Texas Forensic Psych Bed Lists Still Held 1,626 People at Fiscal Year's End, HHSC Reports
A November HHSC report shows 1,149 waiting for non-maximum-security forensic beds and 477 for maximum-security beds. Statewide average waits were 163 and 213 days.
At the end of fiscal year 2026, 1,149 people in Texas were waiting for a non-maximum-security forensic psychiatric bed, and another 477 were waiting for a maximum-security bed, according to a November 2026 report from the Texas Health and Human Services Commission.
These are not people waiting for a routine counseling appointment. They are on inpatient forensic commitments — found incompetent to stand trial or not guilty by reason of insanity — and many wait in county jails until a hospital bed opens. Justice cannot be completed, for the accused or for the public, while a court order sits on a list.
The report, required by Rider 47 of the current General Appropriations Act, was posted on HHSC's reports page as the Waiting Lists for Mental Health Services Report for fiscal year 2026, which ended Aug. 31. Wait-list counts are a snapshot on the last business day of each quarter.
How long the wait is
For people admitted off the non-maximum-security forensic list in the fourth quarter, the statewide average wait was 163 days, measured from the date a court notified the hospital system of the commitment to the date of admission. The maximum-security average was 213 days.
Those averages hide a wide range. At the facility HHSC lists as Montgomery County Hospital, the fourth-quarter average was 253 days. At El Paso Psychiatric Center it was 337 days. At Harris County Psychiatric Center it was 93 days, and at John S. Dunn Behavioral Sciences Center in Houston, 101 days. HHSC notes that an average is calculated only from people actually admitted that quarter, not from everyone still waiting.
The non-maximum-security list was 1,266 at the end of the first quarter and 1,149 at the end of the fourth. The maximum-security list rose from 468 to 477 over the year. The system is removing people — 838 came off the non-maximum-security list in the fourth quarter alone, for admissions, case resolution, restoration of competency in jail and other reasons — but the lists remain long.
Why beds stay full
HHSC says coordination with courts and jails is central, and that some people remain in state hospitals after they no longer need inpatient care because housing, residential placements or community support is missing. Those delayed discharges keep beds from opening for people still in jail.
Transition support specialists, funded by a prior legislative rider, had discharged 192 people to a less restrictive setting as of July 31, 2026, the report says — 159 adults and 33 youth.
A Forensic Support Team pilot launched in April 2025 in Dallas and Travis counties has, HHSC reports, removed 239 people from state hospital forensic wait lists through monitoring, re-evaluations, diversion and court collaboration. The agency also points to outpatient and jail-based competency restoration as alternatives when courts find them appropriate. The most recent outcome numbers HHSC gives for those programs are from fiscal year 2025, not 2026.
Community rolls are strained, too
The same report counts "underserved" people already in community care who qualified for a higher level of service than staffing allowed. Underserved adults rose from 934 in the first quarter to 1,133 in the fourth. Underserved children fell from 363 to 220.
Local authorities reported trouble recruiting and keeping caseworkers, citing private-sector competition, higher pay elsewhere and heavy caseloads. Most Texas counties are designated mental-health professional shortage areas, HHSC says. In fiscal 2026 the agency reported spending about $395.1 million on adult community mental health services and $101.1 million on children's services; those figures are as of October 2026 and may change at close-out.
Winter also brings other strains on clinics and families; we recently covered DSHS flu guidance in Flu Often Peaks in Winter. What Texas DSHS Says About Symptoms, Spread and Who Is Most at Risk.
Courts, jails and neighbors
A person found incompetent to stand trial is not a closed case. Victims wait. Deputies hold someone who may need a hospital more than a cell. Taxpayers pay for idle jail days and for hospital construction that still has not caught the list. None of that is solved by slogans.
Leviticus 19:15 says, "Ye shall do no unrighteousness in judgment." Righteous judgment requires that the sick be treated and that the dangerous be securely held, not that people languish for months because a bed, a caseworker or a discharge placement is missing. The numbers are now in front of the next Legislature. Texans should ask what it will take to shorten the wait — and they should measure the answer in days, not in press releases.
