By the 1960s the facility had grown into the largest mental hospital in the world (contending with Pilgrim Psychiatric Center in New York).

[2] The CSH complex currently encompasses about 1,750 acres (710 ha), a pecan grove and historic cemeteries, and serves about 200 mental health patients.

As of 2016 the facility offers short-stay acute treatment for people with mental illness, residential units and habilitation programs for people with developmental disabilities, recovery programs that require a longer stay, and specialized skilled and ICF nursing centers.

[3] In the first decades of the 1800s there was a movement in several states to reform prisons, create public schools, and establish state-run hospitals for the mentally ill.

During the following decade, the population began to decrease due to the emphasis on de-institutionalization, the addition of other public psychiatric (regional) hospitals throughout the state, the availability of psychotropic medications, an increase in community mental health programs, and many individuals moving to community living arrangements.