You have reached your limit of free articles this month.

Enjoy unlimited access to

Starting at just 99¢ for 8 weeks.


  • ePAPER

You have read of premium articles.

Get unlimited access to all of our breaking news, in-depth coverage and bonus content- exclusively for subscribers. Starting at just 99¢ for 8 weeks


Welcome to

This subscriber-only site gives you exclusive access to breaking news, in-depth coverage, exclusive interactives and bonus content.

You can read free articles of your choice a month that are only available on

How Kirk Watson wants to transform the aging Austin State Hospital

Austin’s state-run psychiatric hospital has long shown its age.

The 160-year-old Austin State Hospital — the oldest state psychiatric hospital — is plagued by deteriorating conditions and staffing shortages, limiting the number of people admitted for care and raising questions about its future.

State Sen. Kirk Watson, D-Austin, wants to save the Central Austin campus and remake the hospital into a cutting edge facility for research and treatment of mental illness. He plans to ask lawmakers to approve funding to replace the facility with an institution he’s calling the “MD Anderson of the brain,” referring to the renowned cancer research and treatment center in Houston.

GET THE DAY’S LATEST NEWS: Click here to sign up for our Afternoon Updates email

No longer would the state be alone in running the hospital, but rather, organizations like Travis County Central Health, Austin Travis County Integral Care and University of Texas Dell Medical School would serve as partners, according to Watson’s vision. The latter would train health care professionals to meet the community’s demand.

“This isn’t just about building another building. This is about taking an opportunity,” Watson told the American-Statesman. “We have an energized mental health community and I think if we spend some time planning, yes, we end up with a model that can be replicated nationally.”

Aging facility

Replacing the hospital is estimated to cost between $300 million and $400 million, according to the Texas Health and Human Services Commission.

Austin State Hospital is a 300-bed facility for people with severe mental illnesses, accepting only people who are in danger of hurting themselves or others. Patients usually stay a few weeks, get stable on medication, and then are released to get services in the community.

The Austin hospital has struggled for decades. Staff turnover is high, wages are low and patients and staffers have been routinely injured when patients get violent. Last year, the Centers for Medicare and Medicaid Services threatened to withhold federal money if the facility didn’t fix major issues, including severe nursing shortages and violating policies on restraining patients.

In 2014, a state-commissioned report stated that five state psychiatric hospitals — including the Austin hospital — needed to be replaced because they were in such poor physical condition. Austin’s hospital was established in 1857 as the State Lunatic Asylum. Additional structures were built in the 1950s and 1970s. Sprinkled throughout the 80-acre campus are empty buildings or those repurposed for storage, and functional buildings are sometimes spread apart.

The report found that the hospital was “poorly suited to support contemporary care.”

“Our state hospital system is deteriorating and needs to be fixed or replaced,” said Carrie Williams, spokeswoman for the state’s health commission. “Patients need psychiatric care in the right setting. We need to have a broad vision and be open to taking the system and mental health services to the next level.”

Watson’s big idea

Watson hopes the Legislature will authorize some money next session to start planning, but acknowledges that replacing Rusk State Hospital should be the priority. The Rusk hospital is in such poor condition that the federal government has determined that the hospital didn’t meet requirements as a Medicare provider.

Watson hasn’t outlined any specifics for his plan to remake Austin State Hospital. Even so, many stakeholders have lauded the former Austin mayor for aiming to reinvent mental health care in Central Texas.

Mental health advocates and policy experts told the Statesman that among their biggest wishes for the future of Austin State Hospital is to keep it at its current location at 4110 Guadalupe St.

“We need to keep it there. The best opportunity to involve family members and friends into the care of their loved ones is to keep it in a centrally located place that is accessible by public transportation,” said Greg Hansch, public policy director for the advocacy group National Alliance on Mental Illness Texas, which is based on the Austin hospital grounds.

Last month, the Health and Human Services Commission released the findings of a feasibility study to explore a variety of options for Austin State Hospital, including moving it to another location or consolidating it with Austin State Supported Living Center. Keeping Austin State Hospital at its current location was the least expensive option.

But selling the land could mean more money for the state’s coffers. The state’s General Land Office valued the land at $21 million.

Watson, too, wants to keep the hospital where it is.

In recent months, Watson has met with local health providers to drum up ideas of what a new hospital campus would look like, including ensuring that there is a continuum of care for patients that have a range of mental health conditions. Some of the suggestions include offering better substance abuse programs and more services for people with less intense psychiatric needs.

Putting a psychiatric emergency room on the campus or building some supported housing for clients there might make sense, said Dr. Jim Baker, chief medical officer for Austin Travis County Integral Care. There may be a better way to work with the courts for patients accused of committing crimes, he said.

Watson said it’s also possible that Dell Medical School or some other organization could run the new hospital.

Hansch said that medical students can help fill the need of more health care workers.

Andy Keller, president and chief executive officer of the Dallas-based Meadows Health Policy Institute, said that one of the largest advantages of integrating the state psychiatric hospitals into a medical school or a medical center is leaving behind the stigma of mental illness.

“It would be great that no one ever talked about the Austin State Hospital ever again after this happens. They talk about Dell Medical Center,” Keller said. Mental health is “medical care. As long as the mental patients are off somewhere else, that’s somehow unusual. But people with mental illness also have a lot of physical needs. They’re people.”

Reader Comments ...

Next Up in Texas News & Politics

Rick Perry chimes in on A&M student election; social media reacts
Rick Perry chimes in on A&M student election; social media reacts

Rick Perry, the former governor of Texas and current U.S. energy secretary, questioned the legitimacy of Texas A&M’s student elections in an opinion piece published Wednesday in the Houston Chronicle. Perry wrote that his alma mater’s disqualification of former student body president candidate Robert McIntosh, who garnered the most votes...
Conservation nonprofit breaking new ground in education
Conservation nonprofit breaking new ground in education

R. Brent Lyles has been in environmental education his whole career, from the time he taught seventh-grade science in a poor, rural county in North Carolina to today as executive director of the Colorado River Alliance. The nonprofit is tasked with advocating for the Colorado River, the source of Austin’s water and an economic engine of Central...
Community news: First ‘CodeTalk’ on Wednesday about environment

TRAVIS COUNTY DOWNTOWN AUSTIN First ‘CodeTalk’ on environment The city of Austin will hold its first of five “CodeTalk” sessions from 5 to 7 p.m. Wednesday at Austin City Hall, 301 W. Second St. CodeTalks are topic-based information sessions open to the general public but tailored to those who have profound interests in specific...
Austin board to vote on land parcels, preview revised facilities plan
Austin board to vote on land parcels, preview revised facilities plan

The Austin school board on Monday night is expected to approve the purchase of three land parcels for the expansion of Bowie High School and a future high school in Southeast Austin. Trustees will consider two smaller tracts next to the overcapacity Bowie High School that would go toward a multimillion-dollar expansion and modernization of the school...
Mulling Trump, trains and Lone Star while waiting on MoPac to open

I’ve got questions … What, for instance, does the president really think about trains? Some transit supporters, perhaps creatively looking for silver linings, speculated shortly after Nov. 8 that Donald Trump, having spent his life surrounded by New York subways and commuter trains, might be into locomotion. Can you really picture the...
More Stories