health Services (BHS) -- a division with three primary programs: the Division of Men's Mental Health Services, the Division of Women's Mental Health Services, and the Division of Addiction Recovery Services. BHS provides mental health services to all inmates classified as mentally ill and is committed to providing a continuum of services addressing the mental health, substance abuse, and treatment needs of the incarcerated population.
South Carolina's current mental health framework was substantially shaped by a lawsuit filed against SCDC approximately 20 years ago. The T.R. v. South Carolina Department of Corrections case (No. 2005-CP-40-02925) produced a settlement effective May 2, 2016 that required SCDC to implement a comprehensive Remedial Plan -- overseen by an independent panel of national experts -- that has driven the creation of mental health policies and housing units that did not exist before.
Despite this progress, a Post and Courier investigation published in April 2026 documented that South Carolina continues to struggle with a systemic mental health crisis. A 2024 state-commissioned report found South Carolina has the most fragmented health and human services structure in the nation -- with eight independent agencies, a disjointed community mental health network, and an ongoing crisis in which jails and prisons serve as the primary mental health care providers for a significant portion of the state's most seriously ill citizens.
What South Carolina Prisoners Are Entitled To
Under Estelle v. Gamble (1976), the T.R. v. SCDC Remedial Plan, SCDC Policy HS-19.04 (Mental Health Services - General Provisions), and related SCDC behavioral health policies:
- Mental health screening at reception and throughout incarceration.
- Mental health services (assessment, case management, treatment, and discharge planning) for all inmates classified as mentally ill.
- Mental health levels of care as established in Policy BH-19.20 (Mental Health Levels of Care, issued May 2024).
- Access to the Secure Mental Health Unit (SMHU) for SMI inmates requiring long-term restrictive housing placement.
- Crisis intervention and psychiatric hospitalization when the civil commitment criteria are met.
- Treatment plans and treatment team meetings per SCDC Policy BH-19.05.
Mental Health Screening at Intake
SCDC Policy HS-19.04 establishes that mental health screening is conducted at the Reception and Evaluation Center (R&E) for all new commitments (see Health Services Procedure 700.10). Mental health screening can be expedited based on results of intake screenings conducted by case management and medical staff. Screening urgency classifications:
- Emergent: completed within four hours; inmate kept under direct observation until evaluation is complete.
- Urgent: within a defined short timeframe.
- Routine: standard scheduling.
If your person has a psychiatric history, provide documentation at intake -- prior hospitalizations, diagnoses, and active medications -- to support accurate initial mental health classification.
SCDC Behavioral Health Services (BHS)
SCDC's Office of Behavioral Health Services is organized into three primary divisions:
Division of Men's Mental Health Services: Provides mental health assessment, case management, treatment, and discharge planning for male SCDC inmates classified as mentally ill.
Division of Women's Mental Health Services: Provides the same services for female SCDC inmates.
Division of Addiction Recovery Services: Provides substance abuse treatment programming. Substance abuse treatment is provided alongside mental health care for people with co-occurring disorders.
All BHS services are described as based on evidence-based research and effective/promising clinical practices, and are provided in a cost-effective manner.
Mental Health Classification
SCDC classifies inmates by mental health level, with at least the following classifications referenced in policy:
Mentally ill classification: Inmates who present with mental health concerns are evaluated and classified as mentally ill or non-mentally ill at intake. Those classified as mentally ill receive the full range of BHS services.
Mental health levels (L1, L2, L3, and others): Policy BH-19.20 (Mental Health Levels of Care, issued May 20, 2024) establishes a formal levels of care system. This policy was newly created as part of the T.R. v. SCDC Remedial Plan. The SMHU (Secure Mental Health Unit) specifically serves inmates with L2 or L3 mental health classifications.
Treatment plans: Per Policy BH-19.05 (Treatment Plans and Treatment Team Meetings), all inmates classified as mentally ill have individualized treatment plans developed and monitored by a treatment team that includes a Qualified Mental Health Professional (QMHP).
The Mental Health Levels of Care Policy (BH-19.20)
Policy BH-19.20 "Mental Health Services - Mental Health Levels of Care" was issued May 20, 2024 as a new policy (superseding nothing -- it had never existed before) developed in direct response to the T.R. v. SCDC Remedial Plan. This policy establishes formal levels of mental health care within SCDC, providing a structured clinical pathway for mental health service intensity.
The existence of this policy -- created as late as May 2024 -- reflects how recently the T.R. v. SCDC settlement has been driving systemic improvements. Many of SCDC's current behavioral health policies are recent creations generated by the Remedial Plan, not pre-existing institutional frameworks.
The Secure Mental Health Unit (SMHU)
SCDC Policy BH-19.18 "Secure Mental Health Unit" (SMHU) was issued January 23, 2024 (Change 2 signed March 25, 2024) as another new policy created through the T.R. v. SCDC Remedial Plan.
The SMHU is a specialized housing unit designed for:
- Seriously mentally ill (SMI) inmates with a designated mental health classification, generally L2 or L3.
- Who have met the criteria for Restrictive Housing Unit (RHU) placement due to disruptive behaviors that make it difficult to function within a mental health program or general population.
- Who need long-term (greater than 60 days) restrictive housing placement.
The SMHU is designed as a temporary housing assignment that provides programming, treatment, and structure for SMI inmates in a long-term restrictive housing setting. It is intended to be an alternative to standard RHU for seriously mentally ill prisoners -- providing mental health programming and treatment within the restrictive housing environment rather than isolating them without care.
Gilliam Psychiatric Hospital at Kirkland Correctional Institution
Kirkland Correctional Institution in Columbia, South Carolina is home to the Gilliam Psychiatric Hospital -- the primary specialized psychiatric facility within the SCDC system. Gilliam provides hospital-level psychiatric care for SCDC inmates whose mental health needs exceed what facility-level behavioral health services can provide.
A Post and Courier photograph from June 26, 2025 documented conditions inside Gilliam Psychiatric Hospital, providing visual evidence that the facility continues to grapple with the legacy of inadequate psychiatric care that the T.R. v. SCDC case was designed to address.
The T.R. v. SCDC Lawsuit and Settlement
T.R. v. South Carolina Department of Corrections (No. 2005-CP-40-02925) is the defining legal event in SCDC's mental health history. The case was filed approximately 2005, went to trial, and produced findings by Judge Baxley that:
- "Inmates have died in the South Carolina Department of Corrections for lack of basic mental health care."
- "Hundreds more remain substantially at risk for serious injury, mental decompensation and profound, permanent mental illness."
- Abuses were "captured on video and shocked the nation when shown in open court."
The settlement became effective May 2, 2016. Key settlement terms:
- SCDC must implement a comprehensive Remedial Plan.
- The Remedial Plan is supervised by a panel of independent national experts.
- Strict timetables for implementation, with measurements.
- SCDC has four years to implement the remedial guidelines.
- Compliance requires achieving and maintaining each component for at least 18 months.
Multiple SCDC behavioral health policies -- including BH-19.18 (SMHU, January 2024), BH-19.20 (Mental Health Levels of Care, May 2024), and others -- explicitly state they were created as part of the Remedial Plan. The settlement remains the primary external accountability mechanism for SCDC mental health care.
South Carolina's Systemic Mental Health Crisis
A 2024 state-commissioned report found South Carolina has the most fragmented health and human services structure in the nation -- eight independent agencies with poor coordination. This structural fragmentation affects the community mental health network that prison releases depend on.
A Post and Courier investigation published April 2026 documented that:
- South Carolina jails and prisons have become the primary mental health care providers for the state's most seriously ill citizens.
- The shift from state psychiatric hospitals to community treatment was not accompanied by adequate funding for community mental health services.
- The state's patchwork system of hospitals, clinics, jails, prisons, and group homes is falling short.
- Governor McMaster raised alarms in January 2022, calling the cost of inaction "unimaginable."
This crisis context means that the formal Remedial Plan improvements within SCDC prisons exist within a state system that continues to struggle with mental health care access and fragmentation at every level.
What Families Can Do
If your person is in SCDC custody and has a mental illness:
Provide psychiatric history at intake. Supply documentation at the Reception and Evaluation Center. Prior hospitalizations, diagnoses, and active medications support accurate initial mental health classification.
Know the mental health classification. Ask what mental health classification level your person has been assigned. If they have serious mental illness and have not been classified as mentally ill (or at L2/L3 level), ask why.
Know the treatment plan right. Under Policy BH-19.05, all mentally ill SCDC inmates are entitled to individualized treatment plans developed and monitored by a treatment team including a QMHP. Ask whether your person has an active treatment plan and what it contains.
Know the SMHU. If your person has serious mental illness (L2 or L3) and has been placed in restrictive housing, ask whether SMHU placement has been evaluated. The SMHU was created by the T.R. v. SCDC Remedial Plan specifically to provide programming and treatment in long-term restrictive housing settings for SMI inmates.
Know the T.R. settlement. The T.R. v. SCDC Remedial Plan -- supervised by independent national experts -- is the primary accountability mechanism for SCDC mental health. If care falls below Remedial Plan standards, document the specific failure and file a grievance.
Know the Gilliam Psychiatric Hospital pathway. If your person requires psychiatric hospital-level care, ask whether a referral to Gilliam Psychiatric Hospital at Kirkland Correctional Institution has been considered.
File a grievance. SCDC has an administrative grievance process. File formal grievances for: failure to classify as mentally ill when warranted, failure to provide treatment plans per BH-19.05, SMHU placement denial, failure to provide mental health services per the Remedial Plan, and medication interruption.
Contact Disability Rights South Carolina. DRSC (disability-rights-sc.org) -- formerly Protection and Advocacy for People with Disabilities, Inc. -- is the federally mandated P&A organization for South Carolina. DRSC's predecessor organization described the T.R. settlement as "a critical agreement whose implementation can end a dark chapter in South Carolina history."
Seek legal help. Given the ongoing T.R. v. SCDC Remedial Plan and independent expert monitoring, there is an active accountability framework for mental health care in SCDC. If care falls below Remedial Plan standards, consult a prisoner rights attorney with experience in South Carolina's federal courts (District of South Carolina).
Frequently asked questions
How does SCDC screen prisoners for mental illness?
SCDC Policy HS-19.04 requires mental health screening at the Reception and Evaluation Center (R&E) for all new commitments (per Health Services Procedure 700.10). Screening can be expedited based on case management and medical intake findings. Emergency screening must be completed within four hours with the inmate under direct observation. Inmates presenting with mental health concerns receive routine, urgent, or emergent referral for further evaluation. Provide psychiatric documentation at intake -- prior hospitalizations, diagnoses, and active medications.
What is SCDC's Office of Behavioral Health Services?
SCDC's Office of Behavioral Health Services (BHS) has three primary divisions: Division of Men's Mental Health Services, Division of Women's Mental Health Services, and Division of Addiction Recovery Services. BHS's mission is to provide all inmates access to mental health care, substance abuse care, and Sex Offender Treatment Programs. Services are evidence-based, provided in a continuum of varying intensity levels, and include assessment, case management, treatment, and discharge planning for all inmates classified as mentally ill.
What mental health services does SCDC provide?
Under Policy HS-19.04, mental health services for all mentally ill SCDC inmates include: assessment, case management, treatment, and discharge planning. Under Policy BH-19.05, all mentally ill inmates have individualized treatment plans developed by a treatment team including a QMHP. Services span mental health levels of care (Policy BH-19.20, May 2024), crisis intervention, psychiatric hospitalization when civil commitment criteria are met, and specialized housing including the Secure Mental Health Unit (Policy BH-19.18, January 2024). All policies were created as part of the T.R. v. SCDC Remedial Plan.
What is the T.R. v. SCDC lawsuit and settlement about?
T.R. v. South Carolina Department of Corrections (No. 2005-CP-40-02925) was a lawsuit challenging SCDC's treatment of seriously mentally ill inmates. After trial, Judge Baxley found inmates had died from lack of basic mental health care and hundreds more were at risk. Abuses "captured on video shocked the nation." The settlement effective May 2, 2016 requires SCDC to implement a comprehensive Remedial Plan -- overseen by independent national experts -- over four years, with 18-month sustained compliance required for each component. Most current SCDC behavioral health policies were created as part of this Remedial Plan.
What is the Secure Mental Health Unit in SCDC prisons?
The Secure Mental Health Unit (SMHU), governed by Policy BH-19.18 (January 2024, a new Remedial Plan policy), is designed for seriously mentally ill SCDC inmates with L2 or L3 mental health classifications who have also met criteria for long-term (greater than 60 days) Restrictive Housing Unit placement due to disruptive behaviors. The SMHU provides programming, treatment, and structure in a long-term restrictive housing setting -- designed to give SMI inmates in RHU access to mental health programming rather than pure isolation.
What are SCDC's mental health levels of care?
Policy BH-19.20 "Mental Health Levels of Care" (issued May 20, 2024, a new Remedial Plan policy) establishes SCDC's formal mental health levels of care system. This policy was newly created in 2024 and had never previously existed. Mental health classifications include at minimum: non-mentally ill (receives some services), L2 (requires Secure Mental Health Unit-eligible SMI classification for RHU placement), and L3 (same). The levels determine the intensity and type of mental health services provided and housing eligibility.
What is Gilliam Psychiatric Hospital at Kirkland CI?
Gilliam Psychiatric Hospital is the specialized psychiatric facility within the SCDC system, located at Kirkland Correctional Institution in Columbia, South Carolina. It provides hospital-level psychiatric care for SCDC inmates whose mental health needs exceed what facility-level BHS services can provide. Gilliam is the primary inpatient psychiatric destination within SCDC for seriously mentally ill prisoners in acute crisis or requiring intensive inpatient treatment.
How does SCDC handle mental health care at release?
SCDC Policy HS-19.04 includes discharge planning as one of the core mental health services for mentally ill inmates. The discharge planning process is intended to connect prisoners with community mental health resources upon release. South Carolina's community mental health system -- fragmented across eight independent agencies per a 2024 state report -- is the primary referral destination. Ask the facility what community mental health provider has been identified, whether a first appointment has been arranged, and whether Medicaid enrollment is underway.
What can families do if mental health care is denied in SC?
Provide psychiatric documentation at intake. Know the mental health classification level and ask why your person has not been classified if they have a mental illness. Know the treatment plan right under BH-19.05. Know the SMHU for SMI inmates in long-term restrictive housing. Know the T.R. Remedial Plan -- most behavioral health services are part of this court-driven reform and failures are violations of the plan. File SCDC grievances for all care denials and classification failures. Contact Disability Rights South Carolina (disability-rights-sc.org) for legal advocacy.
Who oversees mental health care in South Carolina prisons?
SCDC's Office of Behavioral Health Services manages mental health care system-wide. The T.R. v. SCDC Remedial Plan is overseen by an independent panel of national experts under the 2016 settlement -- the primary external accountability mechanism. Disability Rights South Carolina (DRSC, disability-rights-sc.org) is the federally mandated P&A organization and the successor to the organization that called the T.R. settlement "a critical agreement whose implementation can end a dark chapter in South Carolina history." ---
Discovery Offer - Silos 1-2
Search arrest records and find out where they are
If you're trying to locate someone who was arrested or find out where they are being held, TruthFinder searches arrest records, court records, and custody status across all 50 states.