Many mental health centres are operating in premises that are “outdated, unsuitable or unsafe”, the watchdog has said.The Mental Health Commission (MHC) on Friday will publish its 2025 annual report, which notes several areas of improved compliance with regulations.According to the report, there has been a 91 per cent reduction in overcrowding in inpatient centres, from 64 instances in 2021 to five in 2025.In addition, the admission of children to adult units has fallen by 81 per cent over the same period, while the use of restrictive practices has reduced significantly.However, in his report, inspector of mental health services Prof Jim Lucey criticised the physical infrastructure of many centres, describing them as “unsafe”.“This is unacceptable. The perennial nature of this deficit is my real concern. Much-needed capital investment is being provided in some areas, but not in others,” states his report.“The MHC has called year-on-year for a more substantial increase in capital funding for our acute mental service. Poor quality of therapeutic environment contributes to the difficulties which staff and residents experience daily.”Lucey’s report said centres do “all they can” to mitigate these risks, but the failure to resolve this challenge is beyond their control.“It has consequences far beyond a narrow definition of compliance, impacting on the centres’ risk management procedures and staffing,” he said.Lucey added that issues relating to the monitoring of medication in Irish mental healthcare remain a continued cause for concern.“This year’s review of services confirmed the need for more consistent medication management. Resolution of this issue is essential to restore public trust and confidence,” he said.“As a result of our overview, we have been able to give services clearer guidance. Henceforth, approved centres must ensure that where medication is prescribed, it is administered and monitored to ensure appropriate reliability and safety.”Lucey said medication is only one part of multidisciplinary mental healthcare.[ Central Mental Hospital among facilities criticised in latest commission reportsOpens in new window ]“A prescription may be necessary, but it is not sufficient. Approved centres which are compliant in this area will respond to residents’ needs more consistently within their duty of care and this must be included in the resident’s care plan and updated regularly,” he added.Speaking about the annual report, commission chief executive John Farrelly said improvements are encouraging.“However, while the overall national picture is improving, it continues to be constrained by persistent weaknesses in a number of fundamental areas of care and governance,” he said.“Compliance remains too low in areas such as care planning, medication management, staffing, risk management and premises. While these shortcomings are concentrated in a relatively small number of services, they continue to adversely affect what would otherwise be a broadly positive national picture.”