Hospitals across Ontario play a critical role within the broader MHA continuum, supporting individuals with some of the most complex needs. In addition to emergency and inpatient services, hospitals are deeply engaged in community-based care, research, and cross-sector partnerships that improve access, strengthen care transitions, and better support individuals, families, and caregivers.  

At CHEO, for example, researchers are using artificial intelligence (AI) and electronic health records to help identify children and youth who may be at higher risk of returning to the emergency department for mental health concerns, allowing care teams to intervene earlier and plan more targeted follow-up supports. 

Michael Garron Hospital has also introduced a new Psychiatric Emergency Zone (PEZ) to expand specialized mental health and substance use care in its emergency department, including enhanced staffing, stabilization spaces and improved coordination of care.  

Meanwhile, The Hospital for Sick Children, the Centre for Addiction and Mental Health and the Garry Hurvitz Community Centre for Mental Health have partnered to launch the Thriving Minds Information Hub, a digital resource that helps youth, families and care providers navigate mental health programs and services more easily.  

With hospitals and system partners working together, we can move beyond isolated solutions toward a more coordinated approach to MHA care that connects people across the full continuum of care. 

What’s Driving Patient Needs and Emerging Challenges 

While overall emergency department (ED) visits have remained relatively stable compared to pre-pandemic (FY 2019-20) levels, mental health and addictions-related visits have increased significantly, by more than 11 per cent. This growth reflects both the rising need and gaps in access to timely, appropriate care across the continuum.

The pressures are particularly evident in hospital capacity. As of February 2026, patients in inpatient mental health beds represent over seven per cent of the total Alternate Level of Care (ALC) population, but account for a disproportionate 42 per cent of total cumulative ALC days across the province. Delayed transitions create ripple effects across the system, with crowded EDs, a lack of acute care beds for those who need it, and health care providers facing increased strain. 

This imbalance highlights a critical system challenge: too many individuals stay in hospital, not because they require acute care, but because the appropriate community-based supports and housing options better suited to their needs aren’t available.  

Among the most complex challenges facing the system is the care of individuals with dual diagnosis. These individuals often require specialized, coordinated supports that span health, social services, and housing systems. 

Today, some report more than 1 in 5 patients with dual diagnosis remain in hospital for over a year, with some specialized units reporting ALC rates approaching 60 per cent. These prolonged stays are not only costly, often exceeding $3000 per day for individuals with high care needs, but can also negatively impact patient outcomes and quality of life, contributing to the loss of independence and increased dependence on institutional settings.

A better approach is possible. With the right mix of community-based services, transitional supports, and supportive housing evidence shows patients can transition safely out of hospital, improving outcomes while relieving pressure on hospital capacity.  

From Insight to Action 

As the voice of Ontario’s 135 hospitals, the Ontario Hospital Association (OHA) is renewing its leadership in MHA care through the establishment of a provincial Mental Health and Addictions Hospital Committee, comprised of Chief Executive Officers (CEOs) from specialized psychiatric hospitals and from hospitals across the province that have substantial mental health activity. The Mental Health and Addictions Hospital Committee (committee) will provide strategic advice to the OHA to support provincial and regional planning, including improved access to specialized services, and enhanced transitions between hospitals and community care.  

In response to growing patient needs and the system’s challenges in keeping pace, the MHA Committee has moved quickly to translate system insights into action. 

A key early milestone has been the submission of a formal response to the Ontario Ombudsman’s 2025 report, Lost in Transition, on the inappropriate hospitalization of adults with developmental disabilities (having both a developmental disability and mental health diagnosis). After consulting with member hospitals and broader sector community partners, the submission outlines a series of targeted, system-level recommendations to improve care coordination, strengthen transitions, and expand access to appropriate housing and community support. This work has already prompted early engagement with both the Ministry of Health and the Ministry of Children, Community and Social Services, an important step toward more integrated, cross-system solutions. 

The committee has also advanced its priorities through a pre-budget submission to the Government of Ontario, reinforcing the need for continued investment in hospital-based mental health and addictions and community services, such as supportive housing, community-based care and scaling hospital-based innovative models of care. 

At the same time, recognizing the urgent pressure facing EDs, the committee has launched an idea book initiative, actively seeking innovative, scalable solutions from across the system to better support patients presenting to EDs with mental health and addictions as their primary concern. This work reflects a commitment to harnessing frontline expertise to spread and scale leading practices. 

To better understand and address these pressures, the committee is also exploring opportunities to gather more timely, detailed insights into how patients with mental health and addictions needs are accessing care in EDs to inform decision-making, targeted interventions, and evidence-based advocacy.

Establishing an MHA Hospital Committee signals a commitment by the OHA to lead in this space, not only by identifying challenges but by driving meaningful change, through targeted policy engagement, data-driven initiatives, and cross-sectoral collaboration.

Ultimately, improving outcomes for individuals with mental health and addictions needs will depend on delivering the right care, in the right place and ensuring that no one remains in hospital simply because there is nowhere else to turn.  

As demand for comprehensive MHA care continues to grow, hospitals across Ontario are stepping up with innovative programs, stronger partnerships and more connected approaches to care as part of a broader system that must continue to adapt to increasingly complex needs. 

The work highlighted throughout this issue reflects the leadership of hospitals and the dedicated work already underway across the province to better support individuals facing mental health and substance use challenges. 

Together, these efforts are helping build a more connected, responsive, and forward-thinking mental health and addictions system in Ontario. ​​