Laurel Ridge Treatment Center on the far North Side plans to lay off 648 employees starting in June, after the federal government terminated its Medicare and Medicaid coverage. The loss of services exposed how fragile our behavioral health system has become and how urgently our community leaders must act, our guest columnist writes.
Laurel Ridge Treatment Center
People wait in line for bagged lunches on June 2 at CAM Downtown in San Antonio. Nearly 51.1% of San Antonio’s unsheltered population reported living with a mental health condition. Untreated behavioral health conditions contribute to chronic homelessness in our community, our guest columnist writes.
Katina Zentz/San Antonio Express-News
With the sudden downsizing of services at Laurel Ridge Treatment Center after the loss of Medicare and Medicaid funding, San Antonio is confronting a mental health crisis that feels too familiar.
Bexar County experienced a similar collapse in inpatient psychiatric capacity in 2015 and 2016, when several facilities closed and hundreds of mental health beds disappeared from the system. Our community was overwhelmed by a growing number of people cycling through emergency rooms and jails without access to adequate care.
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That crisis forced our community to rethink how we care for individuals experiencing a mental health crisis. Community leaders created the Southwest Texas Crisis Collaborative under the leadership of the Southwest Texas Regional Advisory Council to build a more coordinated continuum of care.
This work led to initiatives such as the Program for Intensive Care Coordination, the San Antonio Community Outreach and Resiliency Effort, and the Specialized Multidisciplinary Alternate Response Team. These programs help people with severe behavioral health conditions avoid repeated cycles through emergency rooms, psychiatric facilities and the criminal justice system.
These efforts created a unique and stronger behavioral health system that serves a region spanning 22 counties and about 3 million people. The sudden loss of Laurel Ridge services threatens to undermine much of that progress.
In 2018, San Antonio had about 900 inpatient mental health beds. Today, that number has fallen by 65%. That is only 8.5 beds per 100,000 residents, far below the benchmark of 60 beds per 100,000 considered necessary for adequate care.
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One in 5 San Antonio residents live with a mental health or substance use condition. In a community of 2.1 million people, more than 400,000 people may need behavioral healthcare.
We lack the capacity to meet that need, and when people cannot access treatment, the consequences ripple across the entire community.
Many people in crisis end up waiting in emergency rooms that are not designed to provide long-term psychiatric care, diverting resources from other medical emergencies.
Others receive no care at all.
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Treatable mental health conditions worsen, families experience trauma, and public safety systems face increased pressure. Often, individuals end up as part of our unhoused population.
Nearly 51.1% of San Antonio’s unsheltered population reported living with a mental health condition, while 49.3% reported substance use. Untreated behavioral health conditions contribute to chronic homelessness in our community.
JAILED TO DEATH: The Bexar County jail is a de facto mental health hospital.
Texas established local mental health authorities, or LMHAs, under state law to strengthen community behavioral health systems. The Center for Health Care Services serves as Bexar County’s LMHA, and local investment must keep pace with growing demand.
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The center serves 2.1 million Bexar County residents, and it receives $1.9 million from the city of San Antonio and $5.8 million from University Health, totaling $7.7 million in local support in 2026.
By comparison, the LMHA serving Travis County, which is home to roughly 1.4 million residents, receives $62.4 million in local funding: $14.7 million from Travis County, $13.7 million from the city of Austin and $34 million from Central Health, Travis County’s public hospital.
San Antonio and Bexar County stand at a crossroads. We can continue underfunding mental health care, or we can invest in upstream services that help people before they reach a crisis.
Sustainable funding is needed to expand mental health, substance use, and intellectual and developmental disability services while advancing diversion programs that connect people with low-level offenses to care for behavioral health needs instead of going to jail.
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The loss of services at Laurel Ridge did not create this crisis. It exposed how fragile our behavioral health system has become and how urgently our community leaders must act.
Jelynne LeBlanc Jamison is president and CEO of the Center for Health Care Services.
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