The Royal 2024–25 Annual Report

Igniting SPARQ: Building our future together

This year, we laid the foundation for our next chapter, one that focuses on our SPARQ: Sustainability, People, Access, Research, and Quality.
Message from the President and CEO of The Royal 

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This past year marked a pivotal moment for The Royal as we laid the foundation for our next chapter. Between April 2024 and March 2025, we engaged in deep listening, planning, and collaboration to shape a new three-year strategic plan. Adopted by our Board of Trustees in early April 2025, the plan sets a clear course for how we will lead, partner, and evolve from 2025 to 2028.

What makes this plan special is not just the goals we have set. It is how we got here. Hundreds of people contributed their voices and ideas, including clients, families, staff, physicians, volunteers, researchers, board members, community leaders, and regional partners. Together, we identified the challenges ahead and shaped a shared vision for a stronger, more sustainable organization.

Our strategic plan is built around five priorities: Sustainability, People, Access, Research, and Quality. SPARQ for short. These pillars represent our commitment to being a responsible steward of public resources, creating a healthier workplace culture, reducing barriers to care, advancing life-changing research, and delivering excellence every day. Most importantly, they reflect our promise to the patients and families we serve, to provide compassionate, evidence-based care that meets them wherever they are in their recovery journey.

Strategic plans are not static. As we bring our plan to life, we will keep listening, learning, and adjusting. That is the promise we are making to ourselves and to our community. This report highlights the real progress already happening across The Royal, progress that aligns with where we are going.

To everyone who contributed their voice, their time, and their feedback: thank you. Your insights are shaping our future. I’m looking forward to building it together.

Cara Vaccarino

Message from the Chair of the Board of Trustees

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This has been a year of listening and building a strong and sustainable foundation for the future – ensuring our long-term success while continuing to meet the growing needs of our communities. The Board of Trustees is proud to provide leadership and be fully engaged in this important work throughout the year.

A key milestone was the adoption of our new three-year strategic plan. As a Board, our responsibility is to set strategy, provide oversight, support accountability, and ensure the organization remains focused on delivering impact. We believe this plan — centred on Sustainability, People, Access, Research, and Quality — sets a clear direction and gives The Royal a practical framework to navigate complexity, adapt to change, and deliver on its mission.

The successes of this past year, some of which are reflected in this report, speaks to the strength and resilience of Team Royal. From expanding access to care, to supporting staff wellness, taking key decisions such as initiating a new electronic health record to intensifying The Royal’s collaboration with other hospitals in the region, to leading innovative research, The Royal has continued to respond with purpose and compassion in a hospital system facing significant challenges.

Throughout these efforts, the Board has worked in close alignment the Royal Ottawa Foundation for Mental Health, the Institute for Mental Health Research, and with the senior leadership team to ensure strategic alignment, good governance, responsible stewardship, and alignment with the organization’s values. We remain committed to supporting The Royal as it advances this new strategic plan and continues to evolve as a trusted leader in mental illness and addictions care and research.

This spring we welcomed Dr. Benoit Mulsant as The Royal’s new interim Chief of Staff. A special thank you to Dr. Sandra Northcott for her service as Chief of Staff, and our four outgoing Board members (Lynette Gillen, Niraj Bhargava, Dr. Lewis Leikin and David Somppi) who have each served The Royal for nine years. A deeply appreciative thank you as well to all our Board members and our CEO Cara Vaccarino, for their ongoing leadership and dedication.

On behalf of the Board of Trustees, thank you for your dedication, partnership, and continued confidence in The Royal. We look forward to overseeing the important work that lies ahead of us.

Sharon Squire

Message from the President & CEO of the Royal Ottawa Foundation for Mental Health

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Each passing year brings an opportunity to reflect on the powerful role our community plays in shaping the future of care for people living with mental illness and addiction. The need for better, more equitable access to care has never been greater, and this past year offers remarkable proof of what happens when people like you step up. 

Your support drives action. You show up in countless ways—as donors, volunteers, event organizers, and sponsors—and your generosity continues to push the boundaries of what’s possible.

This year, you helped us take on an urgent priority: improving access. Access to the best care available, delivered by leading specialists equipped with the latest knowledge, training, and technology. Access to care that meets the complexity of mental illness and addiction with the equally complex, innovative solutions they demand.

Thanks to you, The Royal is not only advancing leading-edge research. We’re delivering those breakthroughs directly to the people who need them most, right now. Because better research means better care. Not someday. Today.

We are deeply fortunate to have a community that believes in better and is willing to invest in making it happen.

With gratitude,

Chris Ide
President & CEO, Foundation

Message from the President and CEO of the University of Ottawa Institute of Mental Health Research and Vice-President of Research at The Royal

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At The Royal, we believe that research is care. Every discovery we make and every study we launch is ultimately about improving the lives of people living with mental illness and addiction. That belief is what drives our work and it is what inspired our research strategy.

A landmark study once found it takes an average of 17 years to move research into clinical practice. That gap is not just a number. It represents a very real barrier to better care. Our goal is to reduce that gap by bringing research and care closer together.

In the past year, we continued to integrate research into care settings, deepen our partnerships, and recruit incredible new talent. These efforts are not only shaping the future of mental health care, they are already having a real impact. We are seeing stronger collaboration between clinicians and researchers, more responsive care models, and early signs of better outcomes for the people we serve.

We have focused on engaging more clinicians directly in research, creating interdisciplinary teams, providing support for those who are interested in developing their own research. That work has included putting the architecture of that engagement in place – reducing as many points of friction as possible for clinicians to be researchers, too.

That work is paying off. The number of clinicians leading REB-approved studies rose 30 per cent last year alone. This is ‘Research is Care’ in action – our clinicians and scientists narrowing the gap between the patients they see and the new treatments we are developing.

The work we are doing aligns squarely with the research pillar of The Royal’s new strategic plan and we are excited to see it coming to life. It reflects our goals to accelerate prevention, diagnosis, and treatment through world-class collaborative and interdisciplinary research and innovation, creating equitable, integrated, whole-person, and precision mental health solutions for all.

Dr. Florence Dzierszinski

Our strategic plan

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A shared vision for the future

The Royal’s new strategic plan provides a clear and focused roadmap that will guide how we will lead and collaborate within the mental health system to better serve our communities. It sets out key priorities along with annual objectives and performance measures that will help us track progress and stay accountable to our goals. 

The planning process began in early 2024, with formal consultation taking place from October 2024 to March 2025. Hundreds of people contributed their insights and helped shape a plan that is both grounded in reality and inspired by the future we want to build together.

Adding to this, in early 2025, a Medical Leadership Model Review added valuable perspective on how to strengthen medical leadership across the organization. The recommendations are informing a renewed model that will be implemented in 2025–2026.

This strategic plan brings together business imperatives, organizational values, and bold ambitions. It will guide not just our strategy, but also our operational plans and budgets. At every level of the organization, it provides a shared framework to help us make informed, aligned decisions.

The strategic plan would not have been possible without the time, energy, and wisdom of those who contributed to its development. We are deeply grateful to the many people who shared their perspectives, including staff and physicians at The Royal, client and family advisory groups, volunteers, board members, and community leaders across our ecosystem. Your passion and insight helped shape a plan rooted in shared purpose. It is a purpose that reflects not just where we are today, but where we are going together. Thank you!

Our year through the lens of SPARQ  

SUSTAINABILITY
Our SPARQ goal: To build our successful future on a solid foundation

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This past year marked a turning point for The Royal as we laid the groundwork for a bold three-year strategic plan. At its heart is a clear understanding: to meet the rising demand for mental illness and addiction services with excellence, we must be sustainable. That means making smart, future-focused decisions that strengthen our systems, support our people, and protect the planet, all while providing exceptional care within the realities of a stretched health care budget.

Ontario continues to spend less per person on mental health care than the national average, even as the number of people reaching out for help grows. In this environment, sustainability is not a nice-to-have; it is mission-critical. At The Royal, this means stewarding every dollar responsibly and pushing for the funding and partnerships needed to ensure we can grow and innovate. It also means investing in systems and technologies that help us achieve our goals.

In 2024, our Board of Trustees reaffirmed their commitment to good governance by supporting the development of The Royal’s strategic plan and preparing to lead its execution. To become a high-performing organization, we are focused on strengthening our approach to risk management and increasing accountability at every level. This includes building a stronger culture of financial stewardship where smart spending is everyone’s responsibility.

To support decision-making across our organization, we are continuing to modernize the way we use data. A renewed focus on digital solutions, including improvements to our data systems and readiness for emerging tools like AI, will improve quality and access to care. One of the most significant steps forward is our preparation to implement Epic, a leading electronic health record system that will unify care delivery, streamline clinical workflows, and accelerate our shift toward more integrated, efficient, technology-enabled care with regional partners and across The Royal.

But sustainability is not just about dollars and data. It is also about how we show up as a responsible member of our community and the planet. In the coming years, climate change will have an even greater impact on health and health care delivery. The Royal is proactively assessing our environmental footprint to identify opportunities to address climate-related risks. As we move forward, we will be integrating environmental stewardship more intentionally into operational and strategic planning.

The choices we make today, from how we manage our resources, how we design our systems, to how we care for the environment, will shape the future of mental health care in our region. We are proud to be building that future on a solid foundation.

PEOPLE
Our SPARQ goal: to cultivate a positive work environment through transparency, collaboration and engagement.

The heart of The Royal is its people. This past year, we took meaningful steps to strengthen the culture and conditions that help our teams thrive. We are building a more connected, compassionate, and respectful workplace across all sites.

Supporting the well-being of our people is not only the right thing to do, but it is also essential to delivering safe, high-quality care.

A key focus of our strategic plan is to promote engagement through a culture of respect, trust, and open communication. This commitment was brought to life with the launch of our Culture Club, where staff from across the organization shared what a positive work environment means to them. Their answer was clear: it is rooted in recognition, courtesy, and collaboration, where everyone feels seen and supported.

To help make that vision real, The Royal has invested in dedicated Wellness Rooms. Construction at the Ottawa Campus is almost complete and our Brockville campus is the next focus. These quiet, comfortable spaces are designed so staff can decompress, reflect, or recharge during the workday. They were developed in direct response to what our teams said they needed, reflecting our commitment to psychological safety and mental health in the workplace.

We continue to work in a collaborative leadership model and prioritize ethical practices, transparency, and inclusivity, setting clear expectations that build a positive work environment with a culture of accountability and mutual respect.

This year, we welcomed Laura MacDonald as our new Vice-President of People and Culture. Her leadership is guiding the continued evolution of our workplace strategies with a focus on engagement, equity, HR best practices and organizational well-being.

Respect for the identities, values, and experiences of our staff and physicians is foundational to everything we do. The Royal is committed to fostering an environment where all people, including 2SLGBTQIA+ staff, physicians, and clients, feel safe, valued, and represented.

Equity, diversity, inclusion, Indigeneity, and accessibility (EDIIA) are woven into our core values and reflected in policies and practices across the organization. Some highlights:

• Beginning August 2024, our Manulife NU and Management extended health care plans included Gender Affirmation Benefits to a maximum of $15,000.
• A new partnership was established between The Royal and Noojimo Health to provide staff training and extended services and supports for our Indigenous clients.
• A co-created protocol, Navigating Racism and Discrimination in the Workplace, was launched in February 2025, supported by infographics and hands-on training. This protocol aligns with our policy, CORP V-100: Anti-Racism, Harassment and Discrimination-Free Workplace.
• The EDI-focused “Respect” module was made mandatory, while a new module “Respecting Gender Diversity” was rolled out in late March 2025, emerging from a collaboration with The Ottawa Hospital.

Supporting our people also means creating opportunities for learning, growth, and advancement. In the year ahead, we will continue to modernize people-related programs and systems to enrich the staff and physician experience and strengthen The Royal as a workplace of choice.

When people feel respected, empowered, and supported, they are able to do their best work and deliver the best care. That is the culture we are building at The Royal, together.

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ACCESS
Our SPARQ goal: To break down the barriers to mental health care and provide the highest quality and timely treatment for more patients.

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The need for mental illness and addictions care in our region is not only growing, it is becoming more complex. Long wait times, fragmented services, and the continued shortage of primary care providers have created a system under pressure. Too often, people turn to emergency departments because they have nowhere else to go.

At The Royal, improving access has been a top priority. This means rethinking how and where we provide care, strengthening partnerships across the system, and making it easier for people to get the help they need when they need it.

One important step we’ve taken this past year is the planning of a new Urgent Care Clinic at The Royal’s Ottawa campus. Once implemented, this clinic will fill a critical gap for individuals facing acute symptoms such as severe anxiety, psychosis, suicidal thoughts, or urgent concerns about their medication. By offering timely support, this clinic will help patients stabilize quickly and avoid unnecessary emergency department visits.

Increasing access is not only about clinical services. It also means ensuring people can easily find the right information when they need it. That is the purpose of the Client and Family Resource Hub, a welcoming, accessible space where patients and their family members can find support and practical tools to help navigate their care. Celebrating its second anniversary this spring, the Hub recorded over 6,500 in-person visits this past year and more than 7,000 virtual visits. Monthly visits have increased by 386 percent since it opened, showing the growing need for this kind of accessible, people-first service.

Innovation in care delivery is also opening new doors as we continue to develop and implement opportunities that integrate research and care.

The Royal was the first mental health care organization in Canada to offer Feeling Safe. Developed at the University of Oxford, Feeling Safe is an evidence-based cognitive behavioural therapy for patients with psychosis (CBTp) program that helps individuals reclaim their sense of safety and independence. Rather than challenge beliefs directly, Feeling Safe uses gradual, behavioural strategies to reduce fear and anxiety. The program is currently being studied at The Royal for its effectiveness in a group setting, with the goal of expanding access to more people in need.

Improving access requires clear systems-level leadership, collaboration, and trust. We are working closely with partners in primary care and community health to strengthen pathways across inpatient, outpatient, and transitional services. As we move forward, The Royal will continue to evaluate its role in the broader system and strive for the right balance between general stabilization and specialty care.

The goal is simple but urgent: to make it easier for more people to receive timely, high-quality care.

RESEARCH
Our SPARQ goal: To integrate data-driven learning into care and accelerate the translation of discoveries into practice.

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At The Royal, we are leading a transformative approach to mental health care by tightly integrating data-driven learning into clinical operations and accelerating the translation of research discoveries into practice. This effort is rooted in the strategic aim to evolve into a rapid learning health system—where research and clinical practice are seamlessly interconnected, and insights are continuously fed back into care delivery to improve outcomes.

At the heart of this integration is the concept that "Research is Care." Through structures like the Clinical Brain Research Centre (CBRC), we are embedding research directly at the point of care. The CBRC combines research, technology, and clinical practice across the entire care continuum—from prevention to diagnosis to treatment—enabling personalized, evidence-informed care powered by predictive analytics. By leveraging an advanced integrative data platform, the CBRC offers patients access to cutting-edge interventions such as esketamine, rTMS, and cognitive remediation, while continuously collecting standardized clinical and research data to inform real-time care decisions and future models.

This learning health system model is also reflected in the growing number of clinician-led studies and cross-disciplinary collaborations. In just the past year, clinician-led REB-approved studies increased by 30 per cent, and interprofessional collaborations rose by 63 per cent over four years. This momentum has been bolstered by newly created research and evaluation liaison roles that embed research capabilities within clinical clusters, helping clinicians design, implement, and evaluate care innovations based on patient outcomes.

Several research clinics exemplify this integration of data-driven care. The BMO Innovative Clinic for Depression, for instance, uses real-world data to assess and refine ketamine treatments for difficult-to-treat depression. The Neuromodulation Research Clinic has uncovered how physical activity predicts responsiveness to rTMS, laying the groundwork for more personalized treatment protocols. The Cognitive Health Research Clinic is piloting remote and virtual reality-based cognitive remediation interventions that directly address cognitive impairments often neglected in standard psychiatric care.

To support continuous learning and knowledge sharing, we have also invested in building robust data infrastructures. The Cardio-Neuro-Mind Data Platform (CNMDP), for example, centralizes data from mental, neurological, and cardiac studies using FAIR data principles and open science standards. It enables standardized data collection, analysis, and integration across studies, facilitating rapid discovery and application of new insights.

This transformation is not limited to technology. Our research enterprise is committed to empowering patients and communities to engage in research. Initiatives such as the Research Recruitment Registry and improved consent models make participation easier and more meaningful. Participants not only gain access to advanced care, but also contribute to innovations that may benefit others.

We are redefining how discoveries move from the lab to the bedside. By cultivating an ecosystem where science and care continuously inform each other, we are creating a model for mental health care that is not only more responsive and personalized but faster, smarter, and more equitable.

Read more about research at The Royal in our 2024-2025 Annual Report.

QUALITY
Our SPARQ goal: Integrate evidence-based care and innovation to promote and enhance client and patient experience and outcomes at both the individual and system levels.

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High-quality care is compassionate, safe, and backed by evidence. At The Royal, we are committed to raising the bar through continuous learning, innovation, and evaluation, not just for the people we serve today, but for those who will need us tomorrow.

The initiatives highlighted here reflect meaningful progress over the past year that directly supports the Quality pillar of our strategic plan, while strengthening the overall patient experience across our sites.

In addition to our EPIC implementation, the formation of a Project Management Office (PMO) is playing a key role in supporting initiatives that improve care delivery, operational efficiency, and patient outcomes. From biomedical equipment process optimization to streamlining PPE inspection, the PMO is helping turn strategy into action.

We are also deepening our culture of safety. This past year we introduced an enhanced patient incident review process and recognized more staff with Good Catch Awards for identifying and addressing potential risks. Four new Patient Safety Champions were named, and we saw an encouraging increase in near-miss and no-harm reports—clear indicators of a more open and proactive safety culture.

At the heart of quality is the experience of our patients and families. This year, we transitioned from a short annual survey blitz to ongoing, point-of-care feedback, supported by two new volunteer surveyor roles to assist with data collection. We also contributed to the development of a new, more accessible Client Experience Survey in collaboration with the Ontario Hospital Association and patient advisors from across the province.

Peer support at The Royal also continues to grow. The African, Caribbean and Black (ACB) peer support role became permanent and expanded its hours, offering culturally responsive programs such as WRAP (a manualized group intervention for symptom and illness management delivered in a self-help group context) and Mental Health First Aid. Peer interactions more than doubled in the first quarter following the expansion. A new family peer support program pilot launched with part-time staff providing one-on-one and group support, reaching 125 group-based interactions in its first six months.

We remain focused on measurable quality improvement. Our Ontario Structured Psychotherapy Program (OSP) enrolled 58 per cent more patients than last year. In 2024–25, three-quarters of The Royal’s corporate Quality Improvement Plan (QIP) goals were fully met in key areas, including clinical assessment, patient and medication scanning, and workplace safety.

Our focus on enhancing our partnerships with, and support of, equity-deserving populations continues.  Our OSP program has established partnerships with several Indigenous service providers as well as 2SLGBTQIA+ community organizations, and our Quality Academy welcomed participants from the Weeneeebayko Area Health Authority. Additionally, our clinical and HR teams are collaborating on a strategy to establish an Indigenous Service Liaison position. The aim of this role will be to strengthen our clinical services and enhance efforts to recruit Indigenous staff.

We partnered with many providers in the hospital, primary care and community sectors, to ensure that we are co-designing a system that ensures The Royal plays its part in supporting our system partners.  The Royal is actively engaged with the Ontario Health Teams in our community, meets regularly with our hospital mental health partners, and is engaging with other key providers, including Emergency Services.

At every level of The Royal, we are working to build a system that listens, adapts, and improves. Quality is not just a goal, it’s how we honour the trust placed in us, and how we deliver care that meets people’s needs with skill, safety, and respect.

Our year in numbers

Many of the initiatives featured throughout this report were made possible through donor support. From research and innovation to peer support and wellness spaces, philanthropy allows The Royal to act with purpose, respond quickly, and improve care in meaningful ways. We are proud to work alongside staff, physicians, researchers, and community partners to bring impactful and meaningful change to mental health care. Thank you to our donors for making change possible.