South Carolina Department of Mental Health Celebrates 175th Anniversary
By Susan F. Craft, S.C. Department of Mental Health, Office of Communications
1996 marks the 175th anniversary of a statute creating a public institution to provide care and treatment for the citizens of South Carolina who have a mental illness. The enactment of that statute on December 20, 1821, made South Carolina the second state in the nation to recognize the need for and provide funds for such an institution (Virginia was first) and represented the official birth of what has evolved into the South Carolina Department of Mental Health.
According to legend, when Colonel Samuel Farrow, a member of the House of Representatives from Spartanburg County, traveled to Columbia to attend sessions of the legislature, he noticed a woman who was mentally distressed and apparently without adequate care. Her poor condition made an impact on him and spurred him on to engage the support of Major William Crafts, a brilliant orator and a member of the Senate from Charleston County. The two men worked zealously to sensitize their fellow lawmakers to the needs of the mentally ill. Consequently, the South Carolina State Legislature approved $30,000 to build the S.C. Lunatic Asylum and school for the deaf and dumb.
The Mills Building, designed by Robert Mills, a renowned architect, was completed and ready for occupancy December 18, 1827.
The hospital admitted patients wealthy enough to pay for their own care, as well as the middle class and paupers. Although a few blacks, mostly slaves, were admitted during the first 20 years, they were not officially permitted until 1848. By the 1850s, paupers were admitted for an annual fee of $135, which was billed to the patient's home district. As more paupers were admitted, it became harder to collect fees, and the asylum grew more dependent on state funding.
During the Civil War, funding problems grew worse. Dr. John W. Parker, the superintendent, even had to oppose a plan to turn his complex into a prisoner-of-war camp for Union soldiers, although the grounds were used as a prison camp for Union officers from October 1864 to February 1865. J.F. Ensor, a Maryland native and former Union Army surgeon, became superintendent in 1870. More than once, when local businesses could no longer give him credit, Ensor supplemented the institution's meager budgets with his own funds.
With slavery abolished, African-Americans became a larger part of the asylum's population. The admission of blacks not only added to the patient population, but led to another problem: providing separate facilities for the races. The population increased from 245 in 1870 to more than 300 by 1877.
Notable changes before 1900 included the founding in 1892 of a nursing school, which did not close until 1950, and changing the hospital's name in 1896 to the S.C. State Hospital for the Insane.
By 1900 the State Hospital had 1,040 patients. By 1910, land was purchased north of Columbia, and plans were submitted for a new complex that became known as "State Park." When it opened in 1913, it was for black patients only. This hospital, named Palmetto State Hospital in 1963, was renamed Crafts-Farrow State Hospital in 1965 when it became a geriatric facility.
Dr. C. Fred Williams, superintendent of the S.C. State Hospital from 1915 to 1945, encouraged a program to educate the public about mental illness, its causes, and methods of prevention. The first clinic to provide services for the mentally ill who did not need hospitalization was opened at the S.C. State Hospital in 1920. The first permanent outpatient clinic opened in Columbia in 1923.
Dr. William Peter Beckman joined the S.C. State Hospital staff in 1925 and two years later became director of the Mental Hygiene Department. He traveled throughout the state for 23 years holding one-day clinics for the mentally ill. Many people came to recognize his Model-T Ford on the rugged South Carolina roads and highways.
World War II came, and the State Hospital staff was so depleted the clinics began to suffer. On Nov. 1, 1943, Dr. Williams closed all clinics for the remainder of the war.
Reopening of the clinics were delayed until late 1947 because of the lack of adequately trained personnel. As clinics continued to grow over the state, the need for state and federal funding increased. This aid came in 1946 with the passage of Public Law 487 and in 1952 with passage of the Mental Health Act.
By 1957, clinics were operating in Charleston, Greenville, Richland, Spartanburg, Darlington, and Florence counties.
In 1964, the S.C. Department of Mental Health was created as an independent agency of state government to develop a more comprehensive system, which combined medical care and treatment with expanded community services, mental health education, consultation, professional training, and research.
Dr. William S. Hall became the first State Commissioner of Mental Health. Under his guidance from 1964 to 1985, a comprehensive, statewide mental health care delivery system emerged and grew to encompass 10 major inpatient facilities and 17 community mental health centers with more than 6,000 employees.
During the 1970s, South Carolina experienced a number of firsts: the establishment of a transitional living project to help patients return to the community after long hospital stays; a facility for psychiatric patients who need long-term care; a program for autistic children; and an alcohol and drug addiction treatment center.
In the 1970s, the department created the position of ombudsman and a system of advocates to protect patients' rights and privileges.
Although the 1980s began with great promise, those hopes were short-lived. The 1980 Mental Health Systems Act, which promised new resources and refocused federal support, was effectively repealed by the Omnibus Budget Reconciliation Act of 1981.
Joseph J. Bevilacqua, Ph.D., became the state commissioner of mental health in 1985. Under his leadership, the department supported the Toward Local Care view that patients treated in the community do much better clinically. They get better faster and stay better longer when they receive services in their community, if such programs are reasonably funded, well organized, and easily available.
This year the S.C. State Hospital and Crafts-Farrow State Hospital consolidated their services and moved patients from Crafts-Farrow to the State Hospital campus. This consolidation resulted in the organization of the Division of Psychiatric Rehabilitation Services comprised of 410 beds. Today, entire floors, wards, and cottages on the Columbia campus are closed or are used for administrative offices.
This brief account of the S.C. Department of Mental Health's illustrious history has only skimmed the surface of a deep and abiding commitment to provide quality services to people with mental illnesses. It is our hope that the next century will see continued development of local mental health care and that greater acceptance will allow people with mental illnesses to live with dignity and as independently as they are able.
A 175th Anniversary Committee met for the first time March 7 to begin planning ways to recognize and celebrate this milestone in our agency's history throughout the year, culminating with a grand ceremony Friday, Dec. 20, 1996.