The number of sudden deaths in psychiatric hospitals has increased, partly due to drug-related effects, according to the latest annual report, for 1988, of the Inspector of Mental Hospitals.
The inspector described the prescribing of drugs in some State psychiatric hospitals as "often arbitrary and made without regard to appropriate clinical diagnosis".
"The number of patients, particularly long-stay patients, who are on numerous drugs simultaneously, often at high dosages, was striking.
"In some instances the prescriptions had not been reviewed for some considerable time," Dr Dermot Walsh reported.
The provision of better services for those with mental health disorders also needed to be speeded up, the report said.
As many as half the acute psychiatric beds are occupied by persons who do not need such a high level of in-patient care, Dr Walsh reports. He blames this on the absence of appropriate alternative residential facilities.
He highlights the problem of homeless mentally-ill persons, especially in large urban centres such as Dublin.
The inspector is also critical of the fact that no new acute psychiatric units having been opened last year despite such a unit being ready at the Adelaide and Meath Hospitals.
The inspector acknowledges significant progress in community mental health centres, day hospitals and community residential facilities, but says that this rate of progress should be accelerated.
The report has been laid before both houses of the Oireachtas by the Minister for Health and Children, Mr Cowen.
It shows that the number in psychiatric in-patient facilities continues to fall. There has been a decline from 5,192 patients at the end of 1997 to 5,101 at the end of last year.
Of the 26,000 admissions to inpatient facilities last year, about 6,000 were first admissions. The numbers entering general hospital accounted for one-third of all admissions, and this figure continues to rise.
Commenting on the report, Mr Cowen said: "Much still needs to be done in the provision of comprehensive facilities and services and it is my intention to facilitate health boards in bringing about the improvements and developments identified by the Inspectorate."