Texas State Hospitals are comprised of nine state-owned mental health facilities and one state-owned inpatient residential treatment facility managed by the Department of State Health Services [see map below]. They serve as the last resort for children, adults, and forensic patients with serious mental illness who cannot be served in their communities or pose a significant danger to themselves and/or others. Texas State Hospitals work to stabilize these patients so that they can return to their communities for treatment. Services provided in these facilities include inpatient mental health treatment, nursing services, medical services, social services, therapeutic activities and psychological services.
There are different modes of admission to these facilities. Individuals are often referred by a Local Mental Health Authority or other community source for admission, including local law enforcement. If a person seeks admission without going through an LMHA, the state hospital must conduct an emergency psychiatric screening and the individual is admitted or not at the hospital’s discretion. These voluntary admissions (those that do not take place through referrals) can occur when a parent or guardian of a minor between the ages of 16 and 18 submits a written request for admission on the minor’s behalf. Involuntary admission occurs when an individual is detained by a peace officer and presented for evaluation at the facility. This is known as civil commitment and is intended to protect the individual from him/herself and others.
There are a total of 2,463 beds in the Texas State Hospitals, which most observers say is far less than what is needed. Average length of stay and average cost per patient vary widely among the facilities. Average length of stay averages at 74 days and average cost per patient averages to $21,437. Annual number served by these facilities could not be identified. Texas State Hospitals have been plagued by aging infrastructure, rapid growth in forensic populations, increases in medical costs and workforce shortages. The state hospitals are funded by a mix of payers, with 77 percent of funding in the 2016-17 biennium coming from state General Revenue, 5 percent from Federal sources and a remaining 19 percent from other sources, including Medicaid, state interagency contract funds, and third party reimbursements.Recommended biennial funding for 2018-19 totaled $629 million in state general revenue.