The Mental Health Commission has said that progress remains slow on the implementation of the Government's policy on mental health services.
The policy known as 'A Vision for Change' was published five years ago.
The commission said that in the last year it had to impose stringent conditions on three older institutions, following a report from the Inspector of Mental Health Services in 2009, which showed poor conditions.
Commission chairman Dr Edmond O'Dea said the fundamental changes envisaged when the policy document was being written have not occurred.
He said the document must be implemented in full, to ensure a truly modern, accessible and integrated mental health service is in place.