Some 61 approved centres that provide mental health services were inspected by the Mental Health Commission (MHC) last year, but just six were found to be compliant with all legislative requirements.

According to the MHC's Annual Report 2015, which has just been published, the remaining 55 centres ‘were non-compliant to varying degrees'.

"While progress is being made, it's important to point out that only six approved centres achieved full compliance, and that is disappointing. During 2015, standards of service also fell below what is acceptable in five areas - individualised care-planning, privacy, staff training, safety of premises and the control and administration of medication.

"Some of these have been issues for a number of years. These are areas which need to be brought up to appropriate standards," commented the MHC's Inspector of Mental Health Services, Dr Susan Finnerty.

She pointed out that 43% of approved centres had breached rules on seclusion, ‘meaning patients were kept in seclusion contrary to the rules and in a way that could pose serious risk to their safety and wellbeing'.

Other areas of low compliance included the way in which medicines were prescribed, stored and administered (42%), the use of physical restraint (58%) and the admission of children (26%).

The Code of Practice states that no child under the age of 18 should be admitted to an adult unit in an approved centre except in ‘exceptional circumstances'.

However last year, there were 95 admissions of children to adult units.

"This situation is unacceptable and needs to be addressed as a matter of urgency," commented MHC chairman, John Saunders.

The MHC also expressed concern that the number of involuntary admissions had increased by 9%, from 2,162 in 2014 to 2,363 in 2015.

"Modern mental health policy is that involuntary admission to residential care should be a last resort intervention. We are particularly concerned at the proportion of involuntary admissions where the family and Gardaí are the primary referrers (23% and 47% respectively). These are very high proportions," Mr Saunders said.

The MHC acknowledged that there has been some progress made on mental health service provision in recent years, however it insisted it is now time for a formal review of the Government's policy on mental health - A Vision for Change - which was launched 10 years ago.

The commission also called for the policy to be independently monitored in order to identify areas where it is and is not working effectively.

It also pointed out that there is still a ‘significant absence' of psychology, social work, occupational therapy and other multidisciplinary staff. In fact, staffing continues to be a major challenge and in 2015, the State's mental health services were operating at just 75% of the level recommended in A Vision for Change.

"Service providers are trying to recruit and efforts are being made to fill roles. However the reality is that there is a dearth of mental health professionals required to populate these teams and this is an ongoing challenge for the service providers and for the patients who do not have access to fully resourced teams," commented MHC chief executive, Patricia Gilheaney.

The Annual Report can be read here