Your (Unofficial) Guide to State-Sponsored Therapy in Tennessee
There’s a way to get affordable mental health care that you might not know about. That’s Tennessee’s mental health system.
If you qualify, you can get mental health care at a publicly-funded program for a small co-pay or a low sliding-scale fee. But even if you don’t qualify for services at a state-funded provider, Tennessee’s mental health system can still give you information, referrals to affordable local providers, and other essential help for free.
If you’re in a hurry and want to get the most important information about what’s available in the Tennessee public mental health system and who it’s for, you can read our quick start guide below.
To learn more about public mental health services in Tennessee, keep reading. We’ve done the research to uncover essential facts about who’s eligible, what services you can get, when to go, where to call, and how it works so you can decide if Tennessee’s mental health system might be right for you.
Who Is Eligible?
You should consider looking into the Tennessee mental health system if you (or a loved one) are having a mental health crisis, have a severe mental health condition, have TennCare, or have a limited income.
Everyone in Tennessee can use the state-funded mental health emergency response system. If you or someone you love is in crisis, you can call a state or local crisis line to get the help you need, quickly.
Use the State System When You're in Crisis
Public mental health services are usually the best option if you’re having a mental health crisis and need help right away.
State mental health programs are required to provide mental health crisis response services and are one of the fastest ways to get care when you’re having a mental health emergency.
The people who answer state and local crisis lines can provide caring attention and support as they help you determine the best response to a crisis, whether it’s inpatient treatment or an appointment with a counselor.
Even if you’re not in crisis, you can call a state or local mental health hotline for information about affordable mental health services in your area. When you call, you can find out whether you might qualify for state-funded mental health services, schedule an assessment, or get free information about other affordable local providers.
Other parts of the system have stricter eligibility requirements. You need to meet income eligibility requirements and have a diagnosable mental health condition that affects your daily functioning to qualify for services at a behavioral health safety net provider. However, more people have a qualifying condition than realize it. Don’t assume you’re not eligible!
Fast Facts About Eligibility in Tennessee
If you’re eligible for TennCare, you can use it to get behavioral health care at an in-network provider. You can find the eligibility criteria for TennCare here. In general, you’re eligible if you meet the income limits and have a disability or are the caretaker of a minor child.
If you’re not eligible for TennCare, you may be able to get affordable publicly-funded mental health care if you qualify for the Tennessee Behavioral Health Safety Net program.
You qualify for behavioral health safety net services if you:
- Are 18 or older
- Are a Tennessee state resident
- Are a U.S. citizen or qualified alien
- Have a qualifying mental health diagnosis
- Are not currently in an inpatient facility or a nursing home
- Have a household income at or below 138 percent of the federal poverty level
- Are ineligible for Veterans Administration (VA) benefits or TennCare (or are waiting to find out if you’re eligible for TennCare)
- Lack health insurance with behavioral health benefits or have exhausted all behavioral health benefits in your insurance plan for the plan year
In general, if you meet the other criteria listed above and have a mental health condition listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), you’re eligible. Qualifying diagnoses for Tennessee’s Behavioral Health Safety Net program include:
- Borderline and other personality disorders
- Anorexia, bulimia, and other eating disorders
- Schizophrenia, schizoaffective disorder, and other psychotic disorders
- Post-traumatic stress disorder and other trauma-related disorders, including dissociative disorders
- Obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, and other anxiety disorders
- Bipolar disorder, major depressive disorder, and many other mood disorders, including adjustment disorders and unspecified mood disorders
This list is not exhaustive. You can qualify if you’ve had a single episode of depression or mania, have a mental health condition caused by a medical condition, or are struggling to adjust to a life change (to the extent you could be diagnosed with an adjustment disorder).
If you don’t know whether you have a diagnosable mental health condition, but think you might, it’s worth reaching out to your local program to inquire, especially if you meet other eligibility criteria. You can find numbers for local programs and information lines in the directory below.
To this date, Tennessee has not accepted Medicaid expansion. This means that eligibility criteria for TennCare are in some ways more restrictive than eligibility criteria for the behavioral health safety net program. In order to qualify for TennCare as an adult, you generally need to have a disability or minor dependent children in addition to poverty-level income.
If you do qualify for TennCare, you’re no longer eligible for behavioral health safety net services as soon as your TennCare plan becomes active. However, you can use TennCare to access mental health care services from in-network providers, including from some of the same providers that participate in the Behavioral Health Safety Net program.
If you don’t qualify for TennCare, you may qualify for the behavioral health safety net program. If you don’t meet the income or clinical eligibility criteria for safety net services, you might want to explore whether you qualify for affordable insurance through the state or federal health insurance exchange.
You can also call a state or local crisis or information line to ask for help finding care. Whether you’re looking for basic outpatient care like therapy and medication or are looking for specialty services for serious mental illness, the people who answer can help you find what you need.
Check Out the State System If You Need Specialized Services
Behavioral health safety net programs in Tennessee are great places to find specialized and intensive mental health services like case management and day treatment that can be hard to find anywhere else. These specialty programs can give you extra help when you’re dealing with severe symptoms.
If you’re not eligible for the behavioral health safety net program, but you need specialty services, you can still call a safety net provider to ask for help finding what you need. Some safety net programs also offer services to people who don’t qualify for state assistance, and those that don’t can often help you find what you’re looking for at another provider.
Even if you’re not eligible for services at the program you call, or the program doesn’t offer the service you want, they can probably still help you. The people who work at these programs are knowledgeable about local mental health resources and will often give you free information or even referrals to other affordable providers nearby, including local non-profits that provide free or low-cost counseling.
Where Do You Call to Get Started?
The easiest way to learn more about state mental healthcare in Tennessee is to call a state or local mental health hotline or helpline. The people who answer can give you support and connect you with local resources. You can find state hotline and helpline numbers in the information box directly below.
If you’re interested in a specific program, you can also call them directly. You can find numbers for local safety net programs (and local mental health crisis and information hotlines) in the directory in the next section of this article.
Important Numbers in Tennessee
To get help or support from a peer, you can call the East Tennessee Mental Health Association’s Peer Recovery Call Center, which is available during the day Monday through Wednesday and in the afternoon on Saturday, at (865) 584-9125.
For help finding mental health services, you can call the Tennessee Department of Mental Health and Substance Abuse Services Helpline at (615) 532-6700 or (800) 560-5767.
Public mental health services in Tennessee are managed on the state level by the Tennessee Department of Mental Health and Substance Abuse Services. For general information about Tennessee’s system, you can contact their helpline at (800) 560-5767.
You can also call the program you’re interested in directly. You can find the number for your area’s safety net programs in the directory below.
Tennessee Mental Health Directory
There are two ways to get publicly-funded mental health services in Tennessee: through TennCare or through the behavioral health safety net program.
If you have TennCare, you get behavioral health benefits through Optum. You can learn more about how your behavioral health benefits work on Optum’s Here4TN website. Their site includes a provider search for in-network behavioral health providers.
If you’re not eligible for TennCare, are not sure, or are in the process of applying, you can seek affordable state-funded services through Tennessee’s behavioral health safety net program.
Each region is served by several safety net providers that offer a full range of specialty and basic outpatient mental health services. You can find which programs serve your area and their contact numbers (including local crisis and information hotlines) in the directory below.
If you need information after hours or aren’t sure whether you’re experiencing a mental health crisis, it’s okay to call a crisis line for help. The staff who answer are trained to quickly figure out what you need and can tell you what steps you need to take to connect with the right services.
If you’re interested in telehealth, Tennessee Voices provides online telemental health services for the behavioral health safety net. Their telehealth services are available in a number of counties across the state. To learn more, you can visit their website or call them at (800) 670-9882.
Also Consider: Federally Qualified Health Centers
Federally qualified health centers (FQHCs) are another great way to get affordable publicly-funded mental health services in Tennessee.
These federally-funded programs provide cutting-edge care in places where good primary healthcare was once hard to find. Most provide integrated care so you can get primary medical and mental health services at the same location.
Each FQHC accepts Medicaid and Medicare and offers low sliding-scale fees if you don’t have insurance. Their eligibility requirements are generally less strict than the requirements for the state-funded system.
You can search for FQHCs near you by using the online search tool on the U.S. Health Resources and Services Administration website.
The state mental health system is complicated and can be confusing to navigate. If you’re having any issues, we’re here to help. Here are some of our solutions to common problems you might experience.
If you’ve run into a problem that we haven’t addressed, don’t give up. Call someone at the program (or a state or local mental health hotline) and tell them what’s going on.
You’re much more likely to get the help you need when you advocate for yourself and are persistent. Tell the person you talk to what you need or what problem you’re having.
If they don’t help the first time, call them back and tell them. If you keep calling and keep calm and focused, you should eventually get through to someone who can help you.
Deep Dive: How Does the System Work?
To understand Tennessee’s mental health system, it helps to understand how it started and how it’s changed since then.
Public mental health services have been around for a surprisingly long time. But for over a hundred years in America, the only way to get them was in a psychiatric hospital.
In the 1960s, Americans started thinking differently about mental health care. Conditions in psychiatric hospitals were getting worse and new medications made it possible to provide mental health treatment on an outpatient basis.
In response, new laws were passed that required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. The most important was the Community Mental Health Act, which President John F. Kennedy signed into law in 1963.
For More Information
To learn more about what the public mental health system was like in the early days—and how psychiatric inpatient care has evolved since then—you can read our article “Do Insane Asylums Still Exist? The Surprising Past and Present.”
To learn more about what inpatient mental health treatment is like now, and the differences between how it works in general hospitals and specialized psychiatric facilities, you can read our article “How Inpatient Mental Health Treatment Works.”
Many state mental health programs trace their origins back to the 1960s when these important changes started to happen.
Tennessee was ahead of the curve. In 1953, ten years before the federal Community Mental Health Act was passed, Tennessee established its state Department of Mental Health and made it state policy to provide matching funds to communities that invested in local mental health programs.
Tennessee opened some of its first community mental health centers in the 1950s. The state’s plan for a comprehensive community mental health system was approved by the federal government in 1966, and many more community mental health centers were founded in the following decade.
Since 1971, the Tennessee Association of Mental Health Organizations (TAMHO) has advocated for mental health consumers and programs in Tennessee. In the 1980s, TAMHO took action to protect the state mental health system after the Reagan administration changed how funds were allocated for mental health services.
The organization also advocated for consumers and communities as the state updated its Medicaid system and launched TennCare in 1994.
What Is the Structure of the Tennessee Mental Health System?
Since 1953, Tennessee has had a strong centralized state mental health department, though the agency’s role has shifted over time.
In the past, the Tennessee mental health department provided some services directly. Today, the Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) has more of a management role. They oversee the four state psychiatric hospitals and the private programs that provide publicly-funded outpatient services.
Unlike many other states, Tennessee does not have county or regional offices that supervise local programs. Instead, TDMHSAS directly oversees a network of 16 private organizations that provide essential mental health safety net services across the state. Of these, 11 have mobile crisis teams that respond to crisis calls. Seven run crisis walk-in centers that offer same-day in-person assessments.
Thanks to the efforts of the state mental health department, as well as TAMHO and other mental health advocates, Tennessee’s public mental health system has continued to evolve to keep up with changing trends in mental health care.
Today, community-based mental health services are available in urban and rural locations across Tennessee, and pioneering integrated care and housing programs have reduced homelessness, psychiatric hospitalization rates, and wait times for inpatient beds.
Still, like many states, Tennessee faces issues with access to mental health care, especially crisis care. The state has responded to these issues by expanding mobile and walk-in crisis services, dedicating millions of dollars to building new crisis facilities, and launching the statewide 988 crisis line.
If you’re in crisis or need mental health services and aren’t sure where to go, you can can call the new statewide 988 hotline or a local crisis line to get help connecting to these new and expanding services. The people who answer know how the system works and will help you get where you need to go, whether it’s to a crisis walk-in center, a behavioral health safety net provider, or a local non-profit.
According to the Substance Abuse and Mental Health Services Administration, only 48 percent of people in Tennessee who have mental health conditions get treatment for them. Many qualify for public mental health services but don’t know about them.
You can make a difference by reaching out and connecting with local mental health resources to get the care you need. If you’re not sure whether you qualify for Tennessee state mental health services, call a state or local crisis and information line. You may find out you can get mental health services through a behavioral health safety net provider or that there’s another affordable option nearby.
The most important thing is to get started—the help you need may be only a call or click away.