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TDMH Milestones in Tennessee 1796-Present

1796-1840 No State facility for the mentally ill in Tennessee.  Care was responsibility of local communities:  included family care, jails, almshouses, poor houses.
1826 Almshouse system established in Tennessee when General Assembly granted Anderson County permission to build an almshouse.  Legislation expanded in 1827 to apply to all counties.
1832 Tennessee Legislature authorized first hospital for insane and appropriated $10,000. 
1840 Tennessee Lunatic Asylum opened in Nashville as the 11th institution for mentally ill in USA.
1847 Dorothea Dix visited Tennessee and found Nashville asylum deficient.  She implored the Legislature to purchase larger site for a new hospital.
1848 Legislature appropriated $40,000 for new hospital for insane.  Site purchased on Murfreesboro Turnpike.
1852 Tennessee Hospital for the Insane (now Middle Tennessee Mental Health Institute) opened with 60 patients transferred from old asylum.
1868 Ewing Building became first mental hospital for Negroes in the USA.
1886 East Tennessee Hospital for the Insane (now Lakeshore Mental Health Institute) opened in Knoxville with the  transfer of 99 patients from the Nashville hospital.
1889 West Tennessee Hospital for the Insane (now Western Mental Health Institute) in Bolivar opened with the transfer of 156 patients from Nashville.
1909 Prohibition law enacted in Tennessee.  No special facilities available for alcoholics, some of whom were cared for at State Psychiatric Hospitals.
1913 State enacted narcotics law which allowed for registration and maintenance of drug addicts.
1916 Dr. Sidney Wilgus, a representative of the National Society for Mental Hygiene, found Tennessee's institutions deficient in meeting minimum requirements for modern treatment of mental disease.
1919 Tennessee Legislature appropriated $10,000 for construction of institution for the feeble-minded.  Additional $100,000 appropriated the next year and site purchased near Nashville.
1919-1921 Federally supported clinics, including ones in Knoxville and Memphis, established for the temporary maintenance of drug addicts.  Experiment abandoned in face of public opposition.
1920 Names of State Institutions changed to Eastern, Central, and Western State Hospitals.  Previously called Hospitals for the insane.
1923 Tennessee Home and Training School for Feeble-Minded Persons (now Clover Bottom Developmental Center) opened and admitted 248 persons during first nine months of operation.
1931 Separate facility for the criminally insane opened on grounds of Central State Hospital.
1943 Gailor Memorial Psychiatric Hospital opened in Memphis as intensive, short-term treatment facility for mentally ill.
1946 National Mental Health Act marks entry of Federal government into mental health care.  Chattanooga Guidance Clinic established, followed by community clinics in Knoxville and Nashville in 1948.
1953 Tennessee Department of Mental Health and Substance Abuse Services created as one of the first such departments in the nation. Governor Clement appointed the first Commissioner of the Department on March 25.
1960 Greene Valley Hospital and School (now Greene Valley Developmental Center) opened in Greeneville with 400 beds.  400 more beds were added by 1963.
1961 Moccasin Bend Psychiatric Hospital and Institute ( now Moccasin Bend Mental Health Institute) opened in Chattanooga as short-term, intensive treatment facility with 150 beds.
1962 Tennessee Psychiatric Hospital and Institute (now Memphis Mental Health Institute) opened as a facility for short-term treatment and research.
  Tennessee Re-Education Center (Cumberland House) opened as model program for emotionally disturbed children.
1963

Division of Mental Retardation established in Tennessee Department of Mental Health. Alcoholism programs transferred to the Tennessee Department of Mental Health from Department of Public Health.

1964 Mental Retardation Facilities and Community Mental Health Centers Construction Act passed at the National level.  Tennessee received $5 million in Federal funds for construction of community mental health centers during the 1960's.
1965 Medicare and Medicaid enacted, beginning shift of some hospitalization and treatment costs from States to the Federal governments.
1969 Arlington Hospital and School (now Arlington Developmental Center) near Memphis opened with 600 beds for the mentally retarded.
1971 "Midnight Raid" at Eastern State Hospital focused attention on deficiencies in care and facilities there.  Resulted in several improvements. 
1972 Wyatt v. Stickney, a federal court case in Alabama, affirmed patient's right to treatment.  Another case, Jackson v. Indiana, led to evaluation of patients in Tennessee's Forensic Services Unit.
1973

Facilities for the retarded renamed Developmental Centers.

The Alcohol and Drug Abuse section created in the Tennessee Department of Mental Health.

Legal Services section established to review impact of court decisions on Tennessee policies, and to review and propose mental health legislation.

1974 As a result of Saville v. Treadway, new procedures developed to guarantee rights of those entering developmental centers.  Patients no longer required to work without pay at State institutions as a result of Townsend v. Treadway.
1974-1979 All residential mental health and mental retardation facilities in Tennessee accredited.
1975 Tennessee Department of Mental Health renamed Tennessee Department of Mental Health and Mental Retardation.
1976 Fifty-bed Forensic Services Building opened at Central State Hospital as part of nationally recognized system of decentralizing forensics services in Tennessee.
1977 State Hospitals renamed Mental Health Institutes.
1978 Mental Retardation Secure Facility opened at Middle Tennessee Mental Health Institute for mentally retarded offenders.
1979

Nat T. Winston Developmental Center opened at Western Mental Health Institute for mentally retarded persons with emotional problems.

Division of Alcohol and Drug Services created in the Tennessee Department of Mental Health and Mental Retardation.

The Tennessee Department of Mental Health and Mental Retardation began a long-range, consumer-based planning process.

1980

First Five-year master plan developed as guide for service development, facility construction, and funding of mental handicap program.  Plan revised in 1982.

Governor's Task Force on the Prevention of Mental Retardation formed.

1981 Federal Alcohol, Drug, and Mental Health Block Grant Act brought major restructuring of relationship among Federal, State, and local governments. Changed pattern of funding for community mental health centers. 
1982 Task Force on Children and Youth appointed to study improvement and expansion of services for this population. 
  New evaluation standards developed for community mental health centers.
1983

Community Initiative plan proposed to allocate additional funds to community health centers through further reductions in census at the institutes.

Healthy Children initiative begins four-year effort to emphasize health care and healthy lifestyle for all children in Tennessee.

1984 Department develops 2 1/2 year plan emphasizing additional community and children's programs.
1986 "Protection and Advocacy for Mentally Ill Individuals Act of 1986"

 

1987

Eric Taylor named Commissioner of Department.

Law to license facilities that provide services to two or more unrelated people who have mental illness, chemical dependency or mental retardation.

The department secured a multi-year grant from the National Institutes of Mental Health for human resource development.

 

1988

"Creativity Unlimited," a traveling arts and crafts show exhibiting the artwork of individuals with mental illness, mental retardation and developmental disabilities, opened. The feature exhibit was Myrllen's Coat.

The Divisions of Mental Health Services and Alcohol and Drug Abuse developed a joint plan for treating persons with dual-diagnosis -- mental illness and/or drug abuse.

 

1989

The Divisions of Mental Health Services and Alcohol and Drug Abuse developed a joint plan for treating persons with dual diagnosis - mental illness and alcohol and/or drug abuse.

The Division of Mental Health Services joined the Department of Human Services and the Division of Juvenile Services (Department of Correction) in the creation of seven home-based family preservation projects.

The Developmental Disabilities Council and the Division of Mental Retardation established an office for People First.

 

1990

Expanded the role and function of the mental health regional planning committees to include Community Mental Health Centers, consumers and representation from other state agencies.

Tennessee's Medicaid Waiver for adults with mental retardation was one of the 25 winners selected from nearly 350 applicants who competed in the 1990 Exemplary State and Local Awards national program.

A supported employment initiative between the Division of Mental Retardation and the Division of Rehabilitative Services was developed to provide the opportunity for 173 individuals with disabilities to work in community job settings.

 

1991

Evelyn Robertson named Commissioner of the department.

New quality assurance program initiated to ensure that clients have timely access to desirable, effective services which meet recognized standards of good practice.

Division of Alcohol and Drug Abuse Services transferred to the Department of Health.

The Tennessee Developmental Disabilities Planning Council established a statewide coalition of disability advocates, funded 10 projects which promoted the employment of persons with developmental disabilities and began publication of a state wide newsletter.

1992

Master Plan for Mental Health Services developed.

1993

The Division of Mental Health Services established an Office of Consumer Affairs.

 

1994

Tennessee prioneered TennCare, a substitute for the Medicaid program.

Department of Justice charged DMHMR to provide supports, resources and expertise to improve the quality of life for Arlington Developmental Center residents.

 

1995

Marjorie Nelle Cardwell named Commissioner of the department.

Construction was completed on a new state-of-the-art facility for Middle Tennessee Mental Health Institute.

Preparation for the Transition to TennCare Partners, the Mental Health Services program within TennCare.

Community mental health block grants were allocated to 30 private non-profit community mental health centers.

Crisis, respite, housing, supported employment, psychosocial rehabilitation and forensic services were made available to consumers.

Journey of Hope funding was targeted to develop education and training for families of individuals with SPMI. Its goal was to provide family members with skills to cope with relatives who had serious and/or persistent mental illness.

Supported Living as a state-funded demonstration project was initiated.

The Division of MR Services started an aggressive policy of downsizing developmental centers and increasing the quality of care available to their residents.

 

1996

The TennCare Partners program was officially launched. Under the TennCare Partners program, the department went through a monumental change involving not only contracted agencies, but also department-run facilities. The regional mental health institutes became more efficient and better able to compete with private providers. And, for the first time, consumers had other choices of where to go for treatment.

Tennessee State government signed onto the Internet and implemented e-mail.

Information Systems Management, in conjunction with the Division of Mental Retardation Services, began developing a new tracking and billing system.

The Partners Program Information System was developed.

Individual Support Planning adopted by Division of Mental Retardation Services.

Commission on Compliance established to oversee Arlington Developmental Center's compliance with remedial court order. Coupled with the settlement agreement between People First, the United States, and the State of Tennessee, institutional reform of the Developmental Centers was initiated.

TDMHMD and the Governor's Office established web sites.

TennCare Partners Appeals Unit was created.

A major public education campaign - Making the Vision A Reality: Opening Doors, Changing Lives was launched to share information regarding opportunities for people with mental retardation or other disabilities to live successfully in the community.

 

1997

Major public education campaign - Making the Vision a Reality: Opening Doors, Changing Lives was launched to share information regarding opportunities for people with mental retardation or other disabilities to live successfully in the community.

State-wide conferences on Treatment Interface between Primary Health Care and Mental Health providers in Managed Care.

 

1998

Elisabeth Rukeyser appointed commissioner of the department.

Governor Sundquist signed mental health parity legislation to ensure that insurance policies cannot discriminate in providing treatment for mental illness. This legislation prohibits insurance policies in Tennessee from enforcing lifetime benefit caps or other restrictions for mental illnesses that are not enforced for physical illnesses and surgical procedures.

Nat T. Winston Developmental Center closed.

Title 33 Revision Commission appointed to review Title 33 of the Tennessee Code Annotated, the law pertaining to mental health and mental retardation.

 

1999

A $12.75 million Children's Mental Health System of Care initiative for children with special needs was begun. The project targets children who are at imminent risk of being placed in State custody, hospitalization in residential placement, state custody and those in need of services which would allow for home care.

A comprehensive revision of Title 33 of the Tennessee Code Annotated was passed on June 23. The name of the Department changed from Mental Health and Mental Retardation to Mental Health.

 

2000

Comprehensive revision of Title 33 of the Tennessee Code Annotated passed June 23. Official name of the department changed from Mental Health and Mental Retardation to Mental Health.

Statewide training on the new Mental Health law began.

The Creating Homes Initiative (CHI) was started to create and expand affordable, safe, permanent and quality housing options in local communities for people with mental illness in Tennessee.

Mental Health Matters, a TDMH radio show, was first broadcast.

 

2001

National Strategy for Suicide Prevention is unveiled.

Greene Valley Developmental Center celebrates 40th Anniversary.

TDMH/THDA award housing grants for people with mental illness.

TDMH Planning and Policy Council holds inaugural meeting

The University of Tennessee and the TDMH jointly offer the
Tennessee Interdisciplinary Health Policy Program (TIHPP) for
Law, medical and pharmacy students.

 

2002

In March, people with developmental disabilities, other than mental retardation, became eligible for services under the MH law. A plan was developed for expansion of services to them, subject to available funding.

Suicide Prevention Awareness Day proclaimed on May 28.

Creating Homes Initiative (CHI) Surpasses 2005 goal of providing 2005
permanent housing options to people with mental illness.

CHI wins top Eli Lilly Housing Award

 

2003

Virginia Trotter Betts named commissioner of the department.

Real Choice Systems Change Oversight Committee convenes for first time with the goal of providing an effective, consumer-directed housing resource system. Housing Within Reach aims to change attitudes and misconceptions regarding community housing for persons with mental illness and co-occurring disorders thus fostering a welcoming environment for residents of Tennessee neighborhoods.

On March 13, the TDMH&MR celebrates its 50th birthday.

TDMH&MR web site re-design offers over 600 pages of access to information and services.

US Department of Housing and Urban Development honors the department’s housing office for promoting fair housing for people with mental illness and co-occurring disorders.

A Health Insurance Portability and Accountability Act (HIPAA) director
was appointed to oversee the department’s compliance in all HIPAA-related
matters.

New TennCare Behavioral Healthcare Contracts Sought by State

Task Force on Dual Diagnosis appointed to study current status of mental health supports for people with mental retardation and developmental disabilities. Identify best practices for delivery of mental health supports.

2003-2004

 

The Tennessee Department of Mental Health & Mental Retardation celebrates 50 years of service to Tennessee. In the coming years, the term Mental Retardation will be changed by the federal government and many states, including Tennessee, to Intellectual Disabilities.

2007

Tennessee’s single state authority for Alcohol and Drug Abuse Services transferred from the Department of Health to the Department of Mental Health and Developmental Disabilities by Executive Order.
Construction was completed on a new state-of-the-art facility for Memphis Mental Health Institute.

2009

Crisis Stabilization Units and Medically Monitored Crisis Detoxification Units open statewide to serve Tennesseans experiencing a mental health or substance use crisis.
Available Suitable Accommodations passed by Legislature to control admissions/access at the 5 Regional Mental Health Institutes in order to maintain an appropriate and safe level of care for every patient who is receiving inpatient services.

2010

Construction was completed on a new state-of-the-art facility for Western Mental Health Institute in Bolivar, Tenn.

2011

E. Douglas Varney named as the new Commissioner of the Department of Mental Health.
Responsibility for developmental disabilities transferred to the Department of Intellectual and Developmental Disabilities. The department’s name officially changes to Tennessee Department of Mental Health and Substance Abuse Services.

2012

Lakeshore Mental Health Institute closes in June, 2012. Patients are transferred to Moccasin Bend Mental Health Institute in Chattanooga, and some come under the care of area providers. Records from the original Eastern State Hospital are preserved, and many artifacts from that time are transferred to the TDMHSAS Office of Communications and the Tennessee State Museum for preservation.


  • Acknowledgements: Beyond the Asylum, by Paul R. Dokecki and Janice Mashburn, Pub. 1984 by State of Tennessee Department of Mental Health and Substance Abuse Services and Mental Retardation.