PUBLISHED / NOVEMBER 11, 2026
Referral sent. Responsibility unresolved.
A psych ER can send a referral and still leave a gap behind it. Who owns that person until a community service accepts the referral?
CANADIAN MENTAL HEALTH · ACCOUNTABILITY AFTER DISCHARGE
A referral
is not a
handoff.
A referral can be sent without the next service accepting it. This campaign asks who stays responsible for a person in that gap, until follow up care is accepted.
An independent campaign by Adam Gould. Built on records. Focused on change.
THE SPACE BETWEEN TWO SERVICES
EMERGENCY CARE 01
Discharged.
REFERRAL SENT↗
? WHO OWNS
THE WAIT?
THE WAIT?
RECEIVING SERVICE 02
Not yet
accepted.
RESPONSIBILITY??
DISCHARGE ≠ ACCEPTANCETHE HANDOFF GAP ↗
THE CORRESPONDENCE RECORD
October 11 to November 2, 2026 Methodology ↗407emails sent
189addresses contacted
53substantive replies
0*transition owners named
*Campaign tally, not a national audit. Includes related mental health and disability policy correspondence. No continuing owner for the handoff gap was identified in the reviewed replies. Read how we counted.
LATEST RECORD / NOVEMBER 10, 2026
More replies.
The handoff question is still open.
CAMH described its declined referral process, the patient advocate identified an Ontario Health standard, and Southlake released one policy record. No office named a continuing transition owner in the later correspondence reviewed through November 10.
The hand checked tally above covers October 11 to November 2. Later replies carry their own dates.
Read the November update ↗PPAO RESPONSE
“To our knowledge, no Ontario statute, regulation, or Ministry directive names a single role accountable for a patient between discharge from a psychiatric emergency visit and a receiving service accepting the referral.”
Psychiatric Patient Advocate Office · November 3, 4:03 PM · Read the full context ↗
01 / THE GAP
Discharge is a moment.
The wait is a whole
other story.
A referral can be sent without the next service accepting it. This campaign asks who tracks that space, who follows up, and who acts if the next door stays closed.
Some services offer bridging care. Existing providers have responsibilities. What we are asking for is a clear, continuing transition role that every person can identify.
Understand the handoff gap ↗02 / THE PAPER TRAIL
Same day.
Back to square one.
On October 30, Ontario Health pointed to the Ministry. The Ministry’s response pointed to Ontario Health.
Read the full context ↗01 / ONTARIO HEALTHOCT 30 · 10:10 AM
“Please contact the
Ministry of Health.”
Mental Health and Addictions
Centre of Excellence
↓The question travels.
The responsibility stays unclear.↑
The responsibility stays unclear.↑
02 / MINISTRY OF HEALTHOCT 30 · 12:56 PM
“Ontario Health is best
positioned to comment.”
Response relayed by
a constituency office
The context matters: at 12:18 PM, Ontario Health also brought its Quality Standards team into the thread. The Ministry’s 12:56 PM reply specifically addressed performance indicators and public reporting. A continuing transition owner remained unidentified in the campaign record.
03 / THE ASK
One role.
A confirmed handoff.
A visible result.
Start with one hospital and its community partners.
Test the process. Publish what happens. Build from there.
ONTARIO FIRST. A CANADIAN QUESTION.
Different systems.
The same question.
The contact register covers all 10 provinces and 3 territories. The replies are correspondence evidence, not a ranking of care.
ONE QUESTION. A BETTER STANDARD.
Make it your
question, too.
Ask your elected representative who stays accountable until follow up care accepts the person.
Build your letterLATEST POSTS / NOVEMBER 11, 2026
The campaign is live.
Here is the first post.
This list is built from published posts at build time. Refresh posts.json and run build.py when a new post goes out.
Frequently asked questions
What does this campaign mean by a referral is not a handoff?
A referral can be sent without the next service accepting it. This campaign asks who stays responsible for a person in that gap, until follow up care is accepted. Read the handoff gap.
Is this legal or medical advice?
No. This site is information and advocacy. It is not medical advice and not legal advice. In a crisis in Canada, call or text 9-8-8. If you are in immediate danger, call 911.