The small communities of Bruce and Grey Counties have been hit hard by Canada’s decades-long opioid epidemic. Opioid cases and death rates soared during the COVID-19 pandemic and still haven’t returned to pre-2020 levels. In response, a team of paramedics and community health workers has built a nimble, compassionate model for addictions-related health care in the community. The Supportive Outreach Service (SOS) grew from a May 2021 crisis in Hanover, Ontario, where a COVID-19 outbreak in a rooming house led to over 50 residents being quarantined, many with mental health and addictions issues and little in the way of personal support networks. For weeks, various local agencies collaborated to meet their needs on-site, asking few questions and providing health care as well as other necessities such as regular meals, hygiene supplies, counselling, and even shoes. The infected residents recovered – and general health indicators of the group had also improved significantly, with many later entering addictions treatment programs. Today, SOS responds to calls seven days a week across Bruce Grey with a similar “no wrong doors” approach – meaning that when someone seeks help through any point of contact, SOS prioritizes their immediate needs and connects them to a range of supports. Its teams provide medical care, harm reduction equipment, vaccinations, crisis management, and supportive addictions treatment aligned with patient goals. In a region with no public intercommunity transit and few private bus carriers, SOS meets patients where they are, through mobile clinics and home visits, rather than asking them to travel to facilities when in crisis.

Mental health care in Canada is fragmented across a diverse ecosystem of providers and delivery methods. Patients often pass through siloed organizations that struggle to coordinate care, information, and resources. The consequences can range from frustration at the challenge of navigating resources to re-traumatization if patients must recount their experiences at each intake. Health care providers interact with different funding streams and privacy laws from all levels of government, which can discourage and complicate collaborations. Converge Mental Health Coalition formed in 2022 to help improve coordination and data sharing among providers. Starting in Alberta with six members, Converge now has over 100 members across multiple provinces and sectors. After interviewing mental health providers across Alberta about their challenges, Converge developed its Information Sharing Framework (ISF), which reframes the sharing of information, often seen as a risk, to be a benefit to organizations – even an obligation, since it can improve patient care. The ISF helps providers identify partner organizations, applicable regulations, reasons for collaborating, and the type(s) of collaboration needed to achieve their goals. Converge’s work helps organizations understand and navigate their place within the response. Information sharing has great potential to reduce administrative burdens and the duplication of work at organizations that are often stretched thin. Implementing it well is easier said than done, but for a growing number of organizations, Converge makes doing so easier.

Health-care practitioners have long known the positive impact that community has on well-being, but it is only recently that linking non-medical resources to health care has been recognized and codified as a national practice in Canada. The Canadian Institute for Social Prescribing (CISP) was founded in 2022 to establish a community of practice and to create a research and evidence base for demonstrating the efficacy of this approach at a national level. Through network building, training and accreditation programs, and practical toolkits, CISP has begun to shift health-care policy and practice across the country.  

Social prescribing is a health-care model that enables providers of health care or of social services to refer individuals to community resources and other non-clinical supports in order to improve their health and well-being in a variety of ways. Some provide basic needs in the form of income supplements, housing, and food. Others connect patients with local activities – such as arts organizations, cultural events, or nature outings – creating a sense of belonging and supporting their physical, mental, social and emotional health. The connections to local organizations are facilitated by link workers within the health or community-care sector. The practice is centred on equity and local context, and is adaptable to different cultures, capacities, and needs. 

Toronto’s mental health system had long been overstretched and underfunded, which has led to a growing need for reactive crisis response from emergency services, including police. Seeking an alternative approach, the City of Toronto launched the Toronto Community Crisis Service (TCCS), which provides free, confidential, trauma-informed in-person support led by mental health workers instead of police. After a pilot in 2022, the TCCS expanded in 2024 to a service providing 24/7 crisis response to everyone age 16 and over, city-wide. TCCS is accessed through a non-police crisis line (2-1-1) or as a transfer from 9-1-1. Mobile crisis teams respond directly to calls with immediate support as well as offering follow-up care, including up to 90 days of case management. TCCS teams include community nurses, harm reduction workers, peers with lived experience, case managers, and Indigenous elders. This approach helps reduce the potential danger and trauma of mental health emergencies, particularly for Black, Indigenous, and 2SLGBTQ+ residents, who face serious risks and systemic biases during police interactions. TCCS has diverted more than 30,000 calls that would otherwise have gone to traditional emergency services, resolving almost 80% of calls transferred from 9-1-1 without police involvement. In November 2025, the service expanded to include a pilot program on the TTC. TCCS demonstrates that cities can prioritize care, dignity, and community leadership without relying on enforcement-based responses.

Despite being among those most in need of social services, unhoused people often face serious barriers to accessing support through traditional service pathways, including long waitlists, discontinuity of services, lack of trust in providers, and inconsistent access to phones. Toronto’s services have often been reactive, reaching people when they are already in crisis or facing severe health challenges. In addition, this population is often criminalized, which can create further barriers to their support and well-being. To better address this community’s needs, Toronto Public Health launched the Downtown Community Outreach Response & Engagement Team (CORE) in partnership with the Toronto Police Service in December 2024. CORE grew from the Downtown Yonge BIA's Community Engagement Team (CET), which started in 2018 with funding from Toronto’s BIA Innovation Fund to respond to people in crisis in streetfront businesses. CORE’s mandate is broader: a proactive outreach (not emergency-response) service, with teams of nurses and police officers who provide both immediate medical care and short-term case management from 8 a.m. to 10 p.m. daily, anywhere in the Yonge-Dundas area of downtown. The teams coordinate access to mental health supports, primary care clinics, and basic living supplies like sleeping bags. It’s a model for proactively supporting people experiencing homelessness where they are, building trust and improving continuity of care.

Launched in August 2024, Ottawa’s Alternate Neighbourhood Crisis Response (ANCHOR) is a community-led program that provides a culturally sensitive and equity-centered response to mental health and substance use crises 24/7. Residents can access the service by calling 2-1-1, with multilingual support available in Arabic, Cantonese, Swahili, and Somali, reflecting Centretown’s diverse community. ANCHOR’s design is based on best practices and community recommendations from the research outlined in the 2023 report by the Ottawa Guiding Council on Mental Health and Addictions. In its first year, ANCHOR received 4,464 calls, with 92% of them resolved with no police involvement. ANCHOR is a key pillar of Ottawa’s 2021–2031 Community Safety and Well-Being Plan, implemented in collaboration with Community Navigation Eastern Ontario, Centretown Community Health Center (CHC) and Somerset West CHC. Implementation started in Centretown – a small, densely populated area with high need – allowing ANCHOR to measure its impact and refine its approach before expanding it services. This expansion is being implemented gradually, guided by community feedback, evaluation outcomes, and sustainable funding opportunities. ANCHOR is building a strong foundation for long-term system change, demonstrating the value of collaborative, community-led solutions to complex challenges.

Black youth can face significant barriers to accessing mental health support, including cost, long wait times, transportation challenges, cultural stigma, and a lack of culturally responsive services. Healing Roots, a youth mental health program run by the Scarborough Centre for Healthy Communities, was created to address these barriers and support the emotional, psychological, and social well-being of Black youth aged 10 to 29 in Scarborough, Ontario. The program is designed to meet young people where they are through a range of evidence-based supports – such as peer connections, mentorship, mental health workshops, and summer camps – aimed at reducing stigma and building resilience among Black youth and their families. Healing Roots has also developed and filmed several public service announcements to encourage conversations about mental health and help-seeking in the community. The program is committed to ensuring that all services are representative of Black cultures, experiences, and identities. As demand for culturally responsive mental health services continues to grow, Healing Roots is working to expand its programming, increase outreach, strengthen partnerships, and improve service delivery.

Many young people experience climate anxiety, eco-grief, and the stress and uncertainty of growing up in a time of worsening climate impacts such as wildfires, drought, and extreme heat. Saskatchewan-based Break The Divide (BTD) created the Climate Emotions and Resilience Program to support youth in rural, newcomer, Indigenous, and racialized communities that are at the forefront of these changes by providing them with spaces to connect with each other and opportunities to take action in their own communities. The program helps young people process climate-related emotions, build coping skills, strengthen peer connections, and move from isolation toward agency, resilience, and local action. BTD hosts workshops and programming in schools and communities seeing the effects of climate change, using a framework of education, dialogue, storytelling, reflection, and action-oriented activities – often facilitated by near peers of the participants. The initiative moves beyond a focus on awareness and behaviour change to help young people form social connections and confidence that will support their mental health while also building local climate resilience, leadership, and belonging. To date, the program has reached over 2,500 students in schools and communities across Saskatchewan, and has helped to normalize conversations about emotions relating to climate change while equipping young people with practical tools for coping, reflection, and community action.