Mental health ‘game changer’

New UT hospital will provide relief to the county jail, allow longer care

The University of Texas Health Science Center at Houston is set to receive the first $6 million of $125 million in state funding to build a psychiatric hospital, the first new public mental health facility in Harris County in 31 years.

The 300-bed hospital will be built on land adjacent to the 274-bed, UTHealth-run Harris County Psychiatric Center, providing relief in an area so underserved that the Harris County Jail is considered the state’s largest mental health facility.

“This is a game changer for Harris County,” said Dr. Jair Soares, chair of psychiatry at UTHealth’s McGovern Medical School. “It should decompress the situation at the jail and allow local patients who needed longer stays to be treated near home.”

Combined with the Harris County Psychiatric Center, the new hospital would make the UTHealth Continuum of Care Campus for Behavioral Health the largest such academic center in the nation.

The Texas Health and Human Service Commission announced Monday it is releasing the first round of funding approved by the 2017 Legislature for mental health projects around the state. UTHealth hopes to break ground on the new hospi-

tal by early 2019 and begin admitting patients in fall 2021.

The new hospital will admit many patients currently discharged by HCPC, which has only acute-care beds and where the average length of stay is about seven to eight days, partly because it has roughly 45 patients waiting to be admitted at all times. The new hospital will have some acute-care beds but mostly be composed of subacute and residential treatment beds.

It also will mark a new model of state residential psychiatric care. Under the nearly 100-yearold model, psychiatric patients requiring long-term treatment are sent to state hospitals in areas far from where the patients and their families live.

Rusk State Hospital, the closest to Houston, is more than a three-hour drive.

Rusk is where HCPC patients needing longer term care theoretically would go, though Soares said only a small percentage do.

The new model calls for such treatment to be delivered in cities, near other psychiatric facilities, as part of an effort to emphasize a continuum of care and do away with the stigma historically associated with mental illness.

HHSC said Monday it will give UTHealth the first installment to allow planning to begin and architects to be hired to design the facility. Soares said the center hopes to receive the rest of the funding, to be given in installments, as the year unfolds.

‘Addresses obvious need’

“This is a huge deal for Houston,” said state Rep. Sarah Davis, R-Houston, a member of the House budget-writing committee who played a key role in passing the mental health funding. “It addresses an obvious need and has the potential to save taxpayer dollars by keeping patients out of jails, where they’re more expensive to house, don’t get adequate long-term psychiatric care and typically end up back on the streets.”

Harris County Judge Ed Emmett, a longtime advocate of the need for more public psychiatric beds, added that “this is some of the best news I’ve heard relative to mental health in some time. It doubles capacity — still not enough — and puts mental health into the whole Texas Medical Center research environment where it will get the same due as conditions like cancer and heart disease.”

Currently, the only public inpatient psychiatric care in Houston besides HCPC is 27 beds at Ben Taub Hospital. Seven of those are in Ben Taub’s psychiatric emergency center for monitored stays of less than 72 hours, and about 20 are at the Neuropsychiatric Center run by the Harris Center for Intellectual and Development Disability, formerly known as the Mental Health and Mental Retardation Authority of Harris County.

The Texas Medical Center owns the land, currently occupied by a small parking garage, where UTHealth will build the new hospital. The TMC is donating the land to the state, which will be considered its owner. UTHealth has a similar arrangement with HCPC, which is jointly owned by the state and county.

Harris County Mental Health Court Probate Judge Rory Olsen said the announcement “shows the state of Texas is working diligently to improve mental health services for the people of Texas.”

“When HCPC opened, it had adequate capacity to serve our needs,” said Olsen, whose 2013 writing on the subject is credited by UTHealth leaders for galvanizing the movement for a new facility. “But in the 31 years that have since passed, the county has grown and our population has grown. Thus expansion is needed to continue staying ahead of the curve.”

From hospital to jail

HCPC was originally intended to house 500 beds. Because of limited funding, it was built to house only 250.

Patients who are discharged from HCPC even though they would benefit from longer-term care often run into trouble with law enforcement. The Harris County Jail calculates that it houses more psychiatric patients than all of the state hospitals combined.

Besides the $6 million Texas HHSC announced Monday will be coming soon to UTHealth, the agency said it will soon release another $41.7 million for other state projects, part of the 2017 Legislature’s $300 million effort to begin improving public inpatient psychiatric care.

The funding represents the first phase of a three-phase effort expected to be continued by the 2019 and 2021 Legislatures.

UTHealth leaders said the campus will be designed to address not only different levels of care but also to integrate the different types of care, including psychiatric, substance abuse and medical care. It will allow psychiatry and behavioral sciences to continue its research into the causes and treatment of behavioral health issues, and to expand its training of the next generation of healers.

Soares said there has some been some preliminary internal design work done on the building, but bidding for the project’s architect has yet to go out.

“It will be great to have the two hospitals together on one campus, providing a continuum of care,” said Soares, also executive director of the HCPC.

“It should have a significant impact on the vicious cycle we see of patients being discharged from acute beds, only to end up returning to treatment or being arrested.”