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History of SASH

San Antonio State Hospital

A Brief History

San Antonio State Hospital (SASH), as you see it today, is a far different place than existed on these grounds more than 100 years ago. In 1892 the Southwestern Insane Asylum opened on the southern edge of San Antonio. Nestled among pecan trees and situated on more than 539 acres, the bucolic setting, with its tree-lined main entrance on South Presa Street, offered “asylum” in the truest sense of the word. The asylum was a self-contained living environment: crops and livestock were raised on the grounds, which at the time included the land across South Presa. A large lake provided fishing and recreational activities for the patients. All staff members lived on the grounds and had to obtain permission to leave. The hospital grounds also included a cemetery where patients were buried when other arrangements were not possible. It was not until 1925 that the words ”lunatic” and “asylum” were removed from the titles of mental institutions and replace by “State Hospital.

In the beginning, each mental hospital was managed by its own individual Board of managers, which reported directly to the Governor. In 1920, mental health facilities were placed under a new agency, the State Board of Control. Another change occurred in 1949 when state hospitals were placed under the direction of the Board of Texas State Hospitals and Special Schools, a nine-member board appointed by the Governor. In the 1950’s and 1960’s, state hospitals became increasingly crowded and at SASH there was a time when as many as 3,000 patients were treated at the hospital with a staff one-third the size of today’s staff, which cares for approximately 300 patients daily. Increasing research and awareness of mental health issues resulted in the 1965 Texas Legislature passing the Texas mental Health and Mental Retardation Act. This act established the Texas Department of Mental Health and mental Retardation (TDMHMR); its purpose: to conserve and restore the mental health of Texas citizens and help people with mental retardation achieve their potential. Texas Department of State Health Services provides a network of residential and community services treatment approximately 151,700 citizens with mental disabilities.

In the mid-1960’s, the last of the original asylum building were torn down and replaced with modern dormitory-style units. In 1961, patient units were again refurbished losing the last of what remained of the old “institutional” look. Today, SASH shares its original 539 acres with the San Antonio State Supported Living Center and the Texas Center for Infectious Diseases. Staff no longer resides on the grounds. The two cemeteries still exist and are sought out by families searching for answers to hidden family histories.

San Antonio State Hospital is one of ten state mental health facilities within the Health and Specialty Care System, and serves individuals residing in 55 counties within 9 Mental Health Authorities.