Knox County leaders who have spent years pleading for more long-term psychiatric beds just watched their best hope get left on the cutting-room floor. The governor's new budget does not include the state dollars they had been banking on to help convert part of the vacant St. Mary’s campus into longer-stay psychiatric space, a move they say is crucial to easing packed emergency rooms and costly jail transports. Without that money, advocates warn, the gap between quick crisis care and true inpatient treatment keeps getting wider.
According to the Knoxville News Sentinel, the Tennessee Department of Mental Health asked for roughly $20 million to expand services connected to the Helen Ross McNabb Center's EmPATH operation, but that request did not show up in Gov. Bill Lee's Feb. 2 budget proposal. The paper reports that State Sen. Becky Duncan Massey said she plans to push for the money in a supplemental budget later this spring.
State Study Says Region Is Already Short On Beds
A 2023 assessment by the Tennessee Department of Mental Health and Substance Abuse Services found that, at current operating levels, private inpatient capacity in the former Lakeshore catchment area is about 88 staffed beds below research-based minimums. The report recommended exploring a new state hospital to help meet the demand. The department also warned that the region's population is expected to grow substantially in the coming decades, a trend that would make the shortfall even worse unless additional long-stay capacity is added. The full analysis is detailed in the department's report.
Local Proposal Still Waiting For Money
Local leaders pitched a plan last year to convert the second floor of the old St. Mary’s hospital into roughly 30 longer-stay psychiatric beds, at an estimated cost of about $20 million, directly above McNabb's EmPATH walk-in unit. WVLT reported that McNabb Center leaders said the extra beds would allow multi-day stabilization and short inpatient stays based on clinical need, instead of EmPATH's design for same-day stabilizations.
Why Moccasin Bend Matters
Since the Lakeshore Mental Health Institute closed in 2013, the closest state psychiatric hospital for long-term care has been Moccasin Bend in Chattanooga, roughly a 100-mile trip for many East Tennessee communities. The Tennessee Department of Mental Health and Substance Abuse Services notes that Moccasin Bend operates multiple acute units and remains the main option for patients who need state-level or forensic evaluation, a setup that increases transport costs and puts extra strain on local first responders.
EmPATH Is Not A Stand-In For Inpatient Care
The Helen Ross McNabb Center's EmPATH unit, Tennessee's first Emergency Psychiatric Assessment, Treatment, and Healing facility, runs 24/7 as a walk-in stabilization site but is built for short stays. The McNabb Center and state documents emphasize that most patients are stabilized in about 23 hours. EmPATH fills a critical gap for crisis triage, but it is not designed to replace longer, multi-day inpatient treatment.
Governor's Budget Sidelines The Local Ask
Gov. Bill Lee's $57.9 billion spending plan, unveiled Feb. 2, highlights priorities that range from school-choice expansions to rural health initiatives. It does not include a dedicated appropriation for a new inpatient psychiatric hospital in the Knoxville area. Coverage of the proposal noted the governor's focus on those broader statewide initiatives even as regional mental health advocates argue that Knoxville's shortage of long-term beds is both severe and getting worse.
What Leaders Say They Will Do Next
Local officials and state lawmakers say they are not walking away from the fight. They plan to keep pressing for a funding path this spring, either through a supplemental appropriation or other state mechanisms. Sen. Becky Duncan Massey and other members of the Knoxville delegation have publicly urged action in light of the department's report and say they will push colleagues to find a solution while also looking at possible local or private bridging funds.
Advocates say steps like EmPATH are important, but they argue that short-term stabilization alone cannot take the place of the multi-day inpatient care that clinicians and families say the region needs. With the budget process now underway, local leaders say the next several weeks will be crucial in deciding whether Knoxville can turn its gains in crisis stabilization into the permanent bed capacity they have been chasing for years.
