Community mental health services have failed to reach standards laid down by the Scottish Office two years ago, according to the Accounts Commission for Scotland.

A report issued last week says 78 per cent of spending remains tied up in institutional care - with£160m spent annually on in-patient beds.

And 'wide variations' in spending are 'more likely to reflect historical patterns of expenditure' than patient need.

The report says the involvement of users and carers is 'better developed' than in many areas of healthcare, but 'once users and carers have expressed a view, not enough is done to implement their ideas'.

It suggests that trusts with high numbers of bed days used by people with minor mental health problems may be using 'inappropriate admission policies'.

The report also highlights the need for more integrated communication between local agencies.

A Shared Approach: developing adult mental health services. www.accountscommission.gov.uk