Some 2,000 people are living in large mental health institutions, despite pledges in the 1980s to close congregated settings.
The Inspector of Mental Health Services, Dr Susan Finnerty, found some residents sharing rooms, toilets and dining facilities.
The annual report of the Mental Health Commission has warned that public mental health services must improve compliance in four key areas or face a real risk of being removed from the register of approved centres.
Commission chief executive John Farrelly said there needs to be a move away from institutionalising mental health patients.
“Notwithstanding improved overall compliance, we can now undeniably say that there are four key areas — premises, risk management, individual care planning and staffing — where standards are simply unacceptable,” said Mr Farrelly.
Urging public services to focus on these areas in the coming months, he said the Health Service Executive should concentrate first on the centres with low standards in care planning and premises.
The commission inspected 66 centres last year and found none had compliance rates lower than 71 per cent.
There were 2,040 involuntary admissions, compared to 2,549 in 2021, and 33 instances of overcapacity, about half the previous year’s total.
The commission took 45 enforcement actions over incidents or serious concerns in 28 centres last year.
Last year, 498 deaths of people using mental health services were reported, including 147 in approved centres. There were 144 suspected suicides including 26 in approved centres.
Twenty children were admitted to adult mental health units, the lowest figure ever recorded.
