On Monday the Health and Human Services Commission (HHSC) announced the release of $47.7 million to begin improving the state’s inpatient mental hospital system, initiating a multiyear project to expand services and upgrade facilities.
The San Antonio State Hospital (SASH) is set to receive an initial $14.5 million toward the construction of a new facility; the estimated total cost for SASH construction and renovations is around $270 million.
“[SASH] serves thousands of people, not just in San Antonio, but in 54 different counties in South Texas,” said Sen. Carlos Uresti, whose Senate District 19 includes the state hospital. “We have duct-taped the state hospital to keep it together and keep it going, and we are finally bringing the necessary funds to give us a state-of-the-art hospital.”
Of the initial funding for the hospital, an additional $500,000 will go toward renovating an existing vacant building on campus to create a 40-bed unit, which HHSC spokeswoman Christine Mann said is an effort to “increase much needed capacity,” and will help to “[keep] people out of emergency rooms and [get them into] much needed treatment.”
“The legislature made a commitment to help us transform our state inpatient psychiatrist hospitals,” Mann told the Rivard Report. She said that some hospitals require renovations while others will need to be completely replaced.
The initial $47.7 million in funding is part of $300 million approved by the Texas Legislature last year following a formal three-phase plan submitted by HHSC to improve, or in some cases completely replace, the 10 inpatient behavioral health hospitals in the state, some of which were built in the 1850s.
Built in 1892, the San Antonio hospital located on the Southside provides psychiatric care for the city’s most vulnerable people, some as young as age 12. Mann explained that a patient may receive services anywhere from several days to several years, depending on the circumstances of their admission.
While patients may voluntarily admit themselves during acute mental health crises, many patients are referred through the courts when they are deemed incompetent to stand trial, or after committing a crime and being found not guilty due to insanity.
The San Antonio hospital currently has 230 patients, with a maximum capacity of 256.
A total of 850 staff members work in various general and specialist roles, attending to an adolescent psychiatric unit for youth age 12 to 17, an adult forensic unit for patients who are violent or are require court-ordered evaluation, a geriatric unit providing long-term services for patients 60 and older, and extended care services for patients 18 and older with mental illness that hasn't responded to treatment.
Uresti told the Rivard Report that he has spent a large part of his political career, beginning as a state representative, working on improving the quality of care and the infrastructure at the San Antonio facility, but securing funding always proved difficult. The $14.5 million SASH received, he says, “is just the tip of the iceberg” of the funding needed.
“I have toured the facilities, and I know that they are in a dilapidated condition, and some of them we can’t even use right now” Uresti said. Conditions at the hospital are “not unique,” he said, and renovating state mental health hospitals needs to remain a priority in upcoming legislative sessions.
“There is much more awareness about how mental health affects people,” he said, and focusing on renovations and improving services will “help people who have suffered way too long.”
The remainder of the $300 million will be distributed to hospitals as needed for the next two years as facilities finalize their building renderings and work toward improving the scope of their services.
“We have finally, in a bipartisan manner, had Democrats and Republicans coming together and saying, ‘Enough kicking the can down the road,' and instead said, 'We are going to put in the funds to make this happen,'” Uresti said.