According to state data shared with the Joint Committee on Access and Forensic Services, almost 800 of the nearly 2,000 patients in Texas state hospitals have been admitted for more than a year. These “365-plus” patients have an average length of stay of 1,591 days—over four years. Texas operates 10 state hospitals for people with mental health issues plus one youth residential treatment center.
Long-stay patients limit capacity for new admissions, creating waitlists for services. The average waitlist for maximum security unit beds peaked in fiscal year 2023 with more than 1,000 people but has since dropped to about half that number. For non-maximum security unit beds, the average waitlist dropped from about 1,400 in 2023 to about 1,200 in 2024, though it has since increased. More than 250 long-stay patients are considered “ready for discharge” by treatment teams but remain hospitalized.
Most of the 365-plus population are forensic patients, meaning their hospital stay is related to the legal system. For forensic patients, discharge authorization requires a judge’s approval. However, discharge timing is influenced by factors beyond judicial determinations. Dr. Jeffery Matthews, Chief Medical Officer for Texas state hospitals, implemented patient discharge needs forms to understand barriers to release. These forms assess appropriate living settings, clinical considerations, and medical needs.
According to December discharge needs form data, about one-third of patients in state hospitals did not require continued inpatient hospitalization if support and monitoring were available outside the hospital. Primary barriers to discharge include lack of available discharge placements, absence of caregivers, and lack of insurance. The state is expanding hospital bed capacity and building new facilities, including the first state hospital in the Dallas-Fort Worth Metroplex. State officials are developing a long-term plan for state hospitals, with a public comment session scheduled for February 2.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.houstonpublicmedia.org/articles/news/health-science/healthcare/2026/01/15/540787/texas-state-hospitals-behavioral-health-patient-stay-data-services-waitlist/