We tend to think of healthcare disparities in terms of race or socioeconomic class, but there’s another important factor that determines health outcomes in South Carolina that we don’t often talk about—geography.
In the more remote corners of South Carolina like the town of Abbeville, which sits in the northwest corner of the state 45 miles south of Greenville, there simply aren’t a lot of specialized health services for those in need. This is a particularly challenging problem for those suffering from mental health or behavioral health illnesses.
“We have virtually no behavioral health services and no full-time psychiatrist doctor in Abbeville County,” explains Ernest Shock, Chief Nursing Officer at Abbeville Area Medical Center.
If a patient in the hospital’s emergency room needed to see a behavioral health specialist, they would often have to wait hours, even days, before a hospital bed opened up that they could transfer to.
“The longest we had a patient-in-crisis wait was 8 days,” he recalls.
This has been an escalating problem since funds for mental health services began getting cut in the 1980s, but things got particularly bad in the wake of The Great Recession in 2008, when many state governments trimmed back on their mental health spending even more. This seems to happen because it’s not seen as a crucial service, but the numbers beg to differ—1 in 17 Americans live with a serious mental illness, including 1 in 10 children.
Fortunately, advancements in telehealth have alleviated some of the strain on rural facilities and eased the struggles of many of these patients. Abbeville’s hospital is again a great example. Thanks to a recent grant to the South Carolina Department of Mental Health, the hospital received funds to purchase telehealth equipment that facilitates psychiatric evaluations for patients. In lieu of waiting for a bed to open up at a state mental health facility, specialists can examine patients remotely and begin directing treatment.
“Oftentimes they just need to tweak their medications,” says Shock. “Instead of waiting for a bed, we can send them home after treatment by the tele-psychiatrist.”
Now that they have the equipment, Abbeville’s telehealth system is entirely self-sustaining. They just pay a set monthly fee to call for a consult via telemedicine to psychiatrist with the South Carolina Department of Mental Health, something which has vastly improved the quality of care for their patients.
Shock recalls one patient in particular, a teenage girl, for whom telehealth evaluation made all the difference.
“She came into the hospital in crisis, and she was harmful to herself and others,” he recounts.
The hospital staff were surprised by her ferocity and strength, given her size. Eventually she was placed in an isolation room and restrained to her bed.
“It was an extreme situation,” he admits.
Thanks to a timely telehealth assessment though, the hospital was able to get her quicker access to an in-patient facility that could treat her properly.
“We got her into that facility the same day,” Shock says proudly.
Abbeville is currently looking at other opportunities to expand their telehealth services in a way that offsets the lack of specialists. Shock points to cardiology as another area which could benefit from this avenue of treatment.
“We’ve reached out about a lot of possibilities,” he says enthusiastically.
And while telehealth solutions are still in their infancy, it’s clearly already making a difference in the quality of care South Carolina’s rural citizens experience.