State Hospitals

State hospital facilities are Medicare-certified and Medicaid-approved, and has been accredited by The Joint Commission (TJC). File a Joint Commission complaint.

If you or a loved one is having a mental health crisis, please call 9-1-1 immediately. Texas Health and Human Services operates nine state hospitals and one residential youth center for people with mental health issues. These facilities are located across the state. Each serves a different population, which may include:

  • Adults.
  • Children.
  • People involved with the justice system.


If you would like to seek admission or discuss whether inpatient hospitalization is appropriate, please contact your local mental health or behavioral health authority.

The Role of the LMHA/LBHA

The appropriate Local Mental Health Authority or Local Behavioral Health Authority screens patients seeking admission to the hospital to determine the least restrictive treatment environment. This includes private providers.

The LMHA or LBHA gives important facts to the facility, including patient identifying information, legal status, medical and medication information, behavioral data and other treatment information.

If a person seeks admission without prior screening by the LMHA, the hospital conducts an emergency medical screening, in compliance with Emergency Medical Treatment and Active Labor Act and consults with the LMHA. EMTALA is a federal law that requires hospital emergency departments to medically screen every patient who seeks emergency care and to stabilize or transfer those with medical emergencies, regardless of health insurance status or ability to pay. The admitting physician has the final authority regarding admission of an individual, consistent with resources available at the hospital. All patients sent to the facility through court commitments are evaluated for admission. In general, to be involuntarily admitted, you must show symptoms of mental illness and that you are a danger to yourself or others.

The appropriate LMHA routinely screens all requests for voluntary admission to ensure hospitalization is the least restrictive treatment alternative. No person is denied voluntary admission without thorough documentation and appropriate referral, as recommended by the screening physician.

What to Expect during the Admissions Process

Almost all hospital admission departments are open 24 hours a day, seven days a week. Admitting procedures include a psychiatric evaluation, a nursing assessment, creating a patient record and taking an identification photograph for the patient’s medical record. We provide the booklet, Your Rights in Facilities, to all incoming patients. We will also give you an Admitting Rights Packet, and we make a record of all your belongings and money.

IMPORTANT: We encourage families to take home valuables and other items you don’t need during hospitalization. Valuables kept at the facility are at the patients’ and families’ own risk.

Patients should bring no more than five changes of clothing. Bring comfortable items such as sports shoes, loose fitting clothing that is easy to wash and comfortable sleeping clothes.

Admission staff search incoming patients and all their personal property to make sure all personal items that can be dangerous to the patient or others are removed and held for safekeeping.

How Forensic Admissions Work

If a judge rules that a defendant is incompetent to stand trial:

  • The judge issues an order for inpatient competency-restoration.
  • The court mails a copy of the commitment order to the state hospital system’s forensic mailbox to add the person to the waitlist for admission to a state hospital.
  • Patients needing maximum security because of the level of the charged offense will be admitted to either North Texas State Hospital in Vernon or Rusk State Hospital.
  • All other patients are admitted to one of the other seven state hospitals across Texas as determined by the county of commitment.
  • Patients are admitted in the order that their commitment is received.

Email the state hospital system if you have questions about their forensic process.

Assessment of Patients

The physician assigned to admission duty provides an admission psychiatric evaluation, physical assessment and admitting orders. Upon arrival to the appropriate treatment program, a physical examination is completed within 24 hours. Admission procedures include tuberculosis skin testing, appropriate laboratory tests, and other diagnostics. Staff conduct a dental screening, address the patient's past medical history and the need for any special precautions, and complete a psychiatric evaluation, nursing assessment, rehabilitation assessment, and social history. Assessments are culturally sensitive and appropriate. With the patient's permission, a treatment team representative, usually the social worker, initiates contact with the patient's family or significant others. Patients are encouraged to include family members and/or significant others in their treatment, as appropriate.

State Hospitals Fee Assessment

Charges to an individual served at a state hospital will not exceed the facility’s current daily maximum rate. The current maximum rate is established by HHSC and reflects the average daily cost of support, maintenance, and treatment.

FY 2024 Current Maximum Daily Rate of Charge to Individuals Served at State Hospitals
FacilityAdult Inpatient ServicesChild and Adolescent ServicesGeriatric ServicesResidential Services
Big Spring$846NANANA
El Paso$931NANANA
North Texas$579$928$1,079NA
Rio Grande$846NANANA
San Antonio$895NA$1,062$609

Assessing fees for services provided to a minor individual in a state hospital:

The following sources of funds are property from which the state may be reimbursed for a minor individual's SMT and are considered separately in assessing a fee:

  • third-party coverage of the minor individual;
  • the minor individual's benefits from governmental and non-governmental agencies and institutions;
  • child support ordered in a divorce or attorney general proceeding or a suit affecting the parent-child relationship pursuant to Texas Health and Safety Code §552.014 and §593.077;
  • real or personal property in the minor individual's guardianship estate or owned by the minor individual; and
  • the net taxable income of the minor individual's parent, in accordance with the Taxable Income of Parents (PDF) formula.

Assessing fees for services provided to an adult individual in a state hospital:

The following sources of funds are considered separately in assessing a fee:

  • third-party coverage of the adult individual;
  • the adult individual's benefits from governmental and non-governmental agencies and institutions;
  • real or personal property in the adult individual's guardianship estate or owned by the adult individual or spouse; and
  • monthly gross income of the adult individual (excluding income from the adult individual's benefits from governmental and non-governmental agencies and institutions) and income of the spouse, in accordance with the Adult Individuals in Inpatient Mental Health Facilities (PDF) formula.

Appealing charges

If the individual or legally authorized representative (LAR) has provided complete financial information and disagrees with any fees assessed by HHSC, the individual or LAR is entitled to appeal such fees.

If considering filing an appeal, the individual or LAR must contact the reimbursement office of the facility providing services. HHSC reimbursement staff will determine if HHSC received complete financial information and notify the individual or LAR of the determination. HHSC recommends learning of the determination prior to initiating an appeal.

To initiate an appeal, the individual or LAR must complete and submit the Request for Appeal form (PDF) to the HHSC Appeals Division per the instructions on the form. If you are unable to access the Request for Appeal form, contact the facility providing services and request to speak with the Reimbursement Office.

Further information

For further information, see the Texas Administrative Code pertaining to charges for services in state facilities: Title 26, chapter 910 relating to Charges for Services in State Facilities.

Tobacco-Free Facilities

All tobacco products are banned on state hospital property. This includes cigarettes, e-cigarettes, cigars, snuff, chewing tobacco and any other tobacco products. Lighters and matches are also banned.

Access to Tobacco

Employees are prohibited from sharing any tobacco products with any person served. Employees, volunteers, visitors, vendors, contractors or anyone on the campus who uses tobacco products must make sure patients cannot access, nor are offered these products. All visitors must store tobacco products and lighters securely out of sight, including tobacco products left in private vehicles parked on hospital property.

Cessation Aids

We permit nicotine patches, nicotine gum, nicotine nasal spray or similar aids designed to help people quit using tobacco. When cessation aids are required for patients, the patient’s doctor in coordination with the treatment team will order them. Patients must have a doctor’s order to use them while in treatment. Employees may not share tobacco cessation aids with patients.