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South Carolina Honors College

The Struggle for Help in South Carolina

Caz Kopf 

Back in the fall of 2020, I could feel a shift in my life. I felt it in class, in conversations with family and friends, and on the weekends lying in bed in the late morning. My heart would thump and my thoughts would spiral. I started therapy and found solace sitting on that gray couch tucked in the corner with my hands wringing themselves to the point of pain. There was now this chasm between a before and an after. The before, high-achieving goals trying to be fulfilled at the dining room table spending hours on homework, and the after, entire days spent in my bed staring at the wall, thinking for what felt like minutes but ended up being hours. I thought I was stuck in the after, but my process with therapy taught me there is so much more. My resources for therapy were a saving grace. However, for people with little to no funds or insurance, starting the healing, arduous journey of therapy is virtually impossible.

Admitting one needs help and finding therapeutic options is a difficult step, but an obstacle for some is paying for it. Starting therapy is already a hard process but worrying about paying for it often scares people away. However, this does not need to be a problem. There are options for in-network and out-of-network therapy and even options for people with no insurance. In-network therapy indicates therapists are credentialed by the insurance provider and clients have a copay while their insurance pays the rest after the deductible is met. Out-of-network therapy means the therapist is either not credentialed by the insurance provider or only accepts private pay, which means clients pay out-of-pocket for sessions. Insurance providers will later reimburse a percentage of what was paid once the deductible is met. Some therapists offer a sliding scale depending on income. A sliding scale allows clients to pay a reduced cost of the therapist’s normal rate. This is an available option for people with restricted or no insurance or has specialty needs. This option gives even more people the opportunity to work on their mental health.

According to Mental Health America, South Carolina ranks 16th in prevalence of mental illness, with first place being the highest. South Carolina also ranks 47th in access to care. It is time for South Carolina to help its citizens. Mental health is just as important as physical health, and they are often tied together. According to the National Alliance on Mental Illness, 706,000 South Carolina citizens are plagued with mental illness. This is 13.7 percent of South Carolina’s population. More than half of this number did not even receive treatment; 47.2 percent of this demographic did not seek out treatment because of the cost. These citizens deserve quality treatment to focus on getting better. Having the stress of not knowing how to pay for therapy is not going to help the journey of healing.

The National Alliance on Mental Illness says 2.3 million people in South Carolina live in communities with not enough mental health professionals. South Carolina needs to focus on its citizens because private pay and insurance are both inconveniences for clients and therapists alike.

“I worked at both public and private mental health care agencies,” says Erin Harrison, mental health counselor at James F. Byrnes High School in Duncan. “The intake forms were a major frustration and led to burn-out and disillusionment.”

Help should be easier to secure for everybody in the state. Citizens should not be scared away from getting the help needed because their state is not helping them.

I am lucky enough to have the resources for therapy and a supportive family. However, not everybody is as fortunate. These people should not be disregarded and forgotten by their state. They deserve the treatment and support to battle mental illness. Mental illness can often fool one into thinking they are alone in the world. Sometimes there’s a disconnect between people dealing with mental illness and everybody and everything around them. It isolates to the point where it feels like one is walking through the day in a fog. As a state, South Carolina needs to pull its citizens out of this fog. It is their duty. It is time for South Carolina to help its citizens, whether rich or poor, to get the treatment they need and deserve.

Works Cited 

"Blue Cross Blue Shield."
Blue Cross Blue Shield | Mental Health Coverage Zencare, Accessed 19 Sept. 2021.

NAMI: National Alliance on Mental Illness, Accessed 19 Sept. 2021.

"Ranking the States." Mental Health America, Accessed 19 Sept. 2021.

"Taking Insurance Vs. Private Pay in Private Practice – The Practice of Therapy." The Practice of Therapy – Resources, Tips and Advice for Success Private Practice, 18 Aug. 2016, Accessed 19 Sept. 2021.

"What is a Sliding Scale? Therapy Payment Options Explained." The Couch: A Therapy & Mental Wellness Blog, 11 Aug. 2021, Accessed 19 Sept. 2021. 

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