UT System chief medical officer stresses importance of reform in mental health hospitals


Five of the 11 mental health hospitals in Texas need to be replaced because of improper infrastructure and need for repair, according to David Lakey, UT System chief medical officer.

“You can no longer fix (the hospitals),” Lakey said. “You basically need to have a bulldozer to destroy them and a crane to build a new one if you want to fix this system.”

Lakey, along with other health professionals and legislators, are pushing for a reform on the state’s mental health hospitals. Lakey said the desire to change mental health facilities comes as some hospitals’ structures are deteriorating, making them unsafe for patients. Lakey said the hospitals, built over 100 years ago, no longer meet patients’ mental health needs.

“One hundred years ago, Texas was a very rural state, and we didn’t understand mental illness, and we didn’t have any medicine for mental illness,” Lakey said. “Now we have good medicines, we have hope, we try to heal individuals and get them back to the their lives.” 

Lakey, along with Andrew Keller, CEO and president of Meadows Mental Health Institute, wrote an editorial for the Dallas Morning News stressing the need for reform in mental health facilities. 

“Right now we’re putting people in (outdated) buildings that are both unsafe and super expensive to use,” Keller told The Daily Texan. 

Both Lakey and Keller provided the example of Rusk State Hospital, which had to close a ward last year due to mold.

“The units (at Rusk State Hospital) were not designed for people with mental illness, because people could hang themselves and commit suicide from the stuff in the ceilings,” Keller said. “(The patients) would have to have sitters with them 24/7 to keep them from killing themselves. Millions of dollars are spent on that staff only because the facility was never intended for this use, so there’s sort of this outrageous situation and it just doesn’t make sense.”

The need for reform of mental health hospitals has been taken to the current legislative session, according to Lakey. Sen. Jane Nelson, R-Flower Mound, who serves as the chairman of the Senate Finance Committee, proposed a $1 billion budget for Texas’ mental health hospital system in SB 1, which would help repair the facilities.

“We’ll have to see what happens on the House side, but if that money got put in, that would allow us to build new facilities,” Lakey said. 

Nelson was unavailable for a comment. 

Molly Lopez, research associate professor for the School of Social Work and an expert in mental health, according to the UT Experts website, said the reform would provide patients with safe spaces to better help them heal. 

“There needs to be some effort broadly to reform the mental health system and that hospitals are a big part of that,” Lopez said. “Ideally, we would create systems where individuals could be in the least restrictive environment within the community and have their needs met. There is definitely a place for hospitals within the system, and those need to be the most effective programs they can be.”

The Texas Senate approved their budget Tuesday. The House of Representatives is expected to approve its version of the bill, HB 1, next week, according to a spokesperson for Rep. John Zerwas, R-Richmond.