Mental Health Commission publishes 2025 Annual Report
Report sees improving compliance levels across inpatient services, but real and persistent challenges remain in a small number of services and areas.
The Mental Health Commission (MHC) has published its 2025 Annual Report, outlining its work to promote, encourage and foster the establishment and maintenance of high standards and good practices in mental health and decision support services throughout Ireland.
The report demonstrates continued improvement across Ireland’s inpatient mental health services. Overall compliance levels increased during 2025, more approved centres achieved full compliance, and the continued reduction in restrictive practices represents a significant advancement in protecting the dignity and rights of people receiving mental health care.
Chief Executive of the Mental Health Commission, John Farrelly, said: “We have seen encouraging improvements across inpatient services, with more centres achieving high levels of compliance. This shows what can be achieved through strong leadership, effective governance and a commitment to quality improvement.
“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. Compliance remains too low in areas such as care planning, medication management, staffing, risk management and premises.
“These are not administrative requirements. They are among the most important determinants of safe, effective and person-centred mental health care. 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.”
The report also highlights concerns raised by the Inspector of Mental Health Services, Professor Jim Lucey, who noted that many approved centres continue to operate in premises that are outdated, unsuitable or unsafe.
“The Inspector has described the persistent failure to address deficiencies in premises as a real concern,” said Mr Farrelly. “However, premises are only one part of the challenge. The continued low levels of compliance across a number of fundamental areas of care demonstrate the need for greater leadership and accountability across the public system.”
In response to non-compliance identified through inspections and monitoring, the MHC undertook 49 enforcement actions involving 32 approved centres during 2025.
“These enforcement actions reflect our commitment to ensuring safe, high-quality care for service users, and to taking proportionate action where required.
“With the Mental Health Act 2026 now signed into law, regulation is moving beyond inpatient services and increasingly into community-based mental health services. It is essential that these foundations are strong because they will underpin how mental health services are delivered and regulated across the wider system.
“Inpatient units have a critical role, but they should not become the default response to the growing mental health needs of society. Much of that care is better provided in the community, and the standards we expect in inpatient services today must become the standards we expect across the wider mental health system tomorrow.
Mr Farrelly said it was worth noting that when compared to previous annual reports, the data contained in the 2025 report demonstrated that significant improvements have been achieved across key areas of Ireland’s inpatient mental health services over the past five years.
“Progress has been recorded in areas such as overcapacity, where there has been a dramatic 91% reduction in overcrowding in inpatient centres, from 64 instances in 2021 down to just five in 2025. In addition, the admission of children to adult units has fallen by 81% over the same period.
“Furthermore, one of the most significant advances has been in the reduction of restrictive practices. Sustained year-on-year decreases in the use of seclusion and restraint have been accompanied by a 90% reduction in restrictive practices involving children since 2018. These improvements - driven in large part by the introduction of new Rules and a Code of Practice by the Mental Health Commission - have transformed the experience of care for many service users. The Inspector has described the reduction in restrictive practices as the most significant advancement in human rights-based mental healthcare in Ireland over the past two decades.”
The annual report also highlights the continued expansion and growing impact of the Decision Support Service, which continued to expand throughout its second full year of operation. During 2025, 5,329arrangement applications were submitted, 3,622 Enduring Powers of Attorney were registered, 18,637 verified ‘MyDSS’ accounts were created, and 1,875 decision support arrangements were under supervision at year-end.
The publication of the 2025 Annual Report comes at a significant time for mental health and decision support services, as the MHC continues preparations for the implementation of the Mental Health Act 2026 and works with stakeholders to strengthen rights-based, person-centred services across Ireland.
Mr Farrelly concluded: “The 2025 Annual Report demonstrates the dedication of service providers, staff, partners and stakeholders across the country who are committed to improving services. Together, we continue to work towards a future where safe, high-quality, rights-based mental health and decision support services are available to all who need them.”
To access the full report, please follow this link: The Mental Health Commission 2025 Annual Report
View the Annual Report 2025 video: Mental Health Commission 2025 Annual Report video
