Austin State Hospital was the first state facility of its kind built west of the Mississippi. Construction started in 1857, and the first patients were admitted in 1861. As the oldest mental health care facility in Texas, the hospital holds a close connection to the history of Austin and the state. By the late 1890s, patient population had increased from the original 12 patients to almost 700. Additional buildings sprung up to support the growing number of patients. The Hospital functioned as a self-supporting village with artesian wells, gardens, a dairy, ice factory and a sewing/tailor shop. The Hospital was more than a treatment facility, it was home to both patients and staff. Many people stayed for many years, some even through their entire lives. Early residents of Austin were drawn to the expansive landscaped campus to take carriage rides on the graveled drives and enjoy picnics under the live oak trees and along the banks of lily ponds. Children explored Japanese gardens and paddled small boats to the tiny islands dotting the large lake on the southeastern corner of the property. Through the years, the hospital continued to expand, housing 3,000 patients in the 1960s. In the past 30 years, the emergence of private mental health hospitals and community care centers has decreased the Hospital’s population. Today, we care for 4,300 patients per year.