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After 158 Years, the Austin State Hospital Deserves Better

James Rambin February 6, 2019 Comment

Last week, we saw the release of a master plan for a redesign of the Austin State Hospital campus, a state-owned mental health facility located at 4110 Guadalupe Street near the Hyde Park neighborhood. A group venture between the University of Texas at Austin’s Dell Medical School and the Texas Health and Human Services system, the plan is just one piece of a $300 million project to replace and renovate the state’s woefully-underfunded system of psychiatric hospitals and other care facilities.

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Touring ASH today. 3rd floor.

A post shared by Jillian Randall (@alphajustakid) on Apr 20, 2017 at 1:09pm PDT

Originally opened as the Texas State Lunatic Asylum in 1861, the facility gained its current, less-spooky title in 1925. Despite the name change, the prison-like property remains fenced away like the asylums of old, its streets disconnected from the grid and its interior cut off almost entirely from the surrounding neighborhood. There are security concerns involved with psychiatric treatment, of course, but even for a facility of this nature, its environment is thoroughly depressing.

An aerial view of part of the Austin State Hospital campus, with Guadalupe Street visible on the left. Image: Bing Maps

Though any redevelopment is clearly a step in the right direction for the state’s ill-equipped mental health services, it’s difficult to look at the current plans and not be disappointed by their downright suburban appearance. Remember, we’re talking about a 66-acre plot of centrally-located land just north of the University of Texas, sandwiched between the two major transit corridors of Guadalupe Street and North Lamar Boulevard. This site is surrounded by state-owned buildings like the office facilities of the Texas Health and Human Services system — which, for the record, are seven stories tall — and yet, this plan appears dominated by two and three-story buildings at best:

A rendering of a potential redevelopment of the Austin State Hospital campus. Click for a larger view. Image: Page

It doesn’t have to be, either, since state-owned property is technically unzoned and not subject to the city’s typical height restrictions. So, why not build up? The hospital’s own master plan report and the larger body of research on mental health facility design indicates single-occupant rooms and larger overall per-patient square footages are associated with reduced rates of violent incidents — and somewhat paradoxically, adding floors to these buildings could allow for more space allocated to each patient.

Though located outside the city upon its initial construction, the current campus of approximately 95 acres is now situated within the center of Austin, with vibrant residential neighborhoods, mixed-use development, and busy streets on all sides.

— ASH Master Plan Report

A land use plan from the ASH Master Plan shows the possibility of a completed redevelopment at the site, a vision perhaps more optimistic than the one seen in the concept rendering. Click for a larger view. Image: Texas Health and Human Services Commission / Dell Medical School

We’re not talking about cramming people in like sardines or building giant prison-like facilities, either. At the scale we’re looking at here, adding only a floor or two to some of the buildings in these renderings would allow for a smaller overall development footprint while accommodating the same square footage and number of available beds. This could free up space for additional growth down the line, or even private development on a portion of the property.

This wouldn’t be the first time the Austin State Hospital allowed outside development on its land — directly south of the facility, the Gables Central Park apartments and shopping center containing Central Market are both located on part of the original ASH property, on a 75-year ground lease from the state. Though we don’t know the current numbers, at the time of the transaction the Gables land deal alone was expected to net the state’s mental health services system millions of dollars a year.

A zoomed-in view of the southeast corner of the concept rendering for the ASH redesign — surface parking lot and all. Image: Page

This sort of public-private land exchange could provide the ASH facility with additional operating funds — which, as the state’s report points out, tends to manifest itself in the form of additional beds — if the facility were willing to consolidate its design with larger buildings and increased floor counts. (A denser built environment would, as a bonus, help preserve more of the old-growth trees at the campus, which could probably have some therapeutic value.)

The new campus framework plan will encourage an open and welcoming environment of health and wellness. The new ASH campus will focus on engaging the community that surrounds it by creating accessible public spaces and street design that includes generous tree-lined sidewalks in order to encourage engagement with residential neighborhood[s].
[…]
The ASH Brain Health Campus Master Plan calls for replacing the outmoded ASH buildings with a modern inpatient facility and a strategy to operationalize the broader redesign of the care continuum within this service area. Creating an attractive and user-friendly brain health campus can be an incentive for strategic partners to locate on campus. By so doing, the campus will help to destigmatize the care of people with mental illnesses, fostering greater empathy and acceptance of these common conditions.

— ASH Master Plan Report

Allowing development on a portion of the property wouldn’t necessarily alter the mission of the ASH facility. In fact, it could help centralize the state’s mental health operations by allowing room for multiple categories of on-site facilities, such as therapeutic housing, transitional care, and other cooperative services to treat patients along what the ASH report calls the full “continuum” of psychiatric care without shuffling them between different locations around the city (or state) during the recovery process — from a short-term crisis center to a longer-term housing facility, for instance.

A slide describing the primary goals of the ASH master plan, with an emphasis on facilities design and the “continuum of care” enabled by a larger variety of on-site mental health services. Click for a larger view. Image: Texas Health and Human Services Commission / Dell Medical School

Partnership opportunities with outside operators are discussed in the new master plan report for the ASH, but again, the scale at which the buildings at this campus are designed will determine the capacity and variety of available on-site services, as well as the amount of revenue the state is able to attain to run its own facilities.

A slide from the ASH Campus Master Plan document, showing the location of the new hospital facility planned as part of the redevelopment’s first phase (marked with an “H”). Click for a larger view. Image: Texas Health and Human Services Commission / Dell Medical School

The Friends of Hyde Park neighborhood organization actually has similar feelings on the potential of this site, and voted back in 2016 to pass a resolution supporting development at the ASH campus with a focus on the property’s suitability for affordable housing. That’s also something additional density in this master plan could facilitate, though supportive housing for patients seems more likely.

I don’t think anyone is against having mental health services there, but the site location would be better served with a mix of services and amenities . . . any one type of service or use for that large central location would be a bad plan. The same health services planned in the design could be included as well as other uses such as additional housing, affordable housing, housing for the homeless, and walkable amenities that the surrounding neighborhoods could also use if they added more stories to the buildings. Unfortunately, if this plan succeeds, it would lock this location into a poor land use pattern for decades to come.

— Pete Gilcrease, Friends of Hyde Park Chairman

After reaching out to the Dell Medical School about the plan with questions related to the concerns I’m voicing here, I received this response from Steve Strakowski, M.D., the school’s founding psychiatry chair:

The images shared this past week come from the ASH campus master planning and are concepts rather than specific building design. We have just entered the design phase and are awaiting Legislative decisions regarding funding. As a concept drawing, the total number of floors is still undefined. However, the size and location of the new hospital took into account continuing the operations of the existing hospital facilities located on the ASH campus to ensure continued care of individuals. 

We’re currently focusing on the new facility within this redesign, and have suggested several opportunities for other partners within this continuum of care. Some of the suggested partners look at supportive housing as options within the future redesign. The goal is to provide care to people in their community and decrease the reliance on the state hospital, leading us to build the appropriate size hospital for the 38 adult counties it serves.

— Steve Strakowski, M.D., Dell Medical School

As Strakowski mentions above, opening a new 240-bed hospital facility at this property is the first priority of the master plan, with the rest of the build-out expected to follow over the next couple of decades — so let’s hope that between then and now, they decide it wouldn’t hurt to add a few floors.

Header image caption: A concept rendering of a streetscape at the redeveloped Austin State Hospital site. Image: Page

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Filed Under: Blog Tagged With: 78751, architecture, design, development, urbanism

About James Rambin

James is an Austin native and fifth-generation Texan, but tries not to brag about it. Email him anything at james@towers.net.

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