Forensic assessments play a crucial role in the Canadian criminal legal system. One of the most common forensic assessments is fitness to stand trial evaluations, which determine whether an individual can competently engage with the legal system. While the United States is currently facing a “competency crisis” due to overwhelming demand for fitness assessments, the extent to which Canada is experiencing similar concerns is unknown. The present study used a mixed methods exploratory design to survey Canadian forensic mental health (FMH) service providers to a) capture a snapshot of the FMH services available in each province and b) determine and compare each province’s current demand and capacity to meet demands for fitness evaluations. Forty FMH sites and 2031 designated inpatient forensic beds were identified across Canada, representing a 16% increase in sites and 31% increase beds since 2006. Thus far, data has been captured from 12 of these sites. The study also conducted semi-structured interviews of service providers involved in the operation of FMH sites across Canada to identify factors influencing our ability to meet fitness demands and highlight recommendations for policy and practice. Reflexive thematic analysis of study interviews (n = 11) identified four themes in participant responses including Challenges to Providing FMH Care, A Growing Burden on the FMH System, Stigma and Lack of Support, and Identified Needs and Attempts at Change. This study underscores the urgent need for enhanced communication, education, and standardized data collection across Canadian FMH services, alongside expanded forensic training and broadening the scope of practice for forensic psychologists. Addressing these issues is essential for averting further crisis in Canada and ensuring just and efficient FMH care.