There was an increase in the number of applications made by gardaí to involuntarily detain people in approved mental health centres last year, according to the Mental Health Commission.

Its annual report for 2020 also shows a decrease in the number of applications by Health Service Executive authorised officers for the involuntary admission of people to hospital.

When a person is involuntarily admitted to a mental health centre, it is done through a family member, a HSE authorised officer, a member of An Garda Síochána or a person who works in health or social care.

Ten years ago the highest number of admissions was through family members but that has decreased and now the largest number of admissions is by gardaí.

In 2020, there were 1,919 admission orders for involuntary detention - 32% were by gardaí - the largest yet.

Most concerning, according to the Mental Health Commission, is that they happened during a pandemic when people may have been even more vulnerable.

The commission said it is not critical of the gardaí who made the applications - instead, it appears to point to the HSE's mental health services.

The report shows there was a decrease in the number of admissions by HSE authorised officers - whose role involves making an application to medical practitioners for involuntary admission.

The commission says the revised Mental Health Act, which is due before Cabinet before the summer recess, needs to ensure that only authorised officers sign off on admission to reduce the involvement of gardaí in the process.

In response, An Garda Síochána pointed out that the Commission on the Future of Policing in Ireland stated that societal-wide issues such as the mental health of individuals are not the responsibility of the Garda alone.

It said the Commission on Future Policing recommended the establishment of multi-agency teams that would include gardaí to respond to the needs of individuals with mental health issues.

The Mental Health Commisson said it has written seeking a meeting with Commissioner Drew Harris to discuss the matter and determine if members of the Garda can avail of suitable training.

An Garda Síochána said sworn members receive training in relation to interview techniques which involve identifying and managing interviewing people with vulnerabilities.

It said that as part of the Continuous Professional Development Core Programme for operational members, An Garda Síochána has provided training on Mental Illness Awareness in keeping with the Mental Health Act 2001.

The programme also covered areas of the types of mental illness, garda powers and procedures and transportation of persons with a mental illness.

All trainee gardaí undertake a two-day internationally recognised ASIST workshop (Applied Suicide Intervention Skills Training) which is delivered in collaboration with the HSE.

Trainee gardaí also study legislation on the Metal Health Act 2001 and the procedures that are required if gardaí invoke their powers.

Responding to the report, the HSE said that in 2020 the overall number of involuntary admissions to mental health services decreased by almost 20%.

It said there are currently 127 Authorised Officers with ongoing recruitment and training of new ones.

The HSE says it is aware that the Department of Health is currently reviewing the Mental Health Act and that the role is being considered as part of that review with a view to enhancing it and increasing the number of Authorised Officers.

Speaking on RTÉ's Morning Ireland, MHC Chief Executive John Farrelly said An Garda Síochána is "a law enforcement agency not a health agency".

"When someone is at their lowest ebb, when they're unwell, when they're mentally ill, it's important that they are met with a health system, not with a law enforcement system," he said.

Professor Jim Campbell at UCD's School of Social Policy, Social Work and Social Justice has said it's "unusual" even in "normal" times, for police officers to be the applicant when citizens are involuntarily admitted to hospital.

He points out that the role of the Authorised Officer is nearly always carried out by social workers in the four jurisdictions of the UK.

The role works best he says when there are available community-based alternatives to consider, which avoids the more restrictive alternative of compulsory admission to hospital. In such circumstances the rights of patients and their families can be protected.

The Mental Health Commission's report also addresses the low compliance rate in services regarding individual care plans.

Everyone using mental health services has the right to a care plan that is personal to them.

They also have the right to be involved in developing their care plan, to know what is in their care plan, and to be involved in reviewing their care plan.

It describes the care, treatment, and interventions that a person should receive, to ensure that they get the right care at the right time.

Inspections of services last year found that 41% of services did not develop comprehensive individual care plans with the residents in the approved centre.

According to MHC Inspector Dr Susan Finnerty there has been little improvement in the past three years.

Dr Finnerty said there is a failure by services to ensure people with a mental illness have an individual care plan that enables recovery.

Chief Executive Officer of Mental Health Reform Fiona Coyle said mental health policy needs to be based on a partnership approach and an individual care plan is key to this.

"These recovery plans are so important and yet again, this report shows that they're the lowest level of compliance, that's not good enough," she said.

Ms Coyle said that if the country is to step up to the 'A Vision for Change in Mental Health Services' - which has been talked about since 2015 - then change is required.

"Leadership is what's needed to make that happen. We need a cultural shift in the way the services are delivered and the way the service user is seen," she said.

The Mental Health Commission said Covid-19 has demonstrated the unsuitability of mental health buildings, which had the lowest level of overall compliance nationally (55%).

It said many facilities are suffering from years of neglect and lack of funding, resulting in people with a mental illness living in or receiving treatment in unsuitable, run-down centres.

While the standard of facilites built in recent years is high, Dr Finnerty said too many substandard buildings remain.

"Funding is now urgently required to either replace or properly renovate the remaining facilities and help move the country further along the line towards a modern mental health service," she said.

The Department of Health said it has finalised the draft general scheme to amend the Mental Health Act of 2001.

It is envisaged that Cabinet approval will be sought before the Dáil summer recess to formally draft the bill and to publish the general scheme according to a spokesperson.