Reimagining Mental Health Care: Cara Vaccarino at the Helm of The Royal

Cara Vaccarino believes that mental health is as vital as physical health. As President and CEO of The Royal Ottawa Healthcare Group, comprising The Royal Ottawa Mental Health Centre, The Royal Institute of Mental Health Research and The Royal Ottawa Foundation for Mental Health, Vaccarino has devoted over 25 years to helping people reclaim their lives from mental illness and addiction. Her work, grounded in specialized treatment, research, and education, reflects the core vision and mission of The Royal.

The calling is deeply personal. Vaccarino lost her mother to suicide caused by treatment-resistant depression when she was just 10 years old, and she understands firsthand the trauma and impact mental illness has on both individuals and their families. That heartbreaking loss inspired her to dedicate her life to helping others navigate complex mental health challenges through patient- and family-centred care grounded in evidence-based treatment.

Vaccarino began her career in research at McGill University and the University of California, Los Angeles (UCLA), before moving into leadership positions at various research institutions, hospitals and private treatment facilities in both Canada and the U.S. Vaccarino holds a Master of Social Work (MSW) from Tulane University in New Orleans, a Master of Science, Health Services Administration (MHA) from University of St. Francis in Chicago, and a Bachelor of Arts (Honours) in Psychology from McGill University in Montreal.

Reflection on how her education and collective experiences have shaped her into the leader she is today, Vaccarino says, “I call myself a lifelong social worker. Working with people and families affected by mental illness and substance abuse showed me how closely medical intervention was linked to income, food and housing security, while working in a clinical setting gave me insights into the acute challenges faced by patients with mental illness and the struggles their families face.”

Vaccarino considers herself blessed to have shared in the personal journeys of individual patients and families. As she transitioned into leadership roles, she’s been proud to be able to work with talented teams to bring about positive change in the community and close the mental health gap by embracing a more holistic approach to treating mental illness and addiction.

Leading transformational change at The Royal

Over the past year and a half, Vaccarino has gained valuable insight from her team as well as from patients and families at The Royal. She remains in regular contact with Chris Ide, President and CEO of The Royal Foundation, and Florence Dzierszinski, President of the Royal Institute of Mental Health Research (IMHR), recognizing the importance of close collaboration among the three organizations. These relationships and experiences continue to shape her vision of positioning The Royal as a catalyst for transformation in the treatment of complex mental illness and addiction, both in Ottawa and beyond.

ABOVE: The leadership team at The Royal Ottawa: Chris Ide, Cara Vaccarino and Florence Dzierszinski. PHOTO: Ashley Fraser

“We’ve just launched a three-year strategic plan called ‘SPARQ’, focused on five key goals of Sustainability, People, Access, Research and Quality. This plan is aimed at optimal resource management, investing in infrastructure and technology, building a workplace culture based on trust, transparency and respect, breaking down barriers with timely and more accessible treatment, focusing more on evidence-based and data-driven innovation and research and ensuring world-class quality care for patients struggling with mental illness and addiction,” Vaccarino explains.

Expanding on SPARQ’s objectives, Vaccarino recently assembled a new senior leadership team, as well as a project management department to develop new programs and services. Research liaisons will be embedded in all clinical programs to facilitate a more comprehensive evaluation of outcomes and impact, with the goal of improving quality. For employees, a Wellness Centre has been established to help them discover a deeper sense of meaning and purpose in their work, ultimately leading to improved care and compassion for patients. The hospital is also working to enhance its accountability through its client and family advisory councils.

New programs and novel breakthroughs

The Royal is one of six partner hospitals in eastern Ontario that have joined Atlas Alliance’s Epic digital health records. The program enables all partner hospitals to securely store, access and share patient health information and records electronically, allowing for seamless patient care with a common health record system. It will improve efficiency and prevent duplication of services and testing. The rollout is expected by fall 2026, with a total of 16 partner medical centres, including several rural hospitals, joining the program.

Additionally, The Royal has partnered with primary care clinics across the region to decrease wait times for primary care referrals for patients who cannot be effectively treated at primary care centres. The Royal also plans to open an Urgent Care Clinic for patients requiring immediate attention and timely intervention, with dedicated nurse practitioners and physicians to oversee operations.

Moreover, the hospital is looking to establish a specialized Dialectical Behaviour Therapy program for patients with borderline personality disorders—many of whom frequently rely on emergency services due to a lack of access to appropriate care. The hospital is also working more closely with the Children’s Hospital of Eastern Ontario (CHEO) with a focus on improving care for transitional-age youth.

Just last month,  The Royal’s Brain Imaging Centre (BIC), the only state-of-the-art research facility in Canada dedicated solely to mental health and neuroscience research, announced a $1.9 million grant from Brain Canada and private donors to launch Canada’s first tri-modal brain imaging platform. The BIC Advanced Multi-Modal Neuroimaging Platform for Psychiatry will allow simultaneous MRI, PET and EEG imaging of the brain, aiding in better diagnosis and personalized treatment of mental illness and addiction.

Yet another highly successful program introduced last year is the Interventional Psychiatry program to treat patients with treatment-resistant or refractory depression. The Royal’s Ontario Structured Psychotherapy (OSP) program, sponsored by the Ontario government, is one of the highest-performing programs in Ontario, providing patients with access to free, evidence-based cognitive behavioural therapy from highly trained psychotherapists.

“Additionally, our work with community mental health partners is aimed at ensuring that our patients safely transition from the hospital into the community, and not into shelters where there is a high prevalence of psychiatric illness and addiction,” adds Vaccarino, who is on the board of The Ottawa Mission.

To further support community housing, The Royal has partnered with Matthew Perry House Ottawa, a supportive recovery community being built in collaboration with Ottawa Community Housing, Ottawa Salus, CAPSA, Rideauwood, Ottawa Black Mental Health Coalition, and Ottawa Aboriginal Coalition. The Royal is providing three acres of land on its property for the construction of housing units that will offer a range of on-site care and support services for individuals undergoing addictions treatment. The facility is expected to open its doors within the next two and a half years.

A humble leader with impressive ideals

Vaccarino is steadily guiding The Royal toward becoming the premier provider of mental healthcare, teaching, advocacy, research and education in the region, with best practices in place, partnerships with other healthcare providers in the region, and staff who are clearly aligned with those objectives. She is also fostering greater community engagement through an open-door and approachable hospital policy.

When asked what she enjoys most about her role, Vaccarino shares, “We have a beautiful alignment of people that are highly skilled and pure of heart, coming to work out of a calling and devotion to helping people with mental illness and addiction reclaim their lives. This is what most appeals to me, as I am a social worker at heart. I also get to meet with a lot of patients who tell me what needs improvement and where I need to focus my attention, which has led to the launch of some of our recent programs.”

Vaccarino is one of only two women currently serving as CEOs of major hospitals in Ottawa—the other being Dr. Vera Etches at CHEO. As she reflects on the importance of advancing equity and inclusion in leadership, she also acknowledges the invaluable expertise and dedication of The Royal’s volunteer Board of Trustees, whose guidance helps shape the organization’s direction. “Even though the majority of the healthcare workforce is women, the higher up the ladder you go, the fewer you see. That’s why it’s so important to keep the conversation going—and to ensure diverse voices are at every decision-making table.”

As for her leadership style, Vaccarino believes her impact stems more from her clinical background than her title. “I think being a female clinician running a hospital has had a greater influence on the people I work with than simply being a woman CEO,” she reflects. “I’ve held nearly every job in a hospital, so I understand the challenges staff face at every level.” True to her humble nature, she adds, “At the end of the day, I prefer to shine the spotlight on the frontline clinicians doing the hard work—and lead quietly from behind.”

To learn more about the various services offered by The Royal, visit https://www.theroyal.ca/

Header Photo: Ashley Fraser