South Carolina has entered into a formal agreement with the U.S. Department of Justice to significantly expand community-based mental health services. The settlement follows a federal investigation that concluded the state had been illegally segregating adults with serious mental illness within institutional settings.
Federal officials found that South Carolina’s reliance on Community Residential Care Facilities, also known as adult care homes, violated both the Americans with Disabilities Act (ADA) and the landmark Supreme Court decision in Olmstead v. L.C., which mandates that individuals with disabilities receive services in the most integrated setting appropriate to their needs.
Under the new agreement, the state is committed to building a more robust support system designed to help individuals transition from institutions to independent living. Key components of the settlement include:
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Intensive Treatment: Expanding specialized community mental health treatment programs.
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Supportive Housing: Increasing the availability of stable, independent housing options for those with serious mental illness.
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Mobile Crisis Response: Making emergency mental health response teams available in every part of the state.
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Peer Support: Enhancing services led by individuals with lived experience in mental health recovery.
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Case Management: Providing dedicated assistance to connect individuals with services based on their specific choices and needs.
The Justice Department’s investigation identified approximately 2,000 adults with serious mental illness living in residential care facilities, often for extremely long durations. Some residents remained in these institutions for years or even decades, despite state officials acknowledging that many of them were capable of living successfully in the community if given adequate support.
Investigators determined that systemic gaps in housing, crisis services, and intensive treatment had left institutional care as the default option for many South Carolinians.
While the state works to carry out the terms of the settlement, federal officials have moved to dismiss the formal complaint. However, the agreement will be strictly monitored to ensure South Carolina achieves full compliance with federal law. The primary goal of the transition is to identify those currently in facilities who wish to live in the community and provide them with the necessary resources to do so safely and successfully.
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