Ontario’s Mental Health Crisis: Worse Care Is Not the Answer

by | Sep 28, 2025 | Advocacy | 0 comments

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A Crisis Decades in the Making

Ontario’s mental health system is in crisis. Families wait months or even years for psychological assessments. Adults with trauma, depression, or anxiety often find themselves navigating a confusing, underfunded system where timely care is scarce unless they can afford private services. Individuals with severe addiction or psychiatric disorders find themselves unhoused and hopeless.

This is not a new problem. In the 1990s, the Ontario government quietly cut many psychologist positions from hospitals. The result was a slow but steady dismantling of publicly accessible mental health care. Psychologists, once embedded in hospitals and community health teams, became increasingly concentrated in private practice. Families without insurance or disposable income were left behind.

Decades later, the consequences are undeniable. Ontario now has one of the most privatized mental health systems in Canada. Wealthier Ontarians access highly trained psychologists in private clinics. Those without resources face long waits, inconsistent services, or no care at all.

The COVID-19 pandemic pushed this fragile system over the edge. Demand for mental health services spiked, conditions became more complex, and existing cracks in the system deepened. By 2020, the Ontario government itself admitted there was a crisis.

“The Roadmap to Wellness“

In March 2020, the government announced the Roadmap to Wellness, its ten-year plan to transform Ontario’s mental health and addictions system. The plan promised to:

  1. Improve quality by building a consistent, evidence-based system.
  2. Expand access by increasing the number of services available.
  3. Reduce wait times through better coordination.
  4. Strengthen community services to ensure people could access support outside of hospitals (Government of Ontario, 2020).

These pillars reflected what psychologists had been saying for years: access was fragmented, quality varied, and too many people were falling through the cracks. The dissolution of psychiatric hospitals decades earlier had left Ontario with a disjointed, underfunded patchwork of services.

Yet, while the Roadmap acknowledged the crisis, it came without the necessary funding commitments. Instead of reinvesting in psychologists and other highly trained providers, the province began to look for faster and cheaper ways to appear as if they were “solving” the problem, with little attention to ensuring longevity of those solutions.

The Fairness Commissioner and the Push for “Access”

Enter the Office of the Fairness Commissioner (OFC). Since 2020, the OFC has been monitoring Ontario’s regulated professions, including psychology, to ensure registration practices are transparent and fair.

Year after year, the OFC flagged concerns with the College of Psychologists of Ontario (CPO, now CPBAO):

  • Too many appeals from applicants denied registration.
  • Long supervised practice requirements, particularly for internationally trained professionals.
  • Equity concerns, including the underrepresentation of racialized members in doctoral-level pathways (Office of the Fairness Commissioner, 2023; 2024).

The OFC’s mandate is important. Internationally trained professionals deserve fair access, and barriers that are unnecessary should be addressed. But instead of carefully reforming registration while preserving public safety, the government saw an opportunity.

In 2023, Ontario passed “as of right” legislation, giving itself authority to override professional colleges in the name of labour mobility. This meant the Ministry of Health could dictate registration standards directly. For psychology, this opened the door to radical deregulation; not to better serve the public, but to reshape the profession in ways that fit the government’s cost-cutting agenda.

Slashing Standards

By 2025, the CPBAO—under pressure from the Ministry—introduced sweeping changes. Historically, Ontario psychologists trained for at least six years under close supervision:

  • Master’s and PhD degrees.
  • Multiple supervised practica.
  • A full-year clinical residency.
  • A year of supervised practice post-degree.
  • Three licensing exams (including oral and ethics).

Master’s-level psychologists, too, were required to complete four years of supervised work experience after graduation, in addition to exams.

These safeguards existed for a reason: psychologists hold the controlled act of communicating diagnoses, meaning they determine whether someone has ADHD, autism, PTSD, or another condition that can change the trajectory of a person’s education, medical care, and life.

The new rules would slash these standards by a minimum of 60%:

  • Only one practicum is now required.
  • The oral examination is eliminated.
  • The ethics exam has been replaced with a no-fail online module.
  • The four-year supervision requirement for Master’s graduates is gone.

In effect, a new registrant could become a psychologist with as little as two years of practical training, compared to seven or more under the old system.


The Truth Behind the Reforms

At first glance, this may look like efficiency. Ontario needs more psychologists, so why not make the process to become a psychologist faster…like, way faster? But this is where the story takes a darker turn.

The real bottleneck in Ontario is not the number of therapists. Social workers and psychotherapists already provide high-quality therapy across the province. The creation of the College of Registered Psychotherapists (CRPO) in 2015 has seen an astronomical rise in access to mental health care supports for individuals with the means to afford them. The problem is that their services are rarely covered by OHIP. For a country that prides itself on free access to health care, and a province who has planted their flag in the name of improving mental health supports, they have completely failed to address the fact that we are facing a funding crisis, not a workforce shortage.

Where Ontario is short is in diagnostic capacity. Only psychologists can perform the assessments that lead to formal diagnoses of ADHD, autism, learning disorders, PTSD, depression, anxiety, and complex mental illnesses. Weakening training in this area simply does not create more capacity; instead, it creates more risk of misdiagnosis.

So why is the government pushing this? The answer is austerity.

By lowering training standards, Ontario can create a new class of psychologists who cost far less to employ. These minimally trained professionals can then be hired to staff underfunded public positions, tasked with treating the sickest and most complex patients; the very population the Roadmap to Wellness identified as needing the highest-quality care.

Meanwhile, highly trained psychologists—those who have the resources to continue onto a PhD, or who earned a PhD level training from outside of Ontario—will continue to leave the public system for private practice, where salaries reflect the years of training required. The government gets to say it has “solved” access, but in reality, it has the very serious potential to create a two-tiered system:

  • Low-paid, minimally trained psychologists in the public system.
  • Highly trained psychologists in private practice, available only to those who can afford them.

At the September 26th CPBAO council meeting (which you can watch in full on YouTube at the time of writing this article), the writing was on the wall. Government representatives came in with sweeping changes already in hand and little interest in hearing the serious concerns raised by council members. The government officiale laid bare the logic behind this approach:

“We may not agree that the same quality of care is there. And I’m not sure about that. But I know that no care is not good quality of care.”

This statement is revealing. It suggests that the government knows quality will suffer, but is prepared to accept that trade-off for the sake of optics. Framed as a choice between “worse care” and “no care,” the conclusion was that Ontarians should take what they can get.

Once you stand back, the pattern is clear. This isn’t about improving access responsibly. It’s about political cover. The government can claim it has fixed the crisis while quietly cutting costs and shifting the risks onto the public. Ontarians are being asked to accept diminished care so that politicians can congratulate themselves for doing “something.”

Equity Undermined, Not Advanced

The Office of the Fairness Commissioner has raised concerns for years about the lack of diversity within psychology, particularly the underrepresentation of racialized members in the doctoral pathway (Office of the Fairness Commissioner, 2023; 2024). On the surface, lowering standards has been pitched as a way to help fix this, but reducing barriers for BIPOC folx to registration.

But the reality is far more insidious. The two-pathway system that I foresee coming based on these changes risks making inequities worse. Those with family wealth and the ability to delay earning an income will continue to pursue PhDs. They will end up in higher-paying roles, both in private practice and in leadership. Meanwhile, students who cannot afford to wait—disproportionately first-generation, racialized, and lower-income trainees—will be forced to stop at the Master’s level simply to get to work.

The result is predictable:

  • Affluent students pursue doctorates, earn higher incomes, and consolidate privilege.
  • Lower-income students stop at Master’s, enter the workforce sooner, and become the pool of lower-paid psychologists staffing underfunded public roles.

This is exploitation. The government positions itself as opening doors, but in practice it’s proposed changes create a two-tiered professional class it can prey on; one highly paid and protected, the other underpaid and overburdened.

In the name of diversity, Ontario risks building a system that entrenches inequality.

Why This Matters for Ontarians

For the public, the implications are stark:

  • More confusion. The title “psychologist” will no longer guarantee the level of training it once did.
  • Greater risk of harm. Misdiagnoses could rise, particularly for marginalized communities already at risk of being misunderstood or pathologized.
  • No real increase in access. Services for the vast majority of Ontarians who are in need to mental health services will still not be OHIP-covered, leaving most still paying out-of-pocket.
  • Taxpayer dollars wasted. Short-term savings from lower salaries int he public sector could balloon into long-term costs from untreated or mismanaged conditions.

The “Elitism” Distraction

At a recent meeting with the CPBAO, the Fairness Commissioner himself reportedly shouted, “You’re elitists!!!” at psychologists raising concerns about lowered standards. The charge is both inaccurate and dangerous, because it dilutes the real risks facing Ontario’s mental health system.

This is not about elitism. Psychologists with PhDs are not holding their degrees over the head of their MA-trained peers. Further, psychologists are not claiming to be “better than” other mental health providers. Different professions exist precisely because different scopes of practice require different training.

No one accuses dentists of elitism because they complete more training than hygienists. No one demands that physicians shorten medical school to solve a doctor shortage. Yet, for reasons that are hard to ignore, psychology is being singled out.

Labeling psychologists as elitist obscures the truth: lowering standards by upwards of 60% is not about equity or access, it’s about creating a cheaper workforce. It’s a rhetorical sleight of hand. By painting professionals as gatekeepers protecting their privilege, the government distracts from its own responsibility to fund a system that provides safe, effective mental health care to a public in need.

The risk is not that psychologists are clinging to status. The risk is that Ontarians will be left with underprepared clinicians handling the most complex and vulnerable cases in the province. This is a matter of public safety.

Calling psychologists elitist is a way to shut down debate. But it’s Ontarians—not psychologists—who will pay the price if care gets watered down.

The Roadmap Betrayed

The Roadmap to Wellness promised to improve quality, expand access, reduce wait times, and strengthen community services. All of these are critically important. But lowering training standards for psychologists by such a drastic degree undermines all four pillars.

  • Quality suffers when training is gutted.
  • Access remains limited without OHIP coverage.
  • Wait times for assessments will not shrink if new psychologists lack the skills to provide them.
  • Community services are not strengthened by inserting underprepared providers into the most complex roles.

In short, the government is betraying its own plan.

A Better Path Forward

If Ontario truly wants to fulfill the Roadmap, the solution is not cutting corners but investing in the system. That means:

  • Fund psychologists in hospitals and schools. Restore the positions cut in the 1990s.
  • Cover mental health services under OHIP. Make therapy and assessment affordable for everyone.
  • Support diversity responsibly. Provide scholarships, mentorship, and pathways for internationally trained professionals, rather than lowering standards.
  • Expand training capacity. Create more residency and supervision placements, rather than shrinking them.

This is how we can increase access without sacrificing quality.

What Ontarians Can Do

My hope (although admittedly I am not sure at this point) is that this is not inevitable. We have entered into a 60 day period for public feedback. Here’s how psychologists, allied providers, and most importantly, the public can act:

  1. Contact your MPP. Demand funding for mental health care, not weakened standards.
  2. Write to the Fairness Commissioner. Share concerns about the risks to public safety.
  3. Support advocacy groups. The Ontario Psychological Association and allied groups are mobilizing.
  4. Tell your story. Share your experience with waitlists, assessments, or gaps in care. Policymakers listen when the human impact is clear.

Ontarians Deserve Better

The Ontario government says it is expanding access for mental health supports, but in reality, it is lowering standards and calling it progress. The Roadmap to Wellness set out the right goals, but those goals cannot be met by gutting the very profession designed to deliver them.

Ontarians don’t need worse care. They need real care. And they need a government willing to pay for it.

References

College of Psychologists and Behaviour Analysts of Ontario. (2025). Changes to registration and training standards. Toronto, ON.

Government of Ontario. (2020). Roadmap to wellness: A plan to build Ontario’s mental health and addictions system. Retrieved from https://www.ontario.ca/page/roadmap-wellness-plan-build-ontarios-mental-health-and-addictions-system

Office of the Fairness Commissioner. (2023). Annual report 2022–2023: A tipping point for fair registration practices. Toronto, ON.

Office of the Fairness Commissioner. (2024). Annual report 2023–2024: A breakthrough year for fair registration practices. Toronto, ON.

jennbossio

Dr. Jenn Bossio is a Clinical and Health Psychologist, the founder and director of the Tri Health Clinic—Ontario’s largest sex and couples therapy practice—and a passionate advocate for system-level change in mental health care. Based in Kingston, she was named Business Person of the Year (2025) and recognized as one of the Top 40 Under 40 (2024). Jenn is committed to redefining the role of psychologists in a rapidly evolving health care landscape.