San Antonio State Hospital: History, Legends and the Abandoned Asylum Myth

On the South Side of San Antonio, off South New Braunfels Avenue, stands the state hospital that has served South Texas for more than 130 years. It opened on April 6, 1892, on a 640-acre site that was then well outside the city, and it was renamed San Antonio State Hospital in 1925. Its original brick asylum buildings are gone, replaced in the 1970s, and in 2024 the state opened a new $357 million hospital on the campus.

Local legend says former patients still walk the grounds and look out of upper-floor windows, and employees have described a heavy feeling of death in the air. This guide covers the documented history, the stories that grew out of it, and one important correction: the abandoned ruins that appear online as the “San Antonio State Hospital” are a different place altogether.

History of San Antonio State Hospital

In 1889 the Texas Legislature authorized a new state asylum for Southwest Texas, to occupy at least 640 acres and care for 500 patients. Construction started in 1890 with $200,000 in state money, and the Southwestern Insane Asylum opened on April 6, 1892, five miles south of San Antonio. It had 142 patients after eight months and 225 by August 1894. Like other asylums of the day it farmed its own land and raised its own livestock.

From then on, the story is one of trying to keep up. The state paid for room for 300 more patients in 1898 and 300 more in 1910. By 1912 the hospital held 1,140 people and by 1915 it had room for 1,800. A psychiatric nursing school ran from 1917 to 1942, the only one of its kind in the state system. In 1925, when Texas dropped “insane” and “asylum” from the names of its institutions, it became San Antonio State Hospital.

Overcrowding returned again and again. The average population was 2,103 in 1926 and 2,308 in 1932. Five new buildings and a nurses’ home opened in 1939, but by 1940 the hospital held 2,854 patients, and more than 700 more people waited in county jails across Texas for a bed. Only white patients were admitted until 1964, when the hospital took its first Black patient. The same year Helen Cloud Austin, who had been refused a job in 1962 because of her race, became its first Black professional staff member.

Conditions drew criticism for decades. A World War II veteran, Stephen Aldridge, committed himself in 1944 and later described attendants beating patients: “Never again do I want to experience the sight of such cruelties.” Newspaper reports over the years raised questions about patients who died soon after admission, and in the 1960s a federal class action that began at Terrell State Hospital led to court orders to cut patient numbers and add staff across the system.

Things changed in the 1970s. The hospital was accredited in 1970, outreach clinics opened across South Texas, and a building program replaced the old main building and wards. The population fell to 531 by 1990. In April 2024 the state opened a new three-story, 454,000 square foot hospital on the campus, part of a statewide rebuild of its psychiatric hospitals.

The ghost stories of San Antonio State Hospital

Faces at the windows

The best-known legend, repeated by KSAT and other local outlets, is that the souls of former patients can be seen at second-floor windows. It is a story that has outlived the buildings it was first told about, since the original asylum was torn down in the 1970s. Today it is told about the hospital in general rather than any one ward.

What staff describe

Current and former employees, quoted anonymously in ghost tour accounts, describe voices and footsteps in empty halls, slamming doors, screams and cold spots, and an overwhelming feeling of being watched. One put it simply: “There’s death around. We hear and see things.” None of these accounts names a specific ghost, and none has been investigated, because the hospital does not allow it.

The "March of Death"

Some ghost tellers connect the hauntings to a string of deaths reported in old newspapers, including a 19-year-old patient who died three days after admission and another man who died after eleven days, whose own doctor said his illness could not explain it. These cases are retold by ghost tour companies from period press reports, and we have not been able to check the original articles, so treat names and details with caution.

Rumors also claim the grounds hold unmarked graves of patients who died in suspicious circumstances. We have found no record or excavation that confirms this.

The abandoned asylum that isn't

Search online for the “abandoned San Antonio State Hospital” and you will find photos of crumbling buildings covered in graffiti. Those buildings were the Bexar County Juvenile Home for Boys, not the state hospital. They have their own ghost stories, but they are decaying, dangerous and patrolled, and going inside is trespassing. Please do not go looking for them.

Where to look

• The hospital frontage on South New Braunfels Avenue: the only part you can see, from the public road.
• The upper-floor windows: where legend places the faces of former patients.
• The historic photos: the original 1890s asylum, with its clock tower, survives only in archive photographs.

Visiting San Antonio State Hospital

San Antonio State Hospital is a working inpatient psychiatric hospital serving more than 50 South Texas counties. It is not a tourist site: there are no tours, no ghost tours and no investigations, and you should not enter the grounds or photograph patients or staff.

If the history interests you, the Texas State Historical Association’s Handbook of Texas and the Asylum Projects archive are good places to read more. For haunted places you can actually visit in San Antonio, the Alamo, the city’s historic hotels and its ghost tours are a far better night out.

Haunted Rooms does not run events here. If you want to investigate a historic building with our team, see our nearest ghost hunts below.

• Visiting Working psychiatric hospital: not open to visitors
• Ghost hunting No. It is an active state hospital

Tips for your visit

• Do not confuse the hospital with the abandoned juvenile home: one is a working hospital, the other is a dangerous ruin.
• Be respectful. People are receiving care here today, and many San Antonio families have relatives who were patients.
• For a haunted overnight in town, book one of San Antonio’s haunted hotels instead.
• If you are researching an ancestor who was a patient, the Bexar County TXGenWeb pages list some historic patient records.

More haunted places nearby

• The Alamo: San Antonio’s most famous haunted landmark
• The haunted train tracks: the South Side’s best-known legend, a few miles away
• Haunted hotels in San Antonio: the Menger, the Emily Morgan and more
• Austin State Hospital: Texas’s first state asylum, opened in 1861
• Haunted places in Texas
• Haunted places in San Antonio

Sources

Facts on this page are checked against the official website, historic records and news coverage. Ghost stories are reported as staff, visitors and investigators tell them, and we say where records contradict a story.

• Texas State Historical Association: San Antonio State Hospital
• Asylum Projects: San Antonio State Hospital
• Texas HHS: Grand opening of the $357 million San Antonio State Hospital (2024)
• Texas HHS: San Antonio State Hospital
• KSAT: 8 haunted places and urban legends on the South Side of San Antonio (2023)
• Ghost City Tours: The haunted San Antonio State Hospital