The number of modern outreach and home-based psychiatric services in the State remains inadequate, according the Inspector of Mental Hospitals for 2003.
The report published today, says the majority of service providers seemed "unsure and insecure in their comprehension of the theory and practice of out-reach, home-based, crisis resolution initiatives".
It claimed the health boards had not adopted newer models of care-delivery or considered the possible advantages to psychiatric care of the recent proposals in the Hanly report for restructuring the health services.
The report showed the number of people in psychiatric hospitals has continued to fall, with 3,701 patients resident in public and private care at the end of 2003. This represents a drop of several hundred on 2002 and almost 7,500 on 1987.
Of the total number patients resident in psychiatric care in 2003, 3,266 were accommodated in health board hospitals and the remainder in private hospitals.
During that year there had been 23,234 admissions to these in-patient facilities, of which 2,349 were non-voluntary.
The report claims that despite the considerable progress that has been accomplished in replacing or improving in-patient premises, there were still some locations that were "unacceptable for care and treatment of patients because of seriously unsatisfactory conditions".
The worst offenders were the Central Mental Hospital and St Brendan's Hospital, both in Dublin, where most of the accommodation was described as substandard.
Also highlighted in the report was the old building at St Brigid's Hospital, Ballinasloe and certain long-stay wards in St Finan's Hospital, Killarney.
This is the final report under the current Inspectorate, which makes way for the Mental Health Commission and a new inspection system.
