The physical environment in certain wards at Mount Carmel is in dire need of improvement, the Commissioner for Mental Health has warned.

In the annual report for 2016, published on Friday, Commissioner John Cachia did not mince his words: “Staff dedication, respect and dignity towards patients cannot be expected to make up for lack of investment in the physical environment of care facilities.”

Read: Corrective action at Mount Carmel Hospital 'long overdue'

The report also says that safety is still an issue on some wards.

The Office of the Commissioner was set up five years ago, but the report provides the second full year review of outcomes’ statistics in accordance with the new legislative set-up.

"Some improvements have been made since the 2015 visit," the report acknowledged.

Watch: Mount Carmel Hospital ‘safest in 30 years’, says minister

The patients seem to be better kept and the vast majority of service users (88%) state that they feel treated with respect and dignity. A total of 86% of users feel that staff were kind and caring towards them. The same cannot be said about the care environment in wards although some improvement in the overall physical environment in certain units has been noted.

Read: Mental health patients need better environment - Commissioner

At the end of 2016 there were 69 persons on long-term treatment orders, of whom more than 60% (42 out of 69) were on community treatment orders, a further encouraging 13% shift towards long term care in the community in 12 months. This replaces the long term detention in hospital for more difficult cases.However, the Commissioner made it clear that he believed that acute psychiatric cases should be treated within Mater Dei.

A new chief executive officer, Stephen Sultana, was recently appointed to Mount Carmel Hospital.

Read: New Mount Carmel Hospital CEO credentials under wraps

IN NUMBERS:• 989 applications and notifications processed• 507 persons detained against their will for observation monitored• 284 treatment or detention orders issued• 111 discharges approved • 17 persons certified as lacking mental capacity.