\u201cI’d say it’s a seismic shift from where we were,\u201d said former Corrections Director Bryan Stirling, who spearheaded these reforms before becoming U.S. attorney for South Carolina<\/a> in 2025.<\/p>\n Challenges remain, but even the lawyer who mounted the class-action suit acknowledges progress in several areas. He and others see the effort by Corrections as a potential roadmap for county jails across the Palmetto State to follow in addressing their own struggles caring for the mentally ill.<\/p>\n An inmate reaches through an opening in a cell door in the Intermediate Care Services unit at Kirkland Correctional Institution in Columbia on Thursday June 26, 2025.<\/p>\n Grace Beahm Alford\/Staff<\/p>\n Stuart Andrews, lead attorney<\/a> on the prison lawsuit, said the attention afforded to mentally ill inmates \u201cis by no means luxurious\u201d in state prison but \u201cnecessary care is being delivered.\u201d The same cannot be said of the state\u2019s network of 54 jails. The level of care \u201cis far worse in the counties,\u201d he said.<\/p>\n The Post and Courier\u2019s five-part Caught in the Cycle series<\/a> revealed how defendants with psychiatric conditions often spend months in county detention centers awaiting treatment needed to restore their ability to stand trial. This leaves the jails struggling to care for \u2014 and control \u2014 people with chronic, complex and often unpredictable behavioral issues.<\/p>\n Since 2015, at least 102 mentally ill people have died i<\/a>n South Carolina jails from dehydration, suicide and other causes, according to a newspaper analysis of state, county and court records.<\/p>\n Legal experts say this predicament leaves the jails vulnerable to the same type of legal challenge that precipitated costly changes to the state\u2019s prison system.<\/p>\n Jails and prisons have become de facto asylums<\/a> in the decades since South Carolina embraced a national movement to shift patients from institutions into community care to avoid warehousing the mentally ill. Resources to support the initiative never fully materialized, resulting in a tattered safety net<\/a> that left many in a crushing loop of emergency hospitalizations, arrests and confinement.<\/p>\n Some 5,337 inmates \u2014 nearly a third of the total state prison population \u2014 receive mental health care behind bars. About 8 percent of that group have severe mental illnesses; others may require less intensive care.<\/p>\n Behavioral health options inside the prison system now reflect this reality, with a goal of meeting inmates’ varying mental health needs. Some prisoners will require hospitalization, while others can function on a low dose of an antidepressant, for instance. The system needs to be able to assess, treat and pivot when necessary, said Dr. Chris Kunkle<\/a>, its deputy director of behavioral health.<\/p>\n \u201cIt’s just really building capacity to treat everybody. We know \u2026 that we’re going to get everything that the street gets,\u201d he said. \u201cSo we’re really just prepared for it.”<\/p>\n It wasn’t always that way.<\/p>\n A Department of Corrections staff member at Kirkland Correctional Institution exits the section of the prison housing Gilliam Psychiatric Hospital in Columbia on Thursday June 26, 2025.<\/p>\n Grace Beahm Alford\/Staff<\/p>\n Locked away and forgotten behind bars<\/p>\n In the not too distant past, some observers characterized the state prison system as a chamber of horrors for the mentally ill. One judge castigated it as an underfunded, understaffed and broken system that violated the rights of mentally ill prisoners, exposing them to abuse, neglect and in some cases, death.<\/p>\n Travra Zanders\u00a0<\/p>\n Grace Beahm Alford\/Staff<\/p>\n Travra Zanders of North Charleston landed in this dysfunctional system in 2000 when he was sentenced to 12 years for a fatal shooting that he maintains was an act of self-defense. Zanders, 19 when he entered prison, was diagnosed behind bars with a mental illness after revealing that he heard voices in his head.<\/p>\n Zanders said he got into fights with other inmates, which led to long stretches in solitary confinement. Prison records show he spent a total of 750 days in restricted housing \u2014 two years and 20 days.<\/p>\n Alone in his cell, the voices grew louder. Care was sporadic and uneven.<\/p>\n \u201cI can just remember being in the room all day,\u201d Zanders recently told The Post and Courier. \u201cI don\u2019t like being on my own because of that.\u201d<\/p>\n Zanders\u2019 family barely recognized him when he came home after being paroled in 2009.<\/p>\n During Zanders\u2019 stretch in prison, the Corrections Department had one full-time psychiatrist ministering to as many as 24,000 inmates. Corrections officials approached the University of South Carolina\u2019s neuropsychiatry department and begged for help, one professor recalled.<\/p>\n Dr. Richard Frierson<\/a> remembers agonizing over the decision with his colleagues. Would they be enabling an inadequate system by putting a Band-aid on it? But they ultimately agreed, viewing the job as missionary work \u2014 akin to entering a third-world country, he said.<\/p>\n \u201cThe people there were suffering,\u201d said Frierson, who began working in the prisons in 2004 as a part-time psychiatrist. \u201cThe patients were suffering.\u201d<\/p>\n This story was made possible by generous reader donations to The Post and Courier Investigative Fund.<\/p>\n To contribute, please go to postandcourierfund.com<\/a>.<\/p>\n You can also send a check to the Spartanburg County Foundation, 424 E Kennedy Street, Spartanburg, SC 29302, and write \u201cPost and Courier Investigative Fund\u201d in the subject line.<\/p>\n The class-action lawsuit, filed a year later, exposed a constellation of issues,<\/a> including numerous stories of mentally ill inmates being gassed and locked in solitary confinement for years at a time. The suit alleged that they were denied effective treatment and caged naked, alone and cold in makeshift crisis cells littered with rotten food, feces and other filth.<\/p>\n Some prisoners were serving more time than their original sentences \u2014 more time than their life expectancies, in some instances \u2014 due to repeated rule-breaking that landed them in solitary with extra years tacked on to their terms.<\/p>\n Unsurprisingly, mentally ill inmates made up a large percentage of those locked in solitary, said Andrews, the lawsuit\u2019s lead attorney. And they weren\u2019t let out for treatment, he said.<\/p>\n A corrections officer watches over a prisoner in a room at Gilliam Psychiatric Hospital at Kirkland Correctional Institution in Columbia on Thursday June 26, 2025.<\/p>\n Grace Beahm Alford\/Staff<\/p>\n Change comes to Corrections<\/p>\n The class-action suit was still grinding through the courts when Bryan Stirling took over the corrections department in 2013.<\/a> The agency had an additional half-dozen part-time psychiatrists by around this time. When Stirling discussed the case with the department\u2019s attorneys, they expressed confidence that the agency could prevail at trial.<\/p>\n \u201cAnd I said, \u2018But is it the right thing to do?\u2019\u201d Stirling recalled. \u201cYes, we can win in court, but is it the right thing to do?\u201d<\/p>\n The two sides reached a settlement in 2016<\/a> that called for the state to spend millions to upgrade the Department of Corrections\u2019 mental health units and add staff. In the first three fiscal years, the agency spent nearly $9.4 million to boost staffing and $1.5 million on other initiatives \u2014 a down-payment on improvements that continued over the next several years, records show.<\/p>\n As a result of the reforms, seriously mentally ill offenders are no longer housed in solitary confinement for more than 30 days for disciplinary reasons. A step-down unit is available to get them out of solitary sooner if they manage their behavior. The number of inmates in restrictive housing, otherwise known as solitary, has dropped from around 1,800 when Stirling arrived to 593 as of this month. And the department now has 17 psychiatrists serving around 17,000 prisoners.<\/p>\n As of May 2025, the agency was in \u201csubstantial compliance\u201d with all but six of the 58 benchmarks required under the 2016 settlement and was closing in on the remaining half-dozen, officials said.<\/p>\n A prisoner sits with with his head shrouded in a cell at Gilliam Psychiatric Hospital in Columbia on Thursday June 26, 2025.<\/p>\n Grace Beahm Alford\/Staff<\/p>\n The Department of Corrections has grown better at recognizing and addressing inmates\u2019 varying mental health needs, rather than leaving their care to untrained officers, said Andrews, the attorney.<\/p>\n<\/p>\n
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