The future facilities at Tanglewood Mall. Courtesy of Carilion Clinic.

Carilion Clinic plans to move its psychiatry and behavioral medicine outpatient services from South Roanoke to Tanglewood Mall by next fall.

The nonprofit health system, which consolidated its children’s services in the Roanoke County retail center last year, will open the new offices and treatment areas in 37,000 square feet of space over two floors. The new location will house mental health services for children, adolescents and adults, as well as Carilion’s Center for Grief and Healing and its Center for Healthy Aging. 

[Disclosure: Carilion is one of our donors but donors have no say in news decisions; see our policy.]

Dr. Robert Trestman, Carilion’s chairman of psychiatry and behavioral medicine department, said Thursday that he expects 800 people will come through the new center each week when it opens, with growth projected.

The buildout is expected to cost about $11 million, said Jennifer Rotenberry, who’s managing the project for Carilion.

The health system’s behavioral health services currently are housed on South Jefferson Street, near Carilion Roanoke Memorial Hospital. Some outpatient services will remain there, Trestman said; high-acuity outpatient opioid treatment programs, for instance, need to remain close to the medical center.

In 2019, Carilion announced plans to build a new behavioral health hospital as part of a $300 million expansion of Roanoke Memorial. The new building, which was to include a separate emergency room for behavioral health patients, would have been across the street from the main hospital.

This August, however, Carilion officials said they were pausing that project based on what they had learned during the pandemic. Nancy Agee, Carilion’s president and CEO, said the following month that her team was looking at replacing some of the semi-private rooms in the original plan with private rooms, and at adding negative-pressure rooms, which she said are rare in psychiatric facilities but became important during the pandemic.

She said Carilion also learned more about using telehealth for behavioral health treatment and wanted to figure out how to better incorporate those services.

No decisions have been made yet about what a new inpatient facility would look like, Trestman said Thursday, or whether it would make more sense to retrofit and modernize the existing building, which has been in service for more than 50 years.

“The world is changing rapidly,” he said. “And so we’ve taken this opportunity to rethink what the acute services should look like.” 

Carilion continues to look at national models to determine what might be the best fit in Roanoke, he said, and he pointed out that costs to build and equip new facilities are at an all-time high.

Although Carilion paused the construction of the behavioral health hospital, it has pressed on with the planned expansion of its flagship Roanoke Memorial, where a new tower currently under construction will house a larger emergency department and consolidated cardiac services. Like health systems nationwide, Carilion also is dealing with lingering, and significant, financial challenges related to the pandemic.

In the meantime, the move to Tanglewood is designed to make outpatient behavioral health services more accessible to the community, Trestman said. Tanglewood is served by Valley Metro bus service and offers easy parking, and he said he hopes that the setting will help reduce the stigma that’s still associated with seeking mental health care. 

“We are here in a shopping mall, in a healthy environment, making it easy for people to come to seek treatment,” he said.

Megan Schnabel is managing editor for Cardinal News. Reach her at or 540-819-4969.