For many living with mental illness, substance use, or both, the crisis response system feels less like support and more like a revolving door. One week it’s an ER visit, the next a short jail stay, then back into the community without lasting care — until the cycle repeats.
How the Loop Works
Emergency Rooms: Short-term stabilization, but scarce psychiatric beds and long waits for follow-up care.
Police Intervention: When crisis looks like crime, individuals end up in cells instead of clinics.
Courts and Jail: Overrepresentation of people with untreated mental illness in correctional facilities.
Release: Little continuity of care, leading to relapse or repeated crises.
Canadian Context
Jail as default: In some provinces, correctional facilities are the largest providers of mental health care.
ER overload: Hospital ERs routinely see “frequent flyers” — people cycling through because no long-term care exists.
Indigenous and racialized communities: Disproportionately affected by criminalization of crisis.
Pilot alternatives: Some jurisdictions testing mental health courts, diversion programs, and peer-led crisis teams.
The Challenges
System silos: Health, justice, and social services rarely share responsibility.
Resource shortages: A lack of community housing, outpatient services, and long-term treatment options.
Stigma: Criminal records and repeated ER visits reinforce labels instead of opening doors to support.
Costly inefficiency: Billions spent on reactive cycles rather than sustained solutions.
The Opportunities
Diversion programs: Redirect people from jail and ERs into community-based treatment.
Integrated care: Link hospitals, mental health services, and housing supports in one continuum.
Peer navigation: Lived-experience guides to break the cycle and connect people to stable supports.
Policy reform: Shift funding from reaction (cells and ER beds) to prevention and continuity.
The Bigger Picture
The revolving door isn’t inevitable — it’s systemic. When crisis is criminalized and care is fragmented, people bounce between emergency rooms and jails instead of finding a path to stability.
The Question
If we can track repeat ER visits and re-arrests, why can’t we track (and fix) the gaps that keep people circling? Which leaves us to ask: how can Canada finally stop the revolving door and replace it with a pathway to long-term healing?
The Revolving Door: Emergency Rooms, Jail, and Back Again
The Cycle Few Escape
For many living with mental illness, substance use, or both, the crisis response system feels less like support and more like a revolving door. One week it’s an ER visit, the next a short jail stay, then back into the community without lasting care — until the cycle repeats.
How the Loop Works
Canadian Context
The Challenges
The Opportunities
The Bigger Picture
The revolving door isn’t inevitable — it’s systemic. When crisis is criminalized and care is fragmented, people bounce between emergency rooms and jails instead of finding a path to stability.
The Question
If we can track repeat ER visits and re-arrests, why can’t we track (and fix) the gaps that keep people circling? Which leaves us to ask:
how can Canada finally stop the revolving door and replace it with a pathway to long-term healing?