The new Inspector of Mental Health Services has said that just 1% of mental health services in Ireland are regulated.
Speaking on the Brendan O'Connor programme on RTÉ Radio, Professor Jim Lucey said this was extraordinary.
He added that very few people realise that the commission cannot insist on standards in 99% of services.
Prof Lucey said Ireland is at a moment of change, but that the whole story around mental health services and regulations needs to be told in order for the change to come about.
He explained that these services appear in private and secondary care, as well as clinics, approved centres and unapproved centres.
HIQA has its role, he said, but most of the mental health journey that people undergo is through an "unregulated place".
Prof Lucey said a report by his predecessor, Dr Susan Finnerty, made 79 recommendations that need to be put into place quickly.
He said that one of the first recommendations he is focusing on will be the proposed changes to the CAMHS service.
Prof Lucey said the obvious body to regulate CAMHS services in the future is the Mental Health Commission.
"It's the body with the experience, the commitment to standards, the team, the understanding of the interface between healthcare and human rights, and it needs to happen and people think it's obvious," he said.
Prof Lucey said that there are 66 adult centres that are subject to inspection by the Mental Health Commission and these centres are inspected by teams every year.
He said the health spend in Ireland is a staggering amount, but that just €1 in every €20 is spent on mental healthcare.
"Now that's a real problem because the imbalance means that where it matters upstream, where we could do preventative or could be holistic, isn't getting the money," he said.
Prof Lucey said that common mental health disorders may be common, but they are not minor issues.
He said it was important that this is communicated, as disorders such as anxiety, eating disorders and depression are increasing.
However, he added, the core disorders that people think are serious, such as bipolar and schizophrenia, have not risen.
It is the stress-related environmental inputs into well-being that we need to address, he said.
Prof Lucey said society needs a shift in its thinking about mental health and the move from awareness to action is essential.
He said: "They are common, but they're not minor. So, anxieties, depressions, addictions, traumatic stress disorders, PTSD, eating disorders. These are all the conditions that have increased in my time.
"Schizophrenia, bipolar mood disorder, the core disorders that people think are serious have not risen at all in our society."
