There are many indicators, but essentially what we see at a sort of middle level, in Ontario and in every province and territory, is that there's a fixed number of hospitalization beds, so hospitalizations are going up a little bit, but because they are a fixed resource, the only way they can go up is if you reduce the length of stay. We're seeing a slight increase in hospitalizations, with a slight decrease in length of stay over time. If that gets squeezed more and more, we're going to start seeing adverse consequences, “bounce backs” and so on.
We're seeing a relatively flat rate of outpatient care, to the extent that we can measure it. I have to apologize; we do not have information from psychologists like my colleague Dr. Grou and others have discussed. This is just physician-based care in Ontario for which we have data, but it is flat.
Then we come to the emergency department, and we have seen—between 2009 and 2017—a 35% increase in demand. In that 16-to-24-year-old category, we see a 100% increase, a doubling. All that tells me is that the system is constrained. There are not enough resources, and people are going to the only place they know, the open door of the emergency department, which, by the way, is not a particularly therapeutic environment for people in crisis.