Case Study

University of Texas Health Science Center – San Antonio State Hospital A Mission of Hope, Healing and Recovery

San Antonio, TX, USA

The Challenge

The Texas Health and Human Services Commission (Texas HHSC) and University of Texas Health Science Center at San Antonio (UT Health San Antonio) sought to replace the outdated buildings of San Antonio State Hospital to help modernize the psychiatric hospital system in Texas.

Texas HHSC and UT Health San Antonio tasked the design team of HKS and New York-based design firm architecture+ with creating a world-class replacement facility. Their goal was to provide a therapeutic environment for patients to enhance their recovery.

San Antonio State Hospital has been in operation since 1892. Texas HHSC and UT Health San Antonio wanted the replacement hospital to honor the history and landscape of San Antonio, including the San Antonio Missions. These five Spanish colonial buildings, which date to the 1700s, are a UNESCO World Heritage site.

The project team discovered unfavorable soil on site during the design development phase of the replacement hospital project. This discovery challenged designers to work swiftly to adjust the hospital’s stacking plan. They accomplished this major undertaking in three weeks.

The Design Solution

San Antonio State Hospital incorporates a patient-first model, with a design intended to honor patients’ dignity and inspire hope. The building features open areas and natural light. Private rooms are provided for all patients.

Each patient building is organized around a central area that includes spaces for community gatherings and recreational activities, as well as treatment and therapy. Entry points and portals throughout the buildings are designed and framed to evoke the entryways and portals of San Antonio’s historic Spanish colonial mission buildings.

The hospital’s exterior design features the decorative quatrefoil motif and vibrant colors seen throughout San Antonio. Each patient building is accented with its own unique glazed brick that serves as an aesthetic element and as a wayfinding identifier that correlates with the building’s interior color palette.

Colorful, strategically placed shading devices help offset solar heat gain on campus. Wood grain panels bring warmth to the interior and exterior design, complementing the hospital’s field brick and limestone. These are familiar elements of south-central Texas architecture.

The Design Impact

San Antonio State Hospital bolsters access to mental and behavioral health services for people throughout South Texas. According to Texas HHSC, the hospital serves approximately 270 people annually from over 50 counties in the region. The 3-story, 535,000-square-feet (49,703 square meters) modern replacement hospital provides 300 private patient rooms in a therapeutic environment. The hospital promotes individual dignity and personal safety for patients, staff and families.

Project Features

  • 300 single-bed patient rooms
  • Inpatient mental and behavioral health care for adults and geriatric patients (Psychiatric Intensive Care Unit, Forensic Unit, Geriatric Psychiatry Unit, Civil Unit)
  • Medical/Dental/Ophthalmology Clinic
  • Non-denominational chapel and meditation/prayer room with ablution room
  • Outpatient competency restoration services
  • Jail-based competency restoration services
  • Recreational gym and movement studio
  • Greenhouse
  • Teaching kitchen
  • 17 patient-safe courtyards