Data show some psychiatric patients wait days in the ER for a hospital admission. Why?

TORONTO — A patient in Alberta waited 16 days in an emergency department for a psychiatric hospital admission last year.

Another in British Columbia waited just over nine days.

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These cases are extreme outliers, but mental health experts say they illuminate a worsening crisis inside of fluorescent-lit emergency rooms across the country — psychiatric patients wait far longer for an in-patient bed than other people.

In Alberta, for instance, patients on average waited more than 33 hours for a bed in a psychiatric unit last year, Recovery Alberta said — 24 hours longer than the overall average of about nine hours.

Quebec psychiatric patients, similarly, spent 33 hours and 39 minutes on average in the emergency department waiting for a psychiatric bed, the province’s Ministry of Health says, almost 10 hours longer than the average patient’s 24-hour wait for a hospital admission.

This disparity in wait time has been the case for decades, experts say, and it’s only getting worse as demand outpaces funding across the spectrum of mental health care.

Research shows the emergency department environment’s near-constant noise, lights that never dim, and turbulent atmosphere can be harmful to a person in a mental health crisis, cause them to deteriorate and lead to a longer hospital stay.

“That chaotic, noisy environment, it’s not therapeutic, (it) has a real meaningful impact on our patients as they wait,” said Alberta Psychiatric Association President Dr. Karen Duncalf.

WAITS BY PROVINCE

After a health provider determines a patient needs a psychiatric ward admission, they remain in the emergency department while waiting for a bed to become available. That includes ensuring there’s enough staff in the ward to care for the new transfer. Until then, they are monitored and treated in the ER.

A patient at risk of harming themself or others can be taken to a seclusion room in the ER, which can be monitored by security, with padded walls, a door that locks from the outside, and in some cases, no windows.

A Vancouver woman who says she was locked in a seclusion room several times between 1992 and 2015 recalls the environment aggravating her paranoia and hallucinations. She can still remember the room vividly — not much bigger than a stretcher, she says, no door handle or light switch, a mattress on the floor and a steel toilet in the corner.

“That was the most confining, horrible, anxiety-provoking experience I ever had in my life,” she said. The Canadian Press is not identifying her because she fears reprisal from her employer and colleagues.

She said the impact has been lasting, and feels permanent. “Once you have gone through a traumatic experience like this once or twice or even more, you’re never the same,” she said.

In other cases, patients can be placed in a standard shared room, subject to the omnipresent noise and light of the department. Emergency room doctors and nurses monitor and care for the patient, and a psychiatric team visits and is on-call.

Dr. Rachel Grimminck, who worked as a psychiatrist in an Alberta emergency department, said it was upsetting to see her patients wait for in-patient beds — she recalls one memorable case where it took close to two weeks.

“The conditions often are very inhumane and it’s incredibly distressing for all of the patients, families and staff in the emergency department,” Grimminck said.

A recent CIHI report sheds light on some of the issues facing emergency departments across the country, including overcrowding, limited staffing and limited bed and stretcher capacity. One of the trends highlighted in the report is that people who needed to be admitted to hospital had longer stays in the ER, with one in 10 spending almost two days or more there.

Comparing wait times between provinces is tricky as hospital processes vary and are measured in different ways. There is no standardized approach or system that captures this information.

Several provinces shared their data with The Canadian Press, others shared partial data, and some said they did not track the wait time of psychiatric patients at all.

Alberta and Quebec reported the longest average wait times for psychiatric hospital admissions last year. The wait time in Alberta was nine hours longer than in 2019. In Quebec, it was close to eight hours longer in 2024 to 2025 than in 2020 to 2021.

A spokesperson for Recovery Alberta said 64 psychiatric patients waited eight days or more in the province’s emergency departments over the last year, representing approximately 0.3 per cent of more than 18,000 patient encounters.

Though British Columbia health officials said they could not provide wait time data, several local health units did. That included Interior Health, which said the longest time a patient waited for a psychiatric bed last year was just over nine days. One patient waited that full amount of time.

Vancouver Island’s health unit said patients waited 21 hours on average in the ER for a psychiatric unit bed in 2025. In 2019, the average was 13 hours. An Island Health spokesperson said the toxic-drug crisis has significantly complicated mental health and substance use presentations to the ER in recent years. More patients need medical clearance or stabilization before they can be admitted.

In Ontario, the Ministry of Health said the wait for psychiatric hospital admission, 20.8 hours, was similar to that for the average patient at 20.2 hours in 2024 to 2025.

In Nova Scotia, psychiatric patients waited 23 hours on average in 2025, up from 14 hours in 2019. The average patient waited three hours in the emergency department for an admission last year. Ten per cent of patients admitted to an acute mental health unit in Nova Scotia last year — 88 patients — waited 36 hours or longer for a bed.

WHY LONGER?

The reason psychiatric patients wait such a long time for an in-patient bed is complex, experts say — there’s the number of beds not meeting current demand, the systemic underfunding of mental health services and the resulting bottlenecks.

The number of people seeking mental health care has also increased in recent years, as has the population.

More than five million people over the age of 15 in Canada met the diagnostic criteria for a mood, anxiety or substance use disorder in 2022, based on Statistics Canada’s latest data, up from 4.4 million in 2019 and 3.7 million in 2015.

Alberta added 65 in-patient psychiatric beds to acute care hospitals between 2019 and 2025, bringing the total to 1,678. Dr. Paul Parks, an emergency medicine physician in Medicine Hat, says that’s not nearly enough.

“There’s no possible way you can take care of hundreds of thousands of more people in dozens of new beds,” Parks said, referencing the province’s population growth of about one million in the last decade, now topping five million.

Guidance from an expert global panel in 2022 found the minimum number of psychiatric beds per 100,000 population should be 30, and the optimal number is 60.

In Alberta, that would mean there are about 33 beds per 100,000.

In British Columbia, where they have 1,438 beds, the ratio is even lower at 25 per 100,000.

Governments in both provinces recently announced the addition of beds, with an Alberta minister calling data on mental health, addiction and housing instability in Edmonton “alarming” and “almost overwhelming” last week, as he announced 400 new treatment, housing and stabilization beds in the capital city area.

A couple weeks earlier in B.C., Premier David Eby announced the addition of 132 mental health treatment beds for people admitted involuntarily in Prince George and Surrey.

Experts say bed capacity isn’t the only issue. Programs that can help prevent crisis visits to the ER by offering proactive community mental health services have consistently been underfunded and therefore can’t meet demand, said Grimminck, now a psychiatrist based on Vancouver Island and clinical assistant professor of psychiatry at the University of British Columbia’s faculty of medicine.

“There’s a substantial gap there in the burden of disease in the population and in the services available,” she said.

If a psychiatric unit has 30 beds and five people occupying them are waiting for proper supports before they can be discharged, new patients are at a standstill in the emergency department, Grimminck said.

“It’s been getting worse and worse,” she said.

Only five to seven per cent of provincial and territorial health budgets on average are dedicated to mental health, compared to the international public policy benchmark of 10 to 11 per cent, according to an April report on the cost of mental health in Canada by CSA Group, a not-for-profit standards organization.

Dr. David Gratzer, psychiatrist-in-chief of Sinai Health in Toronto, said that compared to other illnesses, mental health standards are “different, and frankly lower.”

We accept that someone might wait four or five days in a mental crisis because there isn’t enough funding, Gratzer says, and asks, “Well, why don’t we have the funding?”

The sickest psychiatric patients who need intensive care can wait the longest for a bed, a far cry from emergency department protocols for other patients in critical condition who need an ICU bed, Grimminck said.

She said psychiatric care has historically been siloed from the rest of the hospital because of “structural stigma.”

A study of the medical charts of patients who were admitted to psychiatric units in Calgary, published in BMC Psychiatry in 2021, found people who needed a higher level of care waited longer and were more likely to have an adverse event, such as self-harm, increased agitation or leaving against medical advice.

“While this could be attributed to the severity of their condition, this may also be attributed in part to the amount of time they are spending in the (emergency department),” the study says.

Researchers found those who experienced an adverse event had an average boarding of 35 hours, compared to those who waited 6.5 hours on average and did not. “Boarding” describes a patient’s time in the ER after an admission decision is made.

“It’s just simply not valued or seen as worthy as heart attacks, cancer, strokes,” Grimminck said, speaking of mental health care.

Like the issue itself, the solution is complex, Duncalf said.

“I don’t think it’s one thing. I think increasing in-patient bed capacity, including those high observation beds, but also improving community supports; the availability of housing; appropriate support in the community; having the capacity in our complex care teams in the communities to support these patients,” Duncalf said.

“I think all of those are factors that need to be addressed. I think we really need to take that holistic approach and not just look at one piece of the puzzle.”

ONE SOLUTION

In 2016, Prince Edward Island announced the launch of a 10-year strategy in response to a “significant and increasing” need for mental health and addictions care.

A decade later, if you walk down a hallway from the Queen Elizabeth Hospital emergency department in Charlottetown, there is a bright and quiet space. It’s a separate ER dedicated and designed for mental health and addiction patients.

There, a crisis response nurse assesses mental health patients to determine what they need. That could be to stay a few hours in a recliner chair, speak to a social worker on staff who specializes in psychiatry, get connected to community care, or be admitted to hospital.

Health PEI added the mental health and addictions ER in 2024, as part of a redevelopment project to address gaps in care on the island.

In its first year, Rebecca Jesseman, executive director for mental health and addictions with Health PEI, said there was a 36 per cent reduction in acute care admissions for mental health patients at the hospital, compared to the previous fiscal year.

On average, the new ER gets 2,000 visits a year, she said.

“That’s 2,000 people who aren’t waiting in the emergency department over the course of the year,” Jesseman added. “That really is reducing a lot of the demand on the ED.”

Most people are discharged to community services, which have also been ramped up, such as a mental health intensive day program for patients who require acute care, but not to the level of a hospital admission. There’s also same-day counselling available.

“The key message is recognizing mental health and substance use health as health conditions and ensuring that we are providing an appropriate service and health-based approach and moving away from the stigma that unfortunately has historically coloured a lot of the responses to individuals who present due to mental health and substance abuse,” said Jesseman.

This report by The Canadian Press was first published July 28, 2026.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Hannah Alberga, The Canadian Press