A suicide vulnerability assessment is supposed to be completed every three months for each patient, but is only done in about 62 per cent of cases, Dr Cooper found, recommending a review to find out why.

The ACT Health has a single record-keeping system for mental health services (called MHAGIC), allowing information to be shared and continuity of care for people in the mental health system, but Dr Cooper found it is not being properly used.

Records were "repetitive, poorly structured and did not provide comprehensive information on the course of treatment, discharge and recovery planning", she found.

While the government planned to upgrade the system, that would be "futile" unless staff changed the way they used it, she said.

Canberra has 89 acute care beds for mental health care: 37 in the adult mental health unit at Canberra Hospital, six in the hospital's short-stay unit, 21 in the mental health ward at Calvary, 15 in the older persons unit at Calvary, plus 10 beds at the Dhulwa secure mental health unit at Symonston. Once people are discharged from acute care they are looked after by community mental health teams.

Dr Cooper said each year, about 1000 people in Canberra were discharged from acute mental health services, usually to their family and friends. There was a clear focus on quality and compassionate care.

Two-thirds of people were followed up within a week of discharge - a high achievement, and only five per cent were readmitted within 28 days, another measure of good care.

But the system was compromised by the lack of a comprehensive system for managing the move from acute care to the community.

"This compromises the ability of public health practitioners and carers to effectively manage a person's transition," Dr Cooper said.

There were few records showing contact with GPs, and no standard practices for recording how discharge summaries had been shared with GPs.

Records had not been made of clinical meetings about people's care and treatment.

"Recovery plans" were found in only one third of a random sample of records examined by Dr Cooper.

"This failure of practice means that the MHAGIC records of recovery planning are incomplete. Reliable and complete records of recovery planning are not available to be given to the person, their family or to other carers," Dr Cooper said.

"Neither are they available to other staff or other support organisations to help in their care of the person, including after discharge from acute care."

ACT Health told Dr Cooper that the new MHAGIC system would go live in November and it would ensure that policies and procedures were in place to support the move and train staff.

Liberal health spokeswoman Vicki Dunne said the audit had once again highlighted the health directorate's poor records management and data issues.

"Clients of ACT Mental Health are among the most vulnerable in our community. They and their families deserve better. The ACT taxpayer expects better," she said.