Mental health and substance use disorders are the leading causes of disease in the U.S., and our behavioral health system is failing people and communities in need.

The evidence is overwhelming: more suicides every year, overflowing jails and prisons, an opioid addiction and overdose epidemic and Emergency Departments (EDs) with patients in psychiatric distress with nowhere to go. The number of people and families in our state and nation affected by mental health conditions and substance use disorders is substantial and growing. South Carolina ranks near the bottom on many measures of the adequacy of the behavioral health services system, including the availability of public psychiatric beds, efforts to divert mentally ill individuals and per capita state mental health expenditures. Recent findings from the World Health Organization suggest that every dollar invested in mental health treatment can provide four-fold returns in work productivity. The social, economic and human toll of behavioral health issues is unprecedented and, more than ever, we must collaborate and invest to improve the health and well-being of the people of South Carolina.

Behavioral health illnesses are more common than most people realize. Nearly one in five adults in South Carolina has a mental illness, and nearly nine percent have an addiction to alcohol or illegal drugs. For South Carolinians ages 18 to 25, the percentage is even higher with 14.5% addicted to alcohol or illegal drugs. Table 1 reflects a number of indicators of behavioral health prevalence for the U.S. and South Carolina.

The mental health and opioid crises are closely linked; the majority of individuals with a serious mental illness have more than one diagnosis, including substance use, which often leads to time in jail or imprisonment. The increase in all-cause mortality (increased by 134 deaths per 100,000) among middleaged white and non-Hispanic men and women with low levels of education between 1999 and 2013 is largely attributed to the increase in suicides and drug poisonings.