Kerrville State Hospital (KSH) is located on a hill overlooking the Guadalupe River in Kerrville, Texas. At the turn of the century, a dude ranch named My Ranch occupied this site. In 1915, 1,000 acres were sold to a group of San Antonio investors who converted the ranch into the Mountain Park Sanitorium for patients with tuberculosis. In 1917, Dr. Sam E. Thompson purchased the property and operated the Thompson Sanitorium until 1935, when it was acquired by the State of Texas. The state operated the Sanitorium for African-American patients with tuberculosis for several years before its closing.
The facility was reopened by the state in 1951 as a branch of San Antonio State Hospital serving 119 geriatric women with mental illness from across the state. The following year it became a separate entity known as Kerrville State Home.
By 1959 the hospital had grown to serve 1,200 resident patients with buildings located on 41 acres with an adjacent 580 acres. That same year the 55th Legislature changed the name to Kerrville State Hospital.
On November 1, 1969, the hospital began providing outpatient services to clients in its service area through the KSH Community Services Division. Under the leadership of Dr. Luther W. Ross from 1953 until his retirement in December 1992, the hospital moved from providing institutional, custodial care to providing individualized psychosocial treatment with an emphasis on patients' return to the community.
In May of 1999, KSH began providing services for forensic patients from other Texas state hospitals who have been committed under the Texas Criminal code because they were found to be incompetent to stand trial or were found not guilty by reason of insanity. Transfers received were individuals who have been determined not to be manifestly dangerous, as provided in TAC 402C, and who had a serious and persistent mental illness that would likely require extended treatment.