Term of Award

Spring 2020

Degree Name

Doctor of Public Health in Public Health Leadership (Dr.P.H.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


College of Public Health

Committee Chair

James H. Stephens

Committee Member 1

Haresh D. Rochani

Committee Member 2

Linda G. Kimsey


Objectives: The purpose of this study was to explore significant factors related to access gaps of public mental health care in the state of South Carolina from 2016-2018. According to one source South Carolina was ranked among the nation’s poorest states when it comes to access to mental healthcare. Public mental healthcare utilization among adults age 18 and older diagnosed with severe mental illness (SMI) were analyzed to increase policymakers, mental health stakeholders, and hospital administrator’s awareness on meeting the psychiatric needs of individuals residing in South Carolina. Methods: This study is a non-experimental, retrospective secondary analysis of cross-sectional South Carolina All-Payer hospital discharge data during federal fiscal years of 2016 to 2018. This analysis used multiple logistic regression and multinomial logistic regression to predict the relationship between variables. Results: Adults diagnosed with SMI used emergency department (ED) services for public mental healthcare more than inpatient (IP) units in South Carolina hospitals. Utilization were predominantly associated with demographic characteristics regardless of geographic location. Younger adults (age 18-59) who utilized the ED for public mental health services were significantly more likely to be uninsured than older adults (age 60+). Patients with government assisted insurance used public mental health services in the ED more than patients with any other insurance. Adults diagnosed with major depression visited the ED more than any other SMI type and were more likely to be uninsured or obtain other insurance rather than have insurance through government assisted programs. Conclusion: Results from this study suggests government assisted insurance is a great resource for adults diagnosed with SMI using public mental health services in South Carolina. State budget cuts that decrease funding for adults diagnosed with mental disorders may add to the burden of poor mental healthcare access. Policymakers in South Carolina should tailor mental health interventions that targets younger and black adults diagnosed with SMI to contest high healthcare costs.

Research Data and Supplementary Material


Available for download on Wednesday, April 16, 2025