Why a new, needed addition to a state mental hospital is vacant

The new unit of the Kerrville State Hospital doesn’t have enough staff to open.

By Michael MarksFebruary 22, 2023 12:38 pm,

A new unit at the Kerrville State Hospital was supposed to reduce wait times for patients who need a spot at a state mental health facility. The addition has room for 70 patients. But right now, the new psychiatric unit is vacant, despite the fact that construction finished five months ago.

The facility is about an hour west of San Antonio, and cost the state more than $30 million dollars to build. Eric Dexheimer, investigative reporter for the San Antonio Express-News and the Houston Chronicle, spoke to the Texas Standard about the new unit. Listen to the story above or read the transcript below.

This transcript has been edited lightly for clarity:

Texas Standard: Why aren’t there any patients at this new hospital in Kerrville? I can’t imagine there’s not demand for this. 

Eric Dexheimer: Well, the short answer is that the state hospital system can’t find enough workers like a lot of companies in the country right now. They’re just having a hard time hiring. 

Well, why is it so difficult? I mean, I’m sure there are a lot of ways you reach out to these professionals, if not in Texas, beyond its borders?

Well, there’s a few reasons. One is the national picture is that there’s a worker shortage and companies have been reluctant to raise wages. More specifically, the state of Texas has been reluctant to pay its workers in the health care system what the going rate is. So over the last few months, they’ve tried raising wages a couple of times and they’ve seen bumps in applications, but they’re still having a hard time filling the positions.

So how much of this would you say comes right down to the amount of money that the state’s willing to spend on mental health professionals?

I’d say, you know, at least part of it. The state has always been reluctant to pay workers what they’re worth. At a House committee hearing last week, one of the representatives said, “you know, when it comes to kind of the people’s professions, we’re always trying to nickel and dime.” So I think that’s a large part of it. 

At the same time, there are a lot of people in Texas who are waiting to get a spot in just such a facility. How long is the waitlist for a bed at a state mental hospital right now? 

Well, depending upon that commitment, it can be 270 days to about a year and a half. If a person is just waiting for a regular bed to if they have a psychiatric emergency, or if they’re trying to get restored to competency to stand trial, it’s a little less than a year. But for people who are a little more serious and need high security, it could be a year and a half, sometimes up to two years.

Could you say more about where the patients for these sorts of psychiatric facilities tend to come from?

Sure. So there’s two types of patients. The first one, is what’s called a civil commitment – that’s someone who has been deemed to be a danger to himself or others. And so those people typically are ordered in by a judge for a short period of time, or sometimes they walk in voluntarily. The second type of patient is called a forensic commitment. They come in through the criminal court system. There’s two types of those. One is people who have been judged to be not guilty by reason of insanity, so still need psychiatric treatment. The other kind is a person who has been arrested for a crime but who has mental disabilities such that they render them incompetent to stand trial.

So is there any estimate for when the Kerrville State Hospital might finally be able to take in patients? This is part of a very old institution there in Kerrville. 

That’s correct. This is a brand new unit that was built using money that the Legislature appropriated in 2017 to try to increase capacity. And it’s a maximum security unit, which is the type that is most needed in the state hospital system. They had just recently bumped wages for the second time starting Feb. 1. The state says it’s getting an uptick in applicants, but at the same time, this unit needs about 260 employees to get underway. So I haven’t heard any estimates. But last week they, the administrators for the system, told state legislators they were optimistic that they would have enough people in the coming year to get it open.

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