Locational decisions based on stigma and low funding have handicapped the efficiency of community based mental healthcare in the United States since 1963. However, the pattern of services in the 21st century American South remains largely unknown. This thesis addresses this gap in knowledge by using a mixed methodology including location allocation, descriptive statistics, and qualitative site visits to explore the geography of community clinics offering both physical and mental health services. The City of Houston has proposed using these facilities to anchor new supportive housing, but introducing more fixed costs to a mismatched system could create more problems than solutions. The findings of this study suggest the presence of an unnecessary concentration of services in the central city and a spatial mismatch between accessible clinics and the poor, sick people in need. Furthermore, this research reveals a new suburban pattern of vulnerability, calling into question long-held assumptions about the vulnerability of the inner city. Building supportive housing around existing community clinics, especially in the central city, may further concentrate vulnerable people thereby contributing to intensifying patterns of service-seeking drift and the continued traumatization of mentally ill homeless persons in Houston.

This thesis examines the response to the AIDS crisis in Houston and Dallas, two cities in Texas with the most established gay communities highest number of AIDS incidences. Devoting particular attention to the struggles of the Texas’ gay men, this work analyzes the roadblocks to equal and compassionate care for AIDS, including access to affordable treatment, medical insurance, and the closure of the nation’s first AIDS hospital. In addition, this thesis describes the ways in which the peculiar nature of AIDS as an illness transformed the public perception of sickness and infection. This work contributes to the growing study of gay and lesbian history by exploring the transformative effects of AIDS on the gay community in Texas, a location often forgotten within the context of the AIDS epidemic.