South Carolina prison mental health reforms have reduced solitary confinement and expanded treatment options, according to records and officials from the S.C. Department of Corrections. Following a 2005 class-action lawsuit exposing severe conditions for mentally ill inmates, the state boosted mental health staff and added specialized housing, offering a potential roadmap for county jails struggling with similar populations.
Prison Mental Health Reform After Landmark Lawsuit
The transformation inside state correctional facilities follows a class-action lawsuit filed in 2005 by lead attorney Stuart Andrews. The litigation exposed horrific conditions for mentally ill inmates, including solitary confinement for years at a time and lack of effective treatment, according to court records and legal documents. Former Corrections Director Bryan Stirling, who spearheaded reforms before becoming U.S. attorney for South Carolina in 2025, noted that the agency shifted from having just one full-time psychiatrist to expanding its behavioral health network significantly.
Did you know? As of May 2025, the South Carolina Department of Corrections reached “substantial compliance” with all but six of the 58 benchmarks required under the 2016 settlement agreement.
Solitary Confinement Reductions and Treatment Capacity
Under the 2016 settlement, seriously mentally ill offenders are no longer housed in solitary confinement for more than 30 days for disciplinary reasons, according to Department of Corrections data. The number of inmates in restrictive housing dropped from around 1,800 under former Director Stirling to 593 as of this month. Dr. Chris Kunkle, deputy director of behavioral health, stated that the prison system built capacity to assess, treat, and pivot as necessary to handle roughly 5,337 inmates receiving mental health care behind bars.
Inside Gilliam Psychiatric Hospital and Residential Units
Acute care for male inmates is provided at Gilliam Psychiatric Hospital, an 82-bed facility at Kirkland Correctional Institution in Columbia, according to Department of Corrections officials. Women receive treatment at a separate 12-bed inpatient unit in Lancaster.
Contrasting Conditions in South Carolina County Jails
While state prisons have improved care, the state’s network of 54 county jails struggles with far worse conditions, according to attorney Stuart Andrews. A five-part investigation by The Post and Courier, titled “Caught in the Cycle,” revealed that defendants with psychiatric conditions often spend months in county detention centers awaiting treatment needed to restore their ability to stand trial. Since 2015, at least 102 mentally ill people have died in South Carolina jails from dehydration, suicide, and other causes, according to a newspaper analysis of state, county, and court records.
Legal experts warn that these conditions leave county jails vulnerable to legal challenges similar to the prison lawsuit, as local detention facilities operate as de facto asylums amid a tattered community mental health safety net.
Frequently Asked Questions
How many inmates receive mental health care in South Carolina prisons?
Approximately 5,337 inmates—nearly a third of the total state prison population—receive mental health care behind bars, with about 8 percent of that group suffering from severe mental illnesses, according to Department of Corrections data.
What is Gilliam Psychiatric Hospital?
Gilliam Psychiatric Hospital is an 82-bed acute care facility located within Kirkland Correctional Institution in Columbia, providing dedicated inpatient treatment for male inmates, according to prison records.
How has solitary confinement changed for mentally ill prisoners?
Seriously mentally ill offenders are no longer housed in solitary confinement for more than 30 days for disciplinary reasons, and the total population in restrictive housing has fallen from around 1,800 to 593 under settlement benchmarks monitored since 2016.
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