San Antonio State Hospital Unauthorized Departure

February 2017

Below is a summary of actions that have been implemented, are currently in progress, or that are
proposed to address the occurrence of UDs at the hospital.

Changes made or in progress to address unauthorized departures

Modifying the fence around the plaza of the campus to increase the height and decrease areas
where the fence/wall can be used to assist in climbing over it.
Coordination efforts with San Antonio Police Department (SAPD) to increase the response
time for searching for a patient who has left on an unauthorized departure. The information
required to report a missing patient was consolidated and has assisted in faster processing
times. Additionally, SAPD will increase its visibility on campus by increasing patrols through
the SASH campus as a safety feature.
A review process is conducted following each event. The process is led by the hospitals
clinical director and includes unit leadership.
All church services are now held within the fenced area.
Deadbolt locks are being placed on all exterior unit doors. These are replacing self-locking
locks which do not penetrate as far into the door jam and therefore are not as secure.
Renovations began to relocate the Canteen to being within the fenced area.
Building modifications began to add vestibules in hallways that have direct outside access to
unfenced areas.
Adding alarms to exterior gates to notify staff when a gate is not closed all the way.
Patients and students must enter and exit through lobby doors to prevent side doors being left
open.
Medical services may be provided on the units when possible.
Removal of items around campus that can be used to assist in an elopement (i.e. cement
blocks).
A code for UDs that could be broadcast by phone or radio systems is in development.
Newly hired employees will receive training on checking and testing door locks throughout
the units during new employee orientation.
Maximizing the utility of the surveillance cameras, including reviewing view angles in the
outside patient areas to ensure optimal viewing capabilities.
Exploring alternative communication devices for staff, including Direct Connect options as
an alternative to radios.
Limiting physical access to the campus at various entrance points.
Identifying options for modifying policies associated with grounds access for certain
populations.

Department of State Health Services February 8, 2017