The Austin State Hospital is reopening its doors following a $304.6 million makeover and will soon be providing brain health services to hundreds of Central Texans across dozens of counties.

The big picture

The Austin State Hospital is the state's oldest psychiatric hospital that first welcomed patients back in 1861.

The ASH's rebuild came together over the past decade after a state-commissioned report found much of Texas' psychiatric hospital network was "functionally obsolete," and facing widespread infrastructure and care challenges.

Since then, legislative efforts poured around $2.5 billion into the hospitals run by the Texas Health and Human Services Commission, including the ASH. That plan has also seen hospitals completed in Houston, San Antonio, Kerrville and Rusk, while several other projects are now in planning or development.

Scott Schalchlin, deputy executive commissioner for the HHSC's Health and Specialty Care System, called the continuing statewide hospital initiative a "turning point" for mental health treatment in Texas.

"More than ever people understand this is a medical issue, and it can be treated. More people with mental illness are receptive to treatment, and more people understand that state hospitals are the last stop on that continuum, and that people that receive treatment for mental illness at that level that is most appropriate for them," Schalchlin said during the ASH's grand opening May 15.

The details

The ASH redevelopment broke ground in 2019 as a partnership between the HHSC and Dell Medical School at The University of Texas. HHSC Executive Commissioner Cecile Erwin Young called the project an "unprecedented investment" in the state hospital system's future.

The new ASH, situated on about 15 acres of the state's Triangle health care campus at 4110 Guadalupe St., now contains 240 patient rooms for inpatient psychiatric care. The HHSC expects the new facility will serve nearly 700 people per year once it's up and running.

The three-story, nearly 382,000-square-foot ASH is broken up into 10 patient units with shared community spaces. The hospital also has multiple courtyards with a mix of active and sensory features.

A "downtown" at the center of the ASH offers a gym, general store, cafe, bank, chapel, greenhouse and gardens, and other common areas for patients to gather and practice life skills needed upon their exit from the hospital. The downtown also serves as a meeting place for both clients and visitors.

Stephen Strakowski, associate vice president for regional mental health at Dell Medical School, said the facility's successful modernization reflects the local support for mental health care and will be a boost for both patients and caregivers.

"I believe that having this really beautiful facility in some of the most expensive real estate in the country, on a very busy thoroughfare next to ... hoity-toity marketplaces in the city is a declaration that we in Austin take this seriously, we think it’s important, we want it to be a part of our neighborhoods, and we’re glad to have it here," he said.

Following the ASH's May grand opening, the first new patients will be moving in during the summer.

Patients are admitted to state hospitals through a screening process handled by local mental health authorities; Integral Care is Travis County's.

Put in perspective

The ASH's reopening adds a significant new resource to the local health care landscape and builds on efforts by many area officials to improve access to mental health care.

For Mayor Kirk Watson, the ASH's overhaul marks the end of years of work to modernize the Austin brain health facility. As a state senator, Watson was involved in a bipartisan push to fund state hospital projects including the ASH. It's one of his several health care goals for the city, such as the creation of a medical school at UT.

He called the new Austin State Hospital's funding and development one of his proudest achievements in decades of public service, and said the facility will now serve a central role in local mental health response across jurisdictions.

“This will be the hub of changing how we do brain health," Watson told Community Impact. "I’m not sure we would have success in some of the things we will be doing, and some of the things that we’re currently doing and are starting up, but for having a now-world class brain health center right here in Austin.”

He also said the impact of the new ASH could tie into broader mental health initiatives in Central Texas like the Travis County-led effort to divert people with mental illness away from jail. A pilot for that criminal diversion program promoted by County Judge Andy Brown—which partially stems from research by Strakowski into mental illness and incarceration—is being funded by the city and county and will launch this summer.

“It’s all part and parcel. And what has not happened in the past enough is the recognition that it’s all part and parcel, and you’re seeing that," Watson said. "It’s already started, but [the ASH] will be the hub that kind of catalyzes things."