Ireland's mental health system is "30 years behind" its UK counterpart according to the Mental Health Commission's chief executive.
John Farrelly criticised the "political will" of both the government and senior HSE management when it comes to addressing deficits in the current system.
He made his comments as the Commission launches its 2019 annual report, alongside the 2019 report of the Inspector of Mental Health Services.
Both documents criticise current standards. Overall compliance with regulations across the country's approved mental health services is 78% - a slight fall on the figure for 2018 - but John Farrelly said "this is a very low bar" and that too often the mental health system here is viewed through "outdated, Victorian glasses".
There were 208 instances of over-capacity reported to the MHC last year, with 115 notifications referencing one or more emergency admissions.
In her report the Inspector of Mental Health Services, Dr Susan Finnerty, said it is "stigmatising and discriminatory" that residents are likely to live up to 20 years less than their peers in the general community.
John Farrelly referred to "political will".
"To be honest, I had previously said unless it is addressed at senior cabinet senior, with a Minister, it is going to be hard to fix.
"It has to be owned at senior Ministerial level. Now there is a new board at the HSE and a new CEO but there is a lack of accountability for mental health and you can see that in this report. I worked in England 30 years ago - our services are not at that standard yet. We are 30 years behind."