Seven more Tennessee counties are set to get embedded mental health teams inside their local health departments, after the state landed a five-year, $10 million federal grant aimed at closing gaps in rural behavioral health care. Anderson, Cumberland, Hawkins, Bradley, Coffee, Montgomery and Tipton counties are the new additions, with officials hoping to have services running by early 2027.
The money comes through the Promoting Integration of Primary and Behavioral Health Care program. The UC Now reported on November 3, 2026, that the Tennessee Department of Mental Health and Substance Abuse Services, or TDMHSAS, would receive the $10 million over five years, a day before WATE published its report on November 4, 2026. The grant will fund a master-level therapist and a peer wellness coach in each new county, with programming built around diabetes management, smoking cessation and chronic disease management, the station reports.
As the Lewis Herald notes, the co-location project began as a pilot with the Tennessee Department of Health placing a single mental health clinician inside rural county health departments. That small-scale start has since grown into a statewide push: a separate $7.5 million contribution from the Rural Health Transformation Program is expected to help the co-location project expand to 25 Tennessee counties by early 2027, according to The UC Now.
How the New Model Is Supposed to Work
The idea behind pairing a therapist with a peer wellness coach is accessibility. A state spokesperson told WATE the goal is same-day availability, five days a week, with most referrals expected to come through county health department workers, though referrals can come from elsewhere too.
Peer wellness coaches, specifically, are meant to offer one-on-one coaching to help participants hit personal wellness goals, the station reports. According to The UC Now, those coaches will help people managing behavioral health challenges address chronic conditions, quit smoking, manage diabetes and build healthier lifestyles overall. The same grant is expanding the statewide Peer Wellness Initiative by adding seven new Peer Wellness Coaches and two trainers, per the outlet's reporting.
TDMHSAS Commissioner Marie Williams framed the expansion as a matter of reach. “Making those services more accessible in our state's rural counties just makes sense,” Williams said, according to WATE. Per the Lewis Herald, Williams also expressed gratitude toward community mental health center partners and Department of Health counterparts who have helped expand the work, and she described a whole-body approach to mental health as a way to stretch limited funds toward people who need them.
Providers and the Pilot's Roots
Several community mental health providers are participating in the broader effort, the Lewis Herald reports, including Centerstone, Frontier Health, Professional Care Services, Ridgeview and Volunteer Behavioral Health Care Services. The co-location push traces back to Governor Bill Lee's first executive order, issued in January 2019, which directed state government to focus on expanding services in rural Tennessee, according to the Lewis Herald.
Since then, the state has layered on other rural-focused programs. School-based behavioral health liaisons and criminal justice liaisons now serve all 95 Tennessee counties, the Lewis Herald reports. Project Rural Recovery serves 30 rural counties, while Hybrid Lifeline Peer Project coordinators work exclusively in 25 rural, distressed counties, and Tennessee Suicide Prevention Network regional coordinators have expanded to statewide coverage with an emphasis on rural access, according to the same reporting.
Why Rural Counties Are the Focus
The workforce gap behind this push is stark. A June 2025 brief from the University of Washington Rural Health Research Center found Tennessee's rural counties had far fewer behavioral health clinicians per 100,000 residents than urban counties — 2.4 psychiatrists compared with 13.5, and 33.5 counselors compared with 100.4, among other disparities.
That shortage lines up with how Tennessee ranks nationally. Mental Health America placed the state 44th across 17 measures of mental health prevalence and access, according to a September report in the Chattanooga Times Free Press. The same piece noted Tennessee began issuing interstate practice privileges through the Counseling Compact on Sept. 1, a move intended to help licensed counselors from other states practice in Tennessee more easily.
The co-location expansion also sits inside a much larger funding wave. The Tennessee Department of Health announced grants for 53 Rural Health Transformation Program projects in September, described as expanding services across 44 Tennessee counties, according to WSMV. That program itself grew out of a federal windfall — CMS awarded Tennessee more than $206 million through the Rural Health Transformation Program in late 2025, per the station's reporting.
