Recovery by the River

Texas Health & Human Services Commission|San Antonio, TX

Texas is home to some of the fastest growing cities in the nation. However, the state’s mental healthcare system, particularly forensic services for pre- and post-adjudication, had not adapted its facilities to match current psychiatric care models and trends or needs. As the judicial and correctional systems became overburdened, demand on the existing state hospitals exaggerated the deficiencies. Key political, academic, and government leaders recognized the inefficiency and ineffectiveness of services and initiated an effort to develop a new vision for the entire system, one that provided the best mental healthcare while reducing long-term costs per patient.

Project Type:
Mental Health

Cost:
$282 million

Size:
535,000 sf

The Vision

This vision was ambitious. Those advocating for change understood what it would take: funding for new
facilities, collaboration between all stakeholders, a willingness to learn from and partner with academic
institutions, and a broader spectrum of services throughout the state. From this explosion of optimism,
studies were developed to inform budgets and bed capacities for several new state hospitals. In 2018,
architecture+ was engaged with HKS Architects to program, plan, and design the new 300-bed San Antonio State Hospital on the existing campus. The new modern hospital design would afford both patients and staff a comfortable and safe environment that fosters the process of recovery.

Early visioning sessions referred to the five historic missions along the San Antonio River as inspiration not only for design elements but also the very nature and purpose of the hospital - to heal by instilling comfort and hope. True to the original vision, the design process engaged all stakeholders and evaluated environmental and operational aspects of the hospital. We focused on what care givers and patients at SASH needed for effective recovery, employing innovative and best practices while building on regional culture and values.

The resulting hospital - contemporary, familiar, spacious, intuitive, and filled with natural light - welcomed its first patients in the Spring of 2024. Initial reports from patients and staff are a heartfelt testimony that our combined efforts have hit the mark set by leaders nearly six years prior.