AUSTIN — State hospitals are starting to ban smoking on their property, drawing complaints from advocates who contend the rights of the mentally ill are being infringed upon.

People with psychiatric disorders are twice as likely to smoke as others, according to studies cited by the advocates. North Texas State Hospital campuses in Wichita Falls and Vernon have banned smoking on their grounds by patients or employees. The state hospitals in San Antonio and Rusk are poised to do the same in September. Five state-run mental health facilities, including Austin State Hospital, are considering banning smoking, the Austin American-Statesman reported Monday. "If you go to a hospital, you can get out and smoke a cigarette, if you're able to get up and walk yourself outside," said Beth Mitchell, a senior lawyer with Advocacy Inc., a federally funded watchdog for people with disabilities. "Why should it be any different for someone in a mental health facility?" she said. The state's psychiatric wards used to hand out tobacco and rolling paper to patients. Later, pre-made generic cigarettes were a staple paid for by Texas taxpayers. The subsidized smoking continued until the late 1980s in the name of nicotine therapy. "In group therapy, everybody was smoking ... It was almost like breathing," said Jerry McLane, a spokesman for North Texas State Hospital and an employee there for 25 years. McLane said psychiatric hospitals now are simply including their patients in the seismic shift in national culture, as restaurants and other public buildings have banned smoking. Fears for the health of the smokers themselves also led to the ban, begun more than two years ago at North Texas State Hospital, he said. But some say it's inappropriate to tell a patient who has a mental illness he or she can't smoke, even outdoors. "It may be a bad habit, but people would get a lot crazier if they couldn't get a cigarette," said Christina Magee, 21, a patient at Austin State Hospital who has smoking privileges. Some patients aren't allowed to smoke because of the severity of their disorders. Others can't leave the facility to buy a pack and don't have family members who bring them smokes. They swarm around Magee, with requests that she give or buy a pack for them. Petitions in protest of the proposed ban have been circulating at the hospital, and passions are stoked. Cassandra Davidson, 46, a non-smoker who arrived at the Austin hospital last Wednesday, opposes smoking on the premises. "The smoke is so heavy, you can't wash it off at night. (In the patio area), the butts just cover the ground. It's very nasty. It's a right, but I'm still against it," she said. Scientists have no definitive answers. Some assert that smoking is a soothing crutch for people with mental illnesses. Others say it interferes with their psychiatric medications. "Smoking increases the metabolism," said Dr. Karen Lasser, a researcher at the Harvard School of Public Health. "The body gets rid of the drug sooner and washes it out. You have to take higher doses, and that may mean side effects." Medical research aside, the question is simpler for some, including state Rep. Garnet Coleman, D-Houston, who has bipolar disorder and started smoking when he was in a psychiatric hospital. "One of the things that keeps people saner is they have for themselves that pleasure, whether we consider it to be bad or good," he said.

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