Knox County leaders desperate to add mental health care face a new setback

Gov. Bill Lee declined to endorse a state-financed mental health care expansion in Knoxville, but proponents have hope the money will come together for a part of the state they say is vastly underserved.

The Tennessee Department of Mental Health and Substance Abuse asked Lee to include $20 million in his next budget proposal to expand services at the Helen Ross McNabb Center’s EmPATH Unit.

The new care option was considered an interim solution as the process to build a new mental health hospital continues to unfold. The space would be reserved for those who need to stay longer than 23 hours, which is the limit at the EmPATH Unit.

“The research identified a need in this area and we do believe it’s going to continue to grow,” Marie Williams, Tennessee’s mental health commissioner, said at a Nov. 10 budget hearing. “We really are struggling with beds. We’ve got research requested by the Knox County delegation; a letter was sent to us to come up with a plan.”

State Sen. Becky Duncan Massey, a Knoxville Republican, told Knox News she will push Lee to include the $20 million in his supplemental budget. That budget is created toward the end of the legislative session in April, Massey said.

“They look at the updated revenue projections,” Massey explained. “Then they figure out that, OK, we’ve got a little more that we could budget. What you see in the supplemental is a few things that didn’t get funded originally, you see a few bills that members are trying to pass, you see some of the nonprofit requests.”

Massey joined with state Sens. Richard Briggs, a Republican from Knoxville, and Randy McNally, a Republican from Oak Ridge, to enact the study that showed the need for a new mental health hospital in Knoxville. Support from the Knoxville City Council and Knox County Commission helped to move it along.

“It’s always hard in a tighter budget year to get everything funded that you’re hoping for. I’m gonna be corralling and getting the regional legislators to help advocate. I’ll have more conversations with the commissioner of finance,” Massey said. “It’s a process and we’re gonna work it.”

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Lee’s $57.9 billion budget proposal unveiled Feb. 2 would expand his signature project, taxpayer-funded private school vouchers, and make a dent in the state’s $58 billion road project backlog.

Finance and Administration Commissioner Jim Bryson said on Feb. 2 the budget recognizes that Tennessee’s revenue boom is over, and that revenue growth has slowed. 

Why Knoxville needs a new mental health hospital

An extensive 2024 audit showed the need for a psychiatric hospital in our region.

When Knoxville’s Lakeshore Mental Health Institute closed in 2013, the closest long-term mental health facility was 100 miles away in Chattanooga. It’s hard or even impossible for patients to get there or for police to take people there in a crisis. Only short-term care is available from the state here.

Private hospitals don’t fill the needs of those mandated to receive care after jail or those who are underinsured.

“At current operational levels, the private inpatient capacity is 88 beds short of the research-backed minimum,” the 2024 study says. “With no way to predict increases or decreases in bed counts among private operators and a regional population expected to grow by about 200,000 in the next three decades, it is not unreasonable to think the shortage of staffed adult beds will fall further into deficit.”

Since a 2022, Knoxville City Council and Knox County Commission members have worked to find a solution.

“Knox County has the largest admission to the state facility at Moccasin Bend (in Chattanooga),” a joint 2023 resolution passed by the city council and county commission says.

Who is served by state-funded facilities?

The primary needs of patients at Moccasin Bend are different than those at state-contracted private inpatient hospitals. Schizophrenia and psychotic disorders, drug-related disorders, anxiety and stress-related disorders make up 67% of primary diagnoses at Moccasin Bend, while mood disorders make up 33%.

At state-contracted private inpatient hospitals, mood disorders make up 66%, while the other disorders account for the other 34%.

USA TODAY-Network Tennessee contributed to this report

Allie Feinberg is the politics reporter for Knox News. Email: allie.feinberg@knoxnews.com; Reddit: u/KnoxNewsAllie