Patients with psychiatric problems who desperately need round-the-clock support are being failed by mental health services.

A report published by the Healthcare Commission, the watchdog that inspects health services, warns that improvements must be made in out-of-hours crisis care.

Inspectors found huge variation in the availability of help outside normal working hours. The majority of areas do have specially trained staff providing this support, but under a half of people using services said they had the phone number of someone from their local mental health service whom they could contact late at night.

Also, nearly two-thirds of mental health services received a "poor" rating on how they provided access to crisis accommodation out of hours.

The report concludes that patients need greater access to talking therapies, where people are taught how to overcome anxiety and mild depression by overturning negative thoughts.

Only half of people who took part in the review had access to talking therapies, and in some areas the figure was only one- fifth. Mental health teams also scored badly on how they recorded side effects of drugs given to people with schizophrenia.

Mental health charities warned that the report shows that patients are still being denied a "basic level of care", which would be unacceptable in any other care setting.

"There has been no improvement in the last couple of years to community mental health services, and the current round of cuts are set to see these standards worsen," said Andrew McCulloch, chief executive of the Mental Health Foundation.

"The Government has a duty to make a range of treatment options available to people with mental health problems. Medication is being relied upon because of a lack of alternatives."