Editor’s note: This story includes references to suicide. Resources for people in crisis can be found at the bottom of this story.
Shaman Perskin was an adventurous kid, his father Spencer Perskin remembers. “We had a lot of nicks and knacks and trips to the hospital. He was really playful.”
Cross Creek Hospital Together with Ascension Seton, a psychiatric hospital, has expanded from 106 beds to 196 beds after Ascension Texas closed its behavioral health hospital Seton Shoal Creek Hospital in 2024.
Jay Janner/Austin American-Statesman
Cross Creek Hospital Together with Ascension Seton, a psychiatric hospital, has expanded by 90 beds after Ascension Texas formed the partnership in 2024.
Jay Janner/Austin American-Statesman
Seton Shoal Creek Hospital is now shuttered with a fence around it. The hospital once cared for as many as 147 patients.
Jay Janner/Austin American-Statesman
He was a baker at numerous restaurants and for family gatherings, and was a very caring person, Spencer Perskin said. He said that during the pandemic, Shaman Perskin “made sure we had food and water.”
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Perskin was in his early 20s when he was in a car wreck that injured his back. He was given pain relievers.
“Unfortunately, he got hooked on the meds,” Spencer Perskin said. And then Shaman Perskin turned to heroin. He was in and out of prison and unhoused on and off for the next two decades, but he got clean, his father said.
He worked with the nonprofit Vocal Texas and traveled to Washington, D.C., to advocate for funding to treat opioid addiction and to get naloxone emergency overdose treatment into the hands of more people. “He probably saved a lot of people’s lives,” his father said. “He had a strong sense of righteousness.”
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On July 3, Shaman Perskin was found dead in his hospital room at Cross Creek Hospital Together with Ascension Seton. He had no pulse and had scrubs wrapped around his neck, according to a federal Centers for Medicare and Medicaid Services inspection report done that month. CPR was unsuccessful. Perskin was 10 days away from his 55th birthday.
Shaman Perskin was found dead in his room at Cross Creek on July 3, 2025. A federal inspection report that month found three deficiencies in nursing services, supervision of nursing care and nursing care plan.
Provided by Blake Austin
His family’s lawyer, Jay Doyle, filed a notice on Feb. 27 of their intention to sue and has asked for Shaman Perskin’s medical records. The hospital has not yet responded, Doyle said.
Perskin’s death comes as Austin-area families face fewer inpatient mental health beds and limited choices during psychiatric crises. A Statesman review of federal inspection reports found Cross Creek has twice as many cited deficiencies and inspection reports as any other behavioral health hospital in Central Texas during the past decade.
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Criminal charges were recently filed against a staff member at the hospital. On May 15, nurse Shanay Michelle Meekins, 40, was charged with bodily injury of a child with intention to cause serious bodily injury for a Feb. 11 incident. According to the arrest affidavit, Meekins got into a verbal fight with a 10-year-old patient. Another employee saw Meekins lift the victim by her neck, throw her to the floor and straddle her while choking her with both hands. Two employees intervened to get Meekins off the victim. The victim had bruises on her back and elbow, and a scratch on her arm and reported a headache. She said that during the incident she was unable to breathe and her vision went “pitch black.”
One employee told police that Meekins’ response and use of physical force “did not match the training.” Meekins said in the affidavit she was trying “to guide” the victim and that “it is alright to physically guide a patient as long as you aren’t grabbing the patient.”
The staff filled out an incident report but did not call the police or take additional steps to trigger an inspection. The victim’s grandmother called police.
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Cross Creek is owned by Acadia Healthcare, but as of 2024, it is in partnership with Ascension Texas, Austin’s safety-net nonprofit hospital system.
Ascension Texas, Acadia and Cross Creek did not respond to the Statesman’s requests for interviews about the conditions at Cross Creek. Ascension Texas emailed this statement: “Ascension Seton and Acadia continue to collaborate to advance behavioral health services in the area.”
It noted the increase in the number of beds from 106 to 196 at Cross Creek and noted that “the vast majority of Ascension Seton Shoal Creek’s full-time associates were offered the opportunity to transition to the new Cross Creek site or to engage with the internal mobility team to secure another position within Ascension’s system.”
What happened to Shaman?
The inspection report for Perskin, which analyzes his medical records as well as interviews with staff at the hospital, outlines three deficiencies during Perskin’s care, but it is one of 12 inspection reports at that hospital in the past 10 years with 49 cited deficiencies.
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Perskin dealt with his own mental illness most of his life, first with depression as a kid, and then in his 30s he was diagnosed with borderline personality disorder, his father and sister Spring Clarke said.
He became severely depressed after his physical health began to decline, she said. “He got progressively worse.”
On Feb. 28, 2025, he tried to kill himself by shooting himself in the face. One of his eyes couldn’t be saved. Because of the suicide attempt, he was sent from a medical hospital to a mental health hospital, Georgetown Behavioral Health Institute, where he stayed at least 10 days, Clarke said.
On June 15, he was admitted involuntarily to Cross Creek after threatening to harm himself with a cleaver, according to the July 11 inspection report.
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On the day of Perskin’s admission to Cross Creek, the hospital psychiatrist listed him as a “moderate” suicide risk and ordered Perskin to be observed every 15 minutes for his safety.
On July 2, Perskin “blocked his room with another bed to prevent staff from monitoring him,” the report notes.
The next day, the doctor issued a discharge summary. “The team decided that he was doing better.” The summary then notes that Perskin asked one of his sisters to bring a gun with her when she was supposed to pick him up because “he believed people were waiting for him outside the hospital.”
His discharge was canceled, but Spring Clarke said she and her older sister called the hospital that night to beg them to monitor him and were assured he would be checked on every hour, even though he still had orders to be observed every 15 minutes.
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According to the inspection report, staff came to his room at midnight and 3 a.m., but both times his room was barricaded. At 4:30 a.m., staff were able to unlock the door and found him on the floor, started CPR and called 911.
In the report, both the doctor and the house supervisor said they were not told that Perskin had been barricading himself. The doctor noted, “had she known she would have increased his observations.”
“He’s been hurt by this system over and over again,” Clarke said. “This has happened to him over and over again.”
Lisa Miller hugs Spring Clarke, right. Clarke’s brother, Shaman Perskin, died by suicide while receiving care at Cross Creek Hospital Together with Ascension Seton, and Miller, a former patient at the psychiatric hospital, says she received inadequate care there. At left is Shaman’s father, Spencer Perskin.
Jay Janner/Austin American-Statesman
Previous inspection reports raised concerns
One of the other Cross Creek inspection reports involves the suicide of an adolescent in 2017. After telling the hospital she would kill herself if she had to leave with her guardian, she ran away as she was being discharged and was found dead by suicide the following morning at a nearby construction site.
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Cross Creek also is being sued by family members of Chester Jackson Jr., who was transferred to the hospital in 2019 and is now in a vegetative state, according to the lawsuit. An expert report commissioned by the family said the hospital delayed addressing Jackson’s agitation, improperly restrained him and gave him excessive medication before he went into cardiopulmonary arrest.
Jackson “suffered a catastrophic anoxic brain injury and can no longer communicate, feed himself, walk or perform any activities of daily living,” the lawsuit and report note.
Seton Shoal Creek was the only other Central Texas mental health hospital that had a life-limiting injury or a suicide noted in an inspection report in the past 10 years. In July 2019, a patient was found dead in his room from suicide by strangulation. His doctor had given orders for staff to check on him every 15 minutes because of his suicide risk, but he had been dead at least three hours when he was found, according to the inspection report.
Seton Shoal Creek was owned by Ascension Texas before it closed in 2024 after Ascension Texas announced its partnership with Cross Creek. At the time of its closure, it was operating 46 beds, much fewer than the 147 beds it had operated, in part because of building disrepair and the addition of a 24-bed mental health unit at Dell Children’s Medical Center in 2018.
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With the partnership, Cross Creek began an expansion project to grow the hospital from 106 beds to 196 beds. At the time the partnership was announced, Ascension Texas said in a statement that the arrangement will allow the hospital system to be “better positioned to serve the community through an expanded capacity and care delivery system … to ensure that this community has sustainable, quality behavioral healthcare access long into the future.”
It refuted that it was planning on closing Seton Shoal Creek later that year.
Lisa Miller, a former patient at Cross Creek Hospital Together with Ascension Seton, has formed a Facebook group for people who have been to the hospital.
Jay Janner/Austin American-Statesman
No room at the hospital
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Even as the metro area has grown to 2.3 million people, the area has seen a decrease in inpatient psychiatric beds in the past five years, from 803 beds in 2021 to 754 beds currently. “We don’t have enough bed capacity,” said Dawn Handley, chief operations officer at Integral Care, the mental health authority for Travis County.
When someone calls the 988 suicide prevention hotline or Integral Care’s crisis hotline 512-472-HELP, or arrives at an emergency room and needs an in-patient bed, Integral Care or the hospital begins looking for which facility has a bed that is appropriate for that patient, Handley said.
“Not all inpatient beds are equal,” said Integral Care’s CEO Jeff Richardson.
Bed availability differs based on the age of the patient, whether the patient has been court-ordered to be held in a mental health hospital, whether the patient has a physical health diagnosis that requires an enhanced level of care, and whether they have private insurance, Medicaid or Medicare, or no insurance.
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People often are managed in the emergency department until a bed can be found. When a bed becomes available, patients and their families agree to take it with the hope that they will begin to receive treatment.
On Feb. 24, Lisa Miller, 60, was having constant thoughts of suicide after having to stop her antidepressants because of a heart condition. For the first time in her life, she felt unsafe at home and went to the emergency department at Ascension Seton Cedar Park Hospital.
After hours in the emergency department, the hospital staff found her a bed at Cross Creek. When she arrived, she said she was left in a room by herself without proper supervision, a complaint that recurs in the federal inspection reports. She said she received no orientation and no one made sure she didn’t have anything on her that could be a danger to herself or others.
In the three days she was there, she met with a psychiatrist, whom she says was very good, but the social worker came in, saw she was sleeping and left. “She never came back,” Miller said.
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“There was no real content in terms of therapy,” she said.
Lisa Miller, a former patient at Cross Creek Hospital Together with Ascension Seton, wears bracelets to honor a “survivor” of the hospital.
Jay Janner/Austin American-Statesman
Miller said she felt unsafe after seeing fellow patients sneaking off into rooms by themselves and having inappropriate contact with one another, also documented multiple times in inspection reports.
After three days, Miller discharged herself. “I took myself out because the place was such a (expletive) show,” she said. She later found a bed at Rock Springs in Georgetown. “It was night and day,” she said of the two hospitals. “I couldn’t believe it.”
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A sign for physician parking at Seton Shoal Creek still stands at the now-closed hospital.
Jay Janner/Austin American-Statesman
Where did all the beds go?
Austin’s decreasing number of mental health beds has happened because of hospital closures and scaling back of hospital capacity or future plans.
In addition to Seton Shoal Creek, Austin Lakes Hospital, which was inside St. David’s Medical Center, closed in 2022. The Austin State Hospital’s 2024 remodel of a run-down historic hospital building from the 1850s created 59 fewer beds there. Wellbridge in San Marcos, which had 24 beds, closed in 2018.
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A new planned behavioral health hospital is now on hold. St. David’s HealthCare had announced in 2022 that it would build an 80-bed behavioral health hospital with room for an additional 12 rooms on land it owned by North Austin Medical Center. The $33.8 million project promised to have services for adolescent, adult and geriatric patients.
When it was announced, David Huffstutler, president and chief executive officer of St. David’s HealthCare, said the new hospital “will help to service a huge unmet demand.”
St. David’s has continued to proceed with plans to build a physical health hospital in Leander and an emergency room in Kyle that will lead to an eventual hospital there. The hospital system “has delayed for now the behavioral health hospital,” Huffstutler said. He noted “market conditions” and “cost of the project” as some of the reasons, as well as the need to ensure that the location is the right location, there is a demand, and that St. David’s can provide those services well, he said.
As a for-profit hospital system, the economics of a behavioral health hospital have to work, he said.
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“There is the ability to provide those services in an economic fashion that is sustainable,” he said. “Economics alone, I wouldn’t say are a factor that prevents development.” He did note that “a lot of behavioral health patients do not have resources. The state hospital helps support that and other organizations.”
St. David’s HealthCare, Ascension Texas and Baylor Scott & White do handle mental health cases through their emergency departments, but the goal is to support patients until they can be transferred to a behavioral health hospital that has a bed available.
“Most everyone in the community would agree we do not have adequate behavioral health capacity in the community,” Huffstutler said.
Seton Shoal Creek Hospital is now shuttered. The hospital once had capacity for 147 patients, though it had reduced services to just 46 when it closed in 2024.
Jay Janner/Austin American-Statesman
How many behavioral health beds do you need in a community?
Currently, Texas has about 13.7 inpatient psychiatric beds per 100,000 people, according to KFF, a foundation dedicated to healthcare research. Texas is 38th in the country for the number of beds per 100,000 people. The U.S. average is 19 beds.
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Travis, Williamson, Hays and Bastrop counties had about 34 beds per 100,000 people five years ago, and now have 32. However, those beds are also used by people in the 26 other counties of the state’s Public Health Region 7, and 240 of those beds are at the Austin State Hospital.
Nationally, 46% of state hospital beds are taken up by people who are serving court-involved sentences. In Texas, that number is closer to 69%, according to the Hogg Foundation for Mental Health at the University of Texas. That means that of the 240 beds at the Austin State Hospital, only about 74 are available for someone who has not been sentenced to be held in a mental health facility.
Instead of about 32 beds per 100,000 people, the Travis, Williamson, Hays and Bastrop area has about 25, which it also shares with 26 other counties.
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This doesn’t mean that people who are in the justice system automatically get into a state hospital bed. About 40% of people at Travis County Jail need mental health care, Richardson said. “Our primary level of care is the jail,” he said.
The availability of behavioral health beds is expected to get worse, Handley said. One of the largest behavioral health hospitals in the state, Laurel Ridge in San Antonio, has lost funding from the Centers for Medicare and Medicaid Services, after a series of deaths and safety violations, according to the San Antonio Express-News and other news outlets. That hospital had 330 beds and now operates 20, but could close.
The Austin State Hospital’s new building brings the first psychiatric hospital west of the Mississippi River into the modern age, but when the new building opened in 2024, it lost 59 beds.
Jay Janner/Austin American-Statesman
Not all mental health care needs to be done in a hospital
The number of inpatient psychiatric beds has been on the decline since the 1850s, when asylums were popular. Communities have developed outpatient care instead of locking away people. Outpatient therapy appointments as well as partial hospitalization and intensive outpatient programs have helped treat people before they need an inpatient stay or have shortened their stay in an inpatient hospital.
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Integral Care, the city of Austin and Travis County have been working on other solutions to reduce the amount of people who need what Richardson calls the “deep end” of the system — inpatient hospitals, residential treatment centers or justice-ordered care, all of which are more expensive than early interventions. Trilliant Health’s 2026 market research report found that the negotiated rates for a one-day inpatient psychiatric stay have a median of $1,179. Intensive outpatient therapy, $252 per day. Group therapy, $40 to $109. Individual therapy, $78 to $542 depending on the type and length of the session.
Integral Care has added these projects in the past five years:
The Austin community “has the ingredients” for a comprehensive mental health system, Richardson said. “When it works, it is a continuum of coordinated care,” he said.
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That takes a community collective, including the hospital systems, mental health providers, the jail system and the public mental health system, working on the right touch points for each patient, he said.
Right now, though, “we have way too many people getting care at the deep end of the system,” he said. “That burdens the entire system.”
Get help
If you or someone you know needs mental health help, call 988, the suicide prevention hotline, or 512-472-HELP for Integral Care’s crisis line.
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Integral Care’s walk-in clinic is open around the clock at 1165 Airport Blvd., second floor.