Frequently asked questions.

A new model is necessary for a few reasons. Firstly, access to and quality of intensive treatment varies across Ontario without a provincially coordinated approach to service planning and delivery.

Secondly, intensive services have the longest wait-times of any child and youth mental health (CYMH) core service. Higher-intensity services, such as emergency departments and hospital in-patient units are costly and overused without access to more appropriate intensive services through clear service pathways.

The Ontario Intensive Treatment Pathway (OITP) will create a coordinated system of intensive treatment that is provincially guided and regionally delivered. The new model will provide the right care and treatment at the right time for children and youth with the most intensive mental health needs, as close to home as possible.

The OITP is an exciting opportunity to transform the intensive treatment system in Ontario to ensure that children and youth with serious mental illness have timely access to effective, inclusive, respectful, and individualized intensive treatment with family and community supports to enable their best futures.

The OITP will be a provincially guided, regionally delivered, connected model of treatment for children and youth with the most intensive mental health needs.

Current thinking is that the new system could comprise up to six regional intensive treatment networks (RITNs), that will deliver coordinated and consistent intensive treatment for children and youth within their geographic service area. Regional Hub organizations will oversee the RITNs and be responsible for adapting provincial standards and processes to meet local needs.

The Executive Leader will guide the development and implementation of a provincially consistent approach to the delivery of intensive treatment, provide support and guidance to the Regional Hub organizations, and coordinate training and access to augmented clinical support for system capacity building.

At maturity, the model aims to address long-standing treatment gaps in the community by increasing availability of evidence-based and specialized clinical treatment, improving equity of access and service outcomes, and optimizing existing investments while supporting innovative local approaches.

Starting with LIT for children with intensive treatment needs is responsive to the government’s commitments through Roadmap to Wellness: a plan to build Ontario’s Mental Health and Addiction’s System, the Lead Agency Consortium’s (LAC) Provincial Priorities Report and other longer standing recommendations. CYMH intensive treatment providers have noted that they must frequently divert resources from other CYMH services to meet the demands of their LIT programs. Therefore, improving access to multi-disciplinary specialist clinical capacity to support LIT programming, and streamlining pathways in, to, and from LIT for children with significant intensive needs may also support resourcing for the whole CYMH system.

The model will serve children and youth up to the age of 17 and their families who have been diagnosed or otherwise identified with mental health problems that impair their functioning in more than one area. Many of these children/youth will require intensive intervention either for a defined period of time or periodically throughout their life span, to maintain functioning in their home, school, and/or community.

A key element of the OITP mandate will be identifying clinical presentations/profiles of clients who would benefit from intensive services in a residential setting. Clarity on this will be foundational to the development of appropriate assessments and to achieve service alignment.

Part of the planning stage of OITP is to issue a Call for Proposal to ensure a comprehensive, equitable, and unbiased process for the selection of the Hubs. This work will inform a fair and transparent selection process for Regional Hub organizations and their associated regional intensive treatment networks (RITNs).

Currently, the Call for Proposals for Hubs and RITNs is being planned for some time in 2026/2027. Further details on this process will be solidified and communicated once the clinical populations, clinical program model, treatment modality options and standards are finalized.

Current thinking is that up to six regional intensive treatment networks (RITNs), led by Regional Hub organizations, will be identified. However, it is too early to definitively confirm the number, geography or composition of RITNs that will be established through this work.

Following an open expression of interest, OITP established a Clinical Leadership Advisory Group made up of representatives with clinical subject matter expertise in treating intensive mental health needs in children and youth or operational oversight of these clinical programs. This group will develop a clinical practice model and associated clinical guidelines for live-in treatment (LIT) and also provide evidence-informed clinical advice to guide response to health system issues, pressures, and priorities as it relates to CYMH intensive treatment.

The OITP intends to take a fulsome and integrated approach to its work. The extent to which secure treatment programs and services, as well as Step-Up Step-Down programs, will be focus areas of the model is yet to be determined, however, the System Planning Advisory Group will engage secure treatment and Step-Up Step-Down providers to ensure understanding and alignment as the OITP takes shape.

As the development of the model progresses, analysis will be completed to better understand the profile of clients who are best served through the model. This analysis will be informed by a cross-sectoral engagement plan and available evidence.

Once established, RITNs, under the leadership of the Hub organization, will collaborate closely with partners supporting youth with a variety of complex needs, including the Integrated Pathway for Children and Youth with Extensive Needs and developmental services Co-ordinating Agencies to develop guidance on clear roles, responsibilities, and pathways to appropriate service.

The model will take a phased approach to implementation, which is driven by the current resources and readiness of each identified service area. Implementation of the first regional intensive treatment network (RITN) is expected to begin in 2026/2027.

MOH is investing up to $22.9 million to support the development, implementation, and ongoing operations of the OITP model. As part of the OITP’s planning and readiness stages, a funding approach will be developed and communicated as part of the call for submissions/hub and RITN selection process. The early adopter RITNs are not anticipated to be approved until sometime in 2026/2027. The OITP is not proposing any funding changes to individual intensive treatment providers at this time.

The OITP is about strengthening the overall intensive treatment system in Ontario. This will begin with an investment in clinical, quality and operational standards, as well as training and augmented clinical resources and capacity through the creation of regional networks. Fully operational RITNs will improve regional coordination and capacity and work with community partners to identify local needs and make recommendations through the Executive Leader to MOH to support the most effective use of resources across their service areas.

The LAC has a leadership role in the governance of the OITP to develop and implement the model. The relationship to planning responsibilities of Lead Agencies will be considered in the development of the model and the Executive Leader will work closely with the LAC co-chairs to support Lead Agencies throughout the model’s implementation.

It is expected that Regional Hubs will collaborate closely with Lead Agencies to align their planning efforts.

The OITP is currently led through a Steering Committee with representation from the Ministry of Health, Mental Health and Addiction Programs Branch (MOH), the Lead Agency Consortium (LAC), and the Knowledge Institute on Child and Youth Mental Health and Addictions (the Knowledge Institute). As the OITP continues to move toward implementation readiness, we anticipate that in 2025-2026 the Steering Committee will be expanded to include a broader range of key partners. Details on the member identification and selection process will be forthcoming.

The Steering Committee is supported by an Executive Leader as well as five advisory committees and one reference group.
These groups are working to establish a solid foundation for the OITP while addressing long-standing service gaps. The OITP is also committed to recognizing the autonomy and self-determination of Indigenous communities, through supporting an Indigenous-led parallel process that will address the unique needs of Indigenous children and youth.

The Executive Leader oversees the development and implementation of OITP, under the guidance of the Steering Committee. Both parties work together to ensure a consistent approach to the delivery of intensive treatment services across the entire province.

Indigenous families and communities face significant challenges in accessing culturally competent and consistent intensive mental health treatment services across the province. These challenges underscore the critical need for solutions led from Indigenous perspectives. The OITP is committed to support an Indigenous led parallel process, with a separate and distinct approach and timelines. Indigenous providers will guide the development of this independent stream of work.

To preserve the autonomy and self-determination of Indigenous communities, OITP will collaborate with Indigenous CYMH service providers and other Indigenous leaders to develop clear and accessible pathways to Indigenous-led services and develop standards that support cultural safety and access to culturally appropriate services for Indigenous children and youth wherever they access service. The OITP is also committed to supporting an Indigenous led parallel process.

Sector and system expertise will be included at every level and table associated with the OITP’s development. In addition, an Implementation Advisory Group, reporting to the Executive Leader, will be established to guide the implementation and evaluation of the OITP. They will oversee the creation of a quality standard for the delivery of LIT services. This work will include youth and family engagement in the initial stages of the OITP’s development through to the operationalization of the RITNs.

The Knowledge Institute will guide the development of a youth and family engagement approach, informed by its Quality Standard on Youth Engagement and Family Engagement.

This work has begun with the launch of an advisory committee in April 2025. In addition to the committee, the OITP will further aim to include youth and family voices representative of Ontario’s communities in various activities and initiatives as the work progresses.

Francophone representation comes in part through the launch of our French Language Advisory Committee in the spring of 2025. There is representation from Francophone providers on all OITP advisory groups. This is to further guide the development of pathways and service standards that support access to services in French and help address the needs of Francophone children, youth, and families within the model. Participation in language of choice is encouraged in as many of OITP’s meetings and tables as possible, including through the use of English and French options during Q&A portions of in-person and online meetings.

The Ministry of Health has had preliminary discussions with other ministries, including the Ministry of Children, Community and Social Services, about OITP. These conversations will continue and explore opportunities to align and engage other sector partners in this work. As well, cross-sectoral partners with understanding and expertise related to live-in treatment and complex needs could apply to the OITP’s various advisory groups, through an open call for expressions of interest. This involvement could include the System Planning Reference Group, Clinical Leadership and Implementation Advisory Committees. Other subcommittees created through the development and implementation phases will also invite broad representation among applicants.

Anyone interested in directly supporting the work of OITP is invited to email info@oitp.ca with the subject “Stay Updated” to be added to OITP informational updates. These updates will share announcements of future engagement opportunities and/or vacancies on governance tables. The website will also contain this information.