South Carolina's Mental Health Transformation: A Unified Crisis Response

Introduction

South Carolina is setting the standard for statewide crisis response, proving that a unified approach can transform behavioral health care.

With the Office of Mental Health (OMH) serving as the direct provider across all 46 counties, the Palmetto State has pioneered a model that others are now looking to replicate. By integrating crisis services, standardizing protocols and leveraging timely data, South Carolina has created a blueprint for effective, coordinated crisis care.

The result? Faster response times, better resource allocation and improved patient outcomes.

The Challenge

Before implementing a unified approach, South Carolina’s crisis response was scattered and fragmented. Each of the 46 counties had an individual approach, making it difficult for providers to coordinate care. “Forty-six counties used to mean 46 ways of doing things,” said Deborah, Deputy Director, Community Mental Health Services. “This made it especially challenging for providers who cover more than one area. We’re standardizing processes and uniting our health records into one system.”

Law enforcement agencies also struggled with inconsistent crisis response protocols, leading to varying levels of care across the state. While clinicians had access to the statewide record, they previously lacked a unified, certified EHR that integrated both outpatient and inpatient behavioral health services. This made it difficult to deliver fully informed, coordinated care in real time. Adding to the challenge, the state had only one crisis stabilization center, leaving many regions with limited access to urgent behavioral health support.

The Solution

South Carolina addressed these challenges by implementing a single EHR platform for statewide crisis response. Now, mobile crisis teams, law enforcement and emergency responders have timely access to mental health records, ensuring that patients receive appropriate care wherever they are. Standardized crisis response protocols were also introduced, setting clear expectations for mobile teams. Our agency maintains a 60-minute response time goal for all regions, urban and rural alike. Response times are consistently tracked, with ongoing efforts to improve and ensure timely support statewide.

Hospital-based crisis stabilization units have been expanded, providing a safe, healing environment for individuals in crisis. These units offer 24/7 psychiatric evaluation, suicide prevention services and proactive discharge planning, helping patients transition smoothly into community-based care.

The Results

South Carolina’s crisis response transformation has led to tangible, measurable improvements.

The state now answers 87% of 988 crisis calls locally, a significant jump from 58% prior to implementing the new system.

The average crisis response time has dropped to just 36 minutes statewide, and law enforcement officers are now consistently accompanied by two trained clinicians when responding to behavioral health crises.

Better data has also led to smarter resource allocation. Analytics now inform funding decisions, ensuring that crisis services are expanded where they are needed most. This has led to the growth of EmPATH units—specialized psychiatric emergency departments designed to reduce hospitalization times while providing comprehensive behavioral health care. The future vision includes embedding clinicians in every county’s emergency department and detention centers, ensuring access to crisis care at every touchpoint. “The goal is providing uniform care supported by a unified EHR, where anyone can look at the health record and figure out the plan of care—no matter where they pop up in the state,” said Deborah.

Conclusion

South Carolina is proving that with the right strategy, technology and leadership support, a state can completely transform its behavioral health crisis response. What was once a fragmented system is now a model of efficiency, providing timely, informed care to individuals in crisis. Other states are taking notice, and for good reason—South Carolina isn’t just talking about improving crisis care. They’re doing it. And with the help of partners like Netsmart, they’re doing it well.