Getting mental health care in SC can be hard. Here’s where to turn if struggling.
Getting a primary care appointment is hard enough in the Lowcountry, but accessing behavioral health services like therapy or emergency psychiatric care can compound already difficult situations.
Providing mental health services can be challenging, local health care providers said, because of low insurance reimbursements, regulatory and safety requirements and a disproportionate number of uninsured patients. It can also be difficult to recruit qualified psychiatrists, they said.
“What you’re seeing is psychiatrists are not keeping pace with demand,” said Brad Wright, professor and chair of Health Services Policy and Management at the University of South Carolina’s Arnold School of Public Health. “Not enough are graduating and joining the workforce to meet the rapidly rising demand and increase in mental illnesses, which was exacerbated by a lot of things, including the pandemic.”
Despite widespread efforts to break the stigma associated with mental health issues, it’s still common for behavioral health issues to not be taken as seriously as, say, breaking a bone, Wright said. What ends up happening, he said, is people put off seeking care until the issue gets so bad it can’t be ignored. This can lead to a long – and costly – visit to the emergency room, or a monthslong wait to speak to a professional.
This issue is not unique to the region; physician recruitment and insurance reimbursements are problems plaguing the entire country. Health care providers across the rapidly-growing Lowcountry are taking different approaches to the problem by investing in new facilities and expanding access to telehealth.
The cost of not seeking care
Although illnesses like depression, anxiety and post-traumatic stress disorder have become much less stigmatized in the past few decades, a lingering stigma still does exist, Wright said, and insurance reimbursements still aren’t at parity with physical ailments.
“We’ve tried and tried, but we’re not fully there yet,” he said.
This makes it costly and difficult for health care providers to offer behavioral health services. Patients seeking psychiatric services at Beaufort Memorial Hospital’s inpatient unit are uninsured at a higher rate than at the hospital overall, and insurance reimbursements are lower than for other medical and surgical services.
This is especially true for patients covered by Medicaid and Medicare, who “make up a disproportionate share of psychiatry admissions,” said Emma June Grosskopf, media relations manager at Beaufort Memorial.
Russell Baxley, the hospital’s president and CEO, said that one in three patients receiving care in Beaufort Memorial’s 18-bed psychiatric hospital is uninsured or underinsured, compared to about 6% of overall hospital patients and 15-20% in the emergency room.
The hospital is finding ways to increase psychological health services in the Lowcountry, Baxley said. It partners with the county’s detention center to provide psychiatric services to inmates, and its inpatient mental health hospital is the only one in the region.
Hope comes in the form of a new program
Earlier this year, Beaufort Memorial announced a brand-new crisis stabilization unit at its Pratt Emergency Center. The idea is to provide faster treatment to patients in mental health crises, who often wait three times longer than other patients in the emergency room, he said. Beaufort Memorial also broke ground on its pending Bluffton Community Hospital this year.
“The observation unit allows us to see and treat patients for 24-48 hours in a very psychologically safe setting versus in an emergency room,” Baxley said. Funding for the project comes from a $1.1 million grant from the South Carolina Department of Health and Human Services and a private donation of about $23,000.
Recruiting psychiatrists to work at Novant Health has been a challenge, said Dr. Robert Harrington, the health system’s physician executive for South Carolina. The health care network, which is building new emergency departments and medical offices near the future Beaufort Memorial Hospital in Bluffton, also operates Hilton Head Medical Center in Hilton Head and Coastal Carolina Medical Center in Hardeeville. A new 50-bed hospital is also in the works for Bluffton.
“There are not a lot of people going into psychiatry, and not a lot of residency program graduates in South Carolina,” he said. “People usually set up shop where they finish their training within 30-50 miles.”
MUSC Health Florence Medical Center is in year two of a graduate medical education program with 24 residents, the health system said in March. The program was designed to help address the physician shortage in South Carolina, Harrington said, and it will train doctors in either family or internal medicine.
Novant Health is focusing on linking the Lowcountry to its extensive telehealth network, so residents can have access to counseling.
“The excitement that I have is Novant has a pretty robust telehealth behavioral network established in North Carolina,” said Joel Taylor, president of the Hilton Head area for Novant Health. “We recently had a conversation about how to bring that service to South Carolina.”
The insurance problem
Even patients who do have insurance may not have adequate coverage, Baxley said. Underinsurance is also an issue, he said, and there’s been an uptick in the number of patients with high-deductible or catastrophic health insurance. Patients with these plans pay low premiums, but if anything happens they’re often left with a hefty medical bill.
“We’re seeing more and more that patients aren’t able to pay their portion,” Baxley said. “While they may have insurance, the first $10,000 to $15,000 is paid by the patient, and as statistics show, there’s not a lot of people that have the ability to pay that up front.”
In 2024, the hospital provided $36.9 million worth of uncompensated care, including “bad debt” which is basically unpaid medical bills.
Taylor said the increase in high-deductible plans is an industry-wide phenomenon.
“Are we seeing a corresponding increase in bad debt? Yes. I would not call it dramatic for us. We work very closely with patients to provide payment plans,” he said. “We are committed and required to care for anyone who comes to the emergency department, and we work with everyone to set up a payment plan.”
A systemic problem with health care, Wright said, is that right now there’s a lot of reacting to crises instead of trying to tackle the issues that cause them in the first place.
“With those costs, it’s not clear how they come back to us, whether it’s higher premiums or the cost of care, but no one is doing this stuff for free,” he said.
What to do if you need help
For any medical emergency, step one is to call 911. But if you or someone you know is in need of behavioral health services, here’s a list of local resources available through Beaufort Memorial and Novant Health.
For inpatient care, Beaufort Memorial has an 18-bed psychiatric hospital. Patients are evaluated and treated by psychiatrists, who find the best medication or mix to stabilize them and allow them to go home safely.
Patients can be referred to Beaufort Memorial Sea Island Psychiatry for outpatient services, like medication management.
Beaufort Memorial also offers counseling, electroconvulsive therapy and transcranial magnetic stimulation.
Conditions treated at Beaufort Memorial include anxiety disorders, bipolar disorders, borderline personality disorder, obsessive compulsive disorder, post-traumatic stress disorder and depression.
Psychological & Counseling Associates of the Lowcountry offers therapy, counseling, mental health assessments and specialized programs, including support services for law enforcement.
The South Carolina Department of Mental Health can be reached at 803-898-8581.
National Alliance on Mental Illness (NAMI) Lowcountry can be reached at 843-636-3100.
NAMI’s HelpLine is at 800-950-6264 from 10 a.m. to 10 p.m. Monday through Friday. Users can also text “NAMI” to 62640.
For emergencies, call, text or chat the 988 Suicide & Crisis Lifeline for confidential, judgement-free care.
This story was originally published September 4, 2025 at 1:35 PM with the headline "Getting mental health care in SC can be hard. Here’s where to turn if struggling.."