Mental hospitals in Texas: finding psychiatric care, how admission works, and what comes next

If you need help now: call 911 if someone is in danger or has a medical emergency. Call or text 988, or chat at 988lifeline.org, any time; it's free, and you don't have to be suicidal to reach out. For Spanish, call and press 2; veterans, press 1. Your county's local mental health authority also runs a 24-hour crisis line.

Help right now: 988, 911 or the ER

What's happening	What to do
Someone is hurt, has taken an overdose, has a weapon, or can't be kept safe	Call 911. Stay with the person if you safely can.
Thoughts of suicide, a panic you can't get through, voices, or a family member in crisis	Call or text 988. A trained crisis counselor answers, talks it through and connects you to local help.
You think you need a hospital today	Go to the nearest emergency room, or call your local mental health authority's crisis line (find it below). The ER has to see you, whether or not you can pay.
You'd like someone to come to you	Call your local mental health authority's crisis line and ask about mobile crisis outreach.

Any hospital with an emergency department that takes part in Medicare must give an appropriate medical screening exam to anyone who comes in asking for emergency care, stabilize an emergency condition, or arrange an appropriate transfer if it can't. That federal law, EMTALA, exists so hospitals can't turn away people who may not be able to pay, and it covers psychiatric emergencies (CMS).

What inpatient psychiatric care is

Inpatient psychiatric care means staying in a hospital, day and night, for a mental health crisis: a psychiatric evaluation, medication, a safe setting, therapy and a plan for when you leave. It's the highest level of mental health care, and stays are usually short; the goal is to get you safe and stable, then back to care in the community. In Texas you'll hear about four kinds of places:

Place	What it is
Psychiatric unit of a general hospital	A locked or unlocked unit inside a regular hospital. This is what most people mean by a "psych ward."
Private psychiatric hospital	A hospital that only treats mental health (and often substance use) conditions. Texas licenses them through HHSC under Health and Safety Code chapter 577.
State hospital	Run by Texas Health and Human Services (HHSC). You get in through your local mental health authority or a court (see below).
Crisis stabilization unit	A short-term crisis facility, licensed by HHSC. Most crisis services in Texas are run by the local mental health authorities, and some areas have other crisis facilities short of a hospital; HHSC's crisis services guide describes the types.

When a hospital is the right level

A clinician makes this call with you, but the question is simple: can the person stay safe outside a hospital with the help they have? The VA's widely used risk stratification table describes the highest acute risk as thoughts of suicide with intent to die and being unable to stay safe without outside help, and says that usually calls for a psychiatric hospital stay, voluntary or involuntary. Other reasons people need a hospital include psychosis or mania that makes them unsafe, being unable to care for themselves, or a medical problem on top of the mental health crisis.

If the person is safe at night but needs much more than a weekly visit, a day program may fit instead: partial hospitalization (PHP) or intensive outpatient (IOP). Our guide to IOP vs PHP vs weekly therapy explains the difference.

How to find a mental hospital or psych ward near you

1. In an emergency, the nearest ER is the right door. If the ER doesn't have a psychiatric unit, it can arrange a transfer to a hospital that does.
2. Call your local mental health authority's crisis line. Every Texas county has a local mental health or behavioral health authority (LMHA or LBHA). Its crisis staff can assess you and arrange a bed: in a state hospital, or in a community hospital it contracts with. Find yours with HHSC's local authority locator, or call 2-1-1 and ask.
3. Call or text 988. The counselor can help you decide what level of help you need and connect you to local crisis services.
4. Have insurance? Call the member or behavioral health number on your card. Ask which psychiatric hospitals near you are in network and whether the stay needs approval. In an emergency, go first and call later.
5. Already have a psychiatrist, therapist or doctor? Call them. They know your history and can help you decide where to go.

Why there's no hospital list here: Cima Find Care is a directory of addiction treatment programs, sober living and outpatient providers in Texas. It isn't a directory of psychiatric hospitals, and we don't rank, rate or recommend any hospital. The steps above reach the people who can find you an open bed today.

How admission works in Texas

The Texas Mental Health Code has three routes into a psychiatric hospital. Most admissions are the first one.

Route	Who starts it	The law
Voluntary admission	You (16 or older), or a parent or guardian for a child	Chapter 572
Emergency detention	A peace officer, or an adult who applies to a judge or magistrate	Chapter 573
Court-ordered mental health services	A county or district attorney, or another adult, by a sworn application to the court	Chapter 574

Voluntary admission (chapter 572)

• Who can ask: a person 16 or older can request admission by filing a request with the facility's administrator (572.001). The request is in writing and signed, and says you agree to stay until you're discharged under the law's rules. A 16- or 17-year-old can be admitted this way without a parent's consent. A parent, managing conservator or guardian can also request admission of a child under 18.
• Leaving: you can ask to leave by filing a written request, signed, timed and dated (572.004). The facility must tell the physician within 4 hours, and the physician must discharge you before those 4 hours end, unless the physician has reasonable cause to believe you meet the criteria for emergency detention or court-ordered services.
• If the physician has concerns: the physician must examine you within 24 hours of your request and discharge you unless you meet those criteria, and must tell you if the hospital plans to detain you or apply to a court. You can also withdraw your request in writing and stay.

Emergency detention (chapter 573)

When a person with a mental illness poses a substantial risk of serious harm to themselves or others, a peace officer can take them into custody without a warrant, and an adult can apply to a judge or magistrate for an emergency detention warrant. A guardian can also transport the person for emergency detention. Then (573.021):

• A physician must examine the person as soon as possible, within 12 hours after the officer took them into custody or the guardian brought them.
• The facility can hold the person for no longer than 48 hours after they arrive, unless a judge signs a written order for protective custody. Time spent waiting in the facility for a medical evaluation counts toward the 48 hours.
• If the 48 hours end on a weekend, a legal holiday or before 4 p.m. on the next business day, the person may be held until 4 p.m. on the first business day after. In extremely hazardous weather or a disaster, a judge or magistrate can extend it by 24 hours at a time.

Texas law doesn't use the term "72-hour hold." The 48-hour emergency detention limit, and the 72-hour probable cause hearing below, are the clocks that apply.

Court-ordered mental health services (chapter 574)

• A lawyer: if the person doesn't have one, the judge appoints an attorney within 24 hours after the application is filed (574.003).
• Protective custody: if the court orders the person held until the hearing, a probable cause hearing must be held within 72 hours after they're detained, or the next business day if that falls on a weekend or holiday (574.025).
• Medical evidence: no hearing can be held without at least two certificates of medical examination for mental illness from different physicians, each based on an exam in the 30 days before the hearing, and one from a psychiatrist if one is available in the county (574.009).
• The hearing: set within 14 days after the application is filed (574.005).
• How long an order lasts: a temporary order for inpatient care allows up to 45 days, or up to 90 days if the judge finds a longer period is needed (574.034). An extended order can last up to 12 months (574.035).

For an adult whose main problem is alcohol or drugs, Texas has a separate court process under chapter 462: see can you force someone into rehab in Texas?

Texas state hospitals and local mental health authorities

HHSC runs the state hospital system. Its state hospitals page says the way in is through your local mental health authority (LMHA) or local behavioral health authority (LBHA): it screens people seeking state hospital admission to find the least restrictive place they can be treated. Someone who arrives at a state hospital without that screening gets an emergency medical screening, and the hospital consults the local authority.

HHSC's directory of state hospitals lists Austin, Big Spring, El Paso Psychiatric Center, Kerrville, Rio Grande State Center, Rusk, San Antonio, Terrell, Vernon and Wichita Falls (North Texas State Hospital's two campuses), and the Waco Center for Youth. New hospitals are being built, such as the replacement North Texas State Hospital in Wichita Falls (Office of the Governor), so check HHSC's page for the current list.

• Community hospital beds. Local authorities also buy psychiatric beds in community hospitals. HHSC says admission there is at the local authority's recommendation, based on a crisis assessment (Community Hospital Services).
• The rules. HHSC's admission criteria for a state hospital or a contracted psychiatric bed are in 26 TAC 306, subchapter D: 306.175 (voluntary), 306.176 (emergency detention) and 306.177 (protective custody or court order).
• Waits. HHSC keeps a waiting list for state-funded inpatient psychiatric beds for people who aren't in the criminal courts, and reports wait times by facility (HHSC waiting list report). Patients sent by a criminal court for competency restoration come through a separate forensic process.
• Crisis care. Every local authority runs a 24-hour crisis line and mobile crisis outreach (HHSC crisis services). It's the same number to call when you need ongoing care after a hospital stay and have little or no insurance.

Paying for a psychiatric hospital: insurance, Medicaid and Medicare

Coverage	What to know
Texas Medicaid, general hospital	Psychiatric admissions to an acute care hospital are a Texas Medicaid benefit at every age, in traditional Medicaid and in a health plan (TMHP hospital handbook, September 2026).
Texas Medicaid, freestanding psychiatric hospital	Covered for people 20 and younger and 65 and older. Adults 21 to 64 in a Medicaid health plan can be covered "in lieu of" a general hospital when the plan and the member agree, for up to 15 days per calendar month (TMHP). Children and teens keep their Texas Health Steps benefits there.
Why the age limits	Federal Medicaid treats a facility of more than 16 beds that mainly treats mental illness as an "institution for mental diseases" (IMD) (42 CFR 435.1010) and generally won't pay for adults 21 to 64 there (Congressional Research Service). The same rule shapes rehab: see rehab that takes Medicaid in Texas.
Medicare	Part A covers inpatient mental health care. In a freestanding psychiatric hospital it pays for up to 190 days in your lifetime; the limit doesn't apply to a Medicare-certified psychiatric unit inside a general hospital. You pay the Part A deductible ($1,736 per benefit period in 2026) and Part B's 20% for doctors' services (Medicare.gov).
Private insurance	Marketplace plans must cover inpatient mental health services, and under federal parity law a plan's limits on mental health care generally can't be stricter than its limits on medical care (HealthCare.gov). Ask whether the stay needs prior approval and which hospitals are in network.
No insurance	Start with the local mental health authority, which arranges state-funded care. An ER must screen and stabilize you regardless of ability to pay. Then check whether you qualify for Medicaid: see how to apply for Texas Medicaid.

If drugs or alcohol are part of it

Mental health crises and substance use often come together. Two cautions: alcohol and some drug withdrawals can be medically dangerous, so tell the ER exactly what was used and when; and before discharge, plan the next step for both the mental health condition and the substance use. Our guide to dual diagnosis treatment in Texas explains integrated care, and Cima Find Care lists Texas programs that treat co-occurring disorders. For withdrawal, see alcohol detox in Texas.

What to bring

In an emergency, just go. If there's time, a family member can pack, or bring these later. Every unit has its own list of what's allowed, mainly for safety, so ask before you bring anything else.

• Photo ID and your insurance or Medicaid card.
• A list of your medicines and doses, your pharmacy, and any allergies.
• Names and phone numbers of your doctor, therapist and two or three people you trust, written on paper. You may not have your phone.
• A few days of comfortable clothes. Leave valuables at home.
• A copy of your Declaration for Mental Health Treatment, if you have one (below), and any court papers.

Plan ahead with a mental health advance directive. Texas's Declaration for Mental Health Treatment (Civil Practice and Remedies Code chapter 137) lets an adult write down, while well, their choices about psychiatric medicines and other treatment. It's followed only if a court finds you can't make treatment decisions, it lasts three years unless you revoke it (longer if you're incapacitated when it would expire), and a provider presented with it must put it in your record. HHSC has the form in English and Spanish.

Your rights in the hospital

• You keep your rights. A person with a mental illness keeps the rights, benefits and privileges that federal and state law guarantee (Health and Safety Code 576.001).
• Visitors, calls and mail. Patients in an inpatient mental health facility can receive visitors and communicate by phone and sealed mail, within the facility's general rules, and contact a lawyer, the department, the courts and the state attorney general (576.006). The physician can limit visits, calls or mail only as needed for your welfare or to protect others, must write the reason and how long in your record, and must tell you. Your contact with a lawyer, the department, the courts and the attorney general can't be limited.
• Humane, respectful care. Texas's rights rule for people receiving mental health services in state facilities, community centers and psychiatric hospitals (26 TAC 320.7) guarantees a treatment setting that protects you from harm, gives as much privacy as possible and respects your dignity; to be told the facility's rules for conduct (and staff must note when they told you); and communication about your care in a language and format you understand. This rule used to be 25 TAC chapter 404, subchapter E, and moved to 26 TAC chapter 320 (Texas Register transfer). Consent to psychiatric medicines is covered in subchapter B of the same chapter.
• A rights handbook. HHSC publishes a plain-language rights handbook, and copies must be displayed where people receiving services can see them (26 TAC 320.21). Ask for one.
• A patient's bill of rights. Health and Safety Code 321.002 sets a patient's bill of rights for mental health facilities. Ask for a copy at admission.
• Complaints. Ask the hospital's patient advocate or rights officer first. You can also file a complaint with HHSC against a licensed facility, or get help from the HHS Office of the Ombudsman's behavioral health help.

Teens and parents

• A parent, managing conservator or guardian can request a child's voluntary admission (chapter 572).
• A teen 16 or older can request admission without a parent's consent.
• When a minor admitted at a parent's request asks in writing to leave, the hospital must consult the parent or guardian, and a written objection from them means treatment continues as a voluntary admission (572.004).

Not sure it's a hospital-level problem? See when to get help for your teenager and teen counseling in Texas. In a crisis, the same doors apply: 911, 988 and your local mental health authority.

After discharge: stepping down

Leaving the hospital is a fragile time: the Joint Commission notes that suicide risk is high in the period after someone leaves psychiatric inpatient or emergency care, which is why hospitals and programs plan follow-up before you go (R3 Report Issue 18). Before discharge, ask for:

1. A dated first appointment, not just a phone number: a psychiatrist or nurse practitioner for medicines, and a therapist or program.
2. A written safety plan with warning signs, coping steps, people to call, 988 and your county's crisis line.
3. Enough medicine, or a prescription, to bridge to that first appointment.
4. A step-down program if you need one. Many people go from the hospital to partial hospitalization (PHP), most of the day on weekdays while living at home, then to intensive outpatient (IOP), then to weekly therapy. Cima Find Care lists 114 PHPs in Texas and 160 IOPs in Texas; those are programs that treat substance use (many treat mental health too), so if your needs are mental health only, ask the hospital's discharge planner for a mental health program. What they cost: IOP and PHP costs in Texas.
5. Help with cost if you're uninsured: your local mental health authority, community health centers and sliding fees, in sliding scale therapy in Texas.