Rural hospitals in Ontario are struggling to provide mental health care, with many patients being forcibly admitted due to a lack of resources and staff. At Muskoka Algonquin Healthcare’s two hospitals, about 99 per cent of psychiatric admissions in 2024-25 were involuntary, with 291 out of 295 patients being admitted against their will.
This trend is not unique to these hospitals, as many smaller or rural hospitals in Ontario are facing similar challenges. In Parry Sound, 98 per cent of psychiatric admissions were involuntary, while in Espanola, a similar percentage were admitted against their will.
The data suggests that the kind of mental health care you get in Ontario depends on where you live. Hospitals not designated to provide mental health care are still receiving patients, but they often lack the necessary tools and resources to cope. Without resources in the community to provide outpatient care, doctors may decide that the only option is to force a patient to stay in hospital until they can be transferred to another facility equipped to provide proper care.
According to Dr. Kirsten Jewell, head of emergency medicine for Muskoka Algonquin, “Having a kid, or anybody, wait in that room just for admission to see a psychiatrist for two, three days is terrible. And it makes the patient not want to come back if they are in crisis again.”
Jewell has been practising emergency medicine for over a decade in the region and has seen the challenges in providing mental health care in a system that “fails at outpatient psychiatry across the board.”
Dr. David Gratzer, psychiatrist-in-chief at Sinai Health, notes that mental health emergencies often show a disparity in care. “If a person had a crushing chest pain at 3 in the morning and went into one of these hospitals, I think they would be seen in a timely way and get excellent care… In contrast, I think, in some parts of the province, when a patient with a mental health crisis walks in at 3 in the morning, they don’t get that sort of care.”
Emergency medicine veteran Dr. Alan Drummond knows the challenges of determining the danger a person might pose to themselves or others.
Drummond practises in Perth, where the nearest referral centre is in Brockville, about 64 kilometres away. If he can’t get psych patients there by a certain time of day, they’re stuck overnight against their will in ill-suited spaces at his hospital.
They want to set up virtual consults with psychiatrists farther afield who may be able to provide better perspective on what a patient needs. Connecting a patient to other, better-resourced facilities may mean “admission avoidance,” said the hospital corporation’s interim director of outpatient services, Stephanie Crampton.
As the system struggles to provide adequate mental health care, patients are often left to suffer the consequences of involuntary admissions. To address this, they must consider innovative solutions, such as mental health care that is shaped by the community’s needs.
Dr. Jewell is working to improve the situation.
The situation is critical.