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Staff shortages, under investment and major organisational change mean mental health services are still inadequate in many areas, according to a new report, writes Amy Taylor.

The research, by the Commission for Health Improvement (CHI), said many mental health trusts still face "significant challenges", and that mental health services lag behind the rest of the NHS.

CHI found that a national shortage of psychiatrists and nurses had a major impact on clinical leadership and quality of patient care. Many permanent staff were found to be working long hours to compensate, and said that they felt unsafe due to a high use of agency and bank staff who did not have the skills to support them in a violent incident.

Other findings showed that bed space in many trusts were under severe pressure. Service users and carers in some areas said they had to wait until crisis point before they could be admitted.

Unsuitable and unacceptable buildings and facilities for staff and service users were also identified. Some trusts had built new appropriate accommodation, but Victorian buildings with mixed sex wards, shared bathrooms and poor security were still found to be present in others.

The report concluded that priority tends to be given to adult mental health services at the expense of services for children and older people.

What CHI has found in: mental health trusts from www.chi.nhs.uk