New $305 million Austin State Hospital unveiled as Texas revamps psychiatric system

Sign up for The Brief, The Texas Tribune’s daily newsletter that keeps readers up to speed on the most essential Texas news.

State leaders on Wednesday unveiled a new $305 million hospital, part of an $2.5 billion overhaul of the state’s aging psychiatric hospital system.

Austin State Hospital is a new 240-bed facility that has been built on the existing 80-acre campus located about three miles north of downtown Austin. The Old Main Building, which opened 1861 has been designated a historic landmark. It will continue to be used for offices, when the hospital opens its doors later this summer.

The sleek new building resembles a luxurious apartment complex, with 11 secure courtyards and screened porches, single-person patient rooms, each with its own bathroom, and plenty of recreational options, including a gym, salon, barber shop, chapel, general store, and more.

“This is going to simulate real-life situations so people can work their way through their recovery journey in a place that is here for their healing,” said Austin State Hospital Superintendent Stacey Thompson.

The building features tall windows and intricate modern designs that starkly contrast with the old brick buildings that have stood on the grounds for over a century.

“This is a good thing not only for our patients but our staff as well,” Scott Schalchlin, Texas Health and Human Services deputy executive commissioner.

Schalchlin, who oversees the operations of 10 state hospitals and 13 state-supported living centers, the residential facilities for individuals with intellectual disabilities, said the more modern facility will help with employee recruiting efforts.

“I think it’s also going to attract other professionals and other staff to want to come and work here,” he said.

Austin State Hospital, which has operated since 1861, is the oldest psychiatric hospital in Texas.

“It was constructed before railroads had even reached the city,” said Schalchlin.

State hospitals’ history

Wednesday’s ribbon-cutting is the latest renovation to the state psychiatric hospital system, which has 12 facilities or campuses in 11 cities across the state. When first designed in the late 19th century, the system’s facilities, then called asylums, treated the most mentally ill Texans. But with the introduction of psychotropic drugs in the 1960s, a national movement took hold to do away with the institutionalization of the mentally ill.

Like many state hospitals across Texas, the one in Austin fell into disrepair by the early 2000s. A 2015 state study identified the Austin campus as one of five facilities that should be replaced.

Today, state hospitals treat mostly forensic patients, that is, those individuals transferred from county jails or the state prison system because they were determined to be incompetent to stand trial or because a jury found them not guilty by reason of insanity.

In 2023, a little over 60% of adults treated inside state hospitals came from the criminal justice system, either from county jails or the prison system.

At the urging of county jail officials, state lawmakers undertook a massive funding operation to repair or build new state psychiatric facilities.

The Rusk State Hospital added a new maximum security unit with 100 beds; the Kerrville State Hospital renovation added 70 maximum security beds; the San Antonio State Hospital will renovate an existing 40-bed forensic unit to a 40-bed maximum security unit, and a new 50-bed maximum security hospital is being planned in Lubbock.

State hospitals’ role

Austin State Hospital’s three-floor, 381,687-square-foot building is expected to serve over 600 people per year on average, including criminal competency and civil commitment cases when space allows.

The new Austin facility does not increase the number of beds available to patients and the number of counties this hospital will serve has decreased from 38 to 26 due to new hospitals being built or renovated in Central Texas, including the grand opening of a new 300-bed replacement hospital in San Antonio that occurred in April.

Schalchlin acknowledged this might not be the answer to stemming the demand for mental health services in the community but pointed out that the state hospital system is currently considered the last stop, not the first option. He said partnerships with private hospitals and local mental health organizations are the key to addressing the demand.

“There is always going to be a need for mental health services, and you’re going to see in the upcoming session, as always, the need for more funds,” Schalchlin said.

Andy Keller, president and CEO of the Meadows Mental Health Policy Institute, said the opening of the Austin State Hospital marks an important milestone in the creation of a modernized hospital system for Central Texas.

“This is more than the opening of a brick-and-mortar building; it’s the latest and most exciting chapter of a new system that represents state-of-the-art in care, beginning with intake, continuing throughout treatment, and extending into aftercare,” he said.

We’ve got big things in store for you at The Texas Tribune Festival, happening Sept. 5–7 in downtown Austin. Join us for three days of big, bold conversations about politics, public policy and the day’s news.