The Post and Courier investigates South Carolina's deadly mental health crisis in county jails

CHARLESTON, S.C. — A mentally ill father of two who died of neglect in the state’s largest jail. A police chief who lost an ear during an attack by a man in psychosis. A man who faced about 100 charges or citations over three decades as he battled schizophrenia.

They are among hundreds of people caught in the crushing loop that exists between South Carolina’s overloaded mental health system and its slow-moving courts.

The Post and Courier's new five-part investigative series, “Caught in the Cycle,” reveals how South Carolina’s handling of mentally ill defendants delays justice for crime victims, bleeds money from taxpayers and plunges desperate and vulnerable people even deeper into crisis.

Sparked by a court error that left more than 200 confidential psychiatric evaluations unsealed to the public, the investigation offers a rare, documented look into a system that is typically hidden from public view. Reporters discovered a shredded safety net that forces damaged individuals to cycle endlessly between jails and hospitals, often leaving them without long-term care until minor offenses escalate into major tragedies.

The Post and Courier's investigation reveals key findings:

• A Staggering Death Toll: Since 2015, at least 100 mentally ill people have died behind bars in South Carolina jails. Defendants have languished without adequate care and have died from severe dehydration and medical neglect while waiting an average of eight months to receive treatment intended to restore their mental competency.
• A Flawed “Hamster Wheel” System: The reporting underscores how “competency restoration” does not equate to comprehensive behavioral healthcare. Instead, this process is a system that, at its heart, aims to get people just well enough to convict them.
• Decades of Interactions: Without long-term care, defendants continuously cycled through the system. The unsealed records, along with criminal histories, revealed individuals who had documented interactions with law enforcement upwards of 100 times, usually for minor offenses, that often escalated to larger ones, without getting the help they needed.
• Justice Denied to Victims: The cyclical nature of the system stalls justice for everyone involved. Mentally ill defendants often bounce between jails and hospitals, only to be released back onto the streets, leaving crime victims in a permanent state of limbo waiting for cases to be resolved.
• Massive Taxpayer Burden: The state’s failure to provide adequate care has cost South Carolina taxpayers more than $25 million in wrongful death and medical malpractice settlements since 2014. And some inmates with serious mental illnesses cost taxpayers hundreds of thousands of dollars to house in local detention centers.

“Our investigation exposed the full depths of a growing crisis in our judicial system, where mentally ill defendants cycle through our jails and courts again and again without getting desperately needed treatment — only to be dumped on the streets to commit more crimes,’’ said Jeff Taylor, executive editor of The Post and Courier. “The consequences are often brutal for victims and are costly for taxpayers. Jail staff, police and judges are subjected to horrific circumstances that they are not equipped to deal with. And all the while, the accused remain trapped in despair and the grinding wheels of an overwhelmed system.”

The full story and video are online at postandcourier.com/CaughtInTheCycle

About The Post and Courier:

Founded in 1803, The Post and Courier is South Carolina's largest media company, the oldest newspaper in the state and the second oldest in the United States. Based in Charleston, South Carolina. The Post and Courier is an independently held, family-owned media company dedicated to transparent, fact-based journalism across South Carolina.