A shortage of beds at South Australia's main forensic mental health facility is forcing other "extremely unwell" mental health patients to languish in hospital emergency departments for hours on end, the SA Community Visitor Scheme has said.

In a report, the scheme's principal community visitor, Maurice Corcoran, detailed serious concerns over a lack of secure mental health beds in the South Australian health system.

Mr Corcoran said overcrowding at James Nash House — a facility in Adelaide's north-east for people accused of a crime but deemed mentally unfit to stand trial, or found not guilty by reason of mental illness or awaiting court hearings — was creating bottlenecks elsewhere in the system, including at the Royal Adelaide Hospital.

"Just last week, we were contacted by nurses at the Royal Adelaide Hospital emergency department who were greatly concerned about a prisoner who had been there for over 70 hours," Mr Corcoran said.

"[They had been] handcuffed and shackled — legs and arms — for that whole period of time, because they were waiting for a bed at James Nash House.

"There were no beds available, and as a result this person had to be restrained for that whole period of time."

Alarm problems continue

Mr Corcoran said problems with the new Royal Adelaide Hospital's duress alarms had not yet been addressed, despite consistent calls for action from health professionals.

He said urgent action was needed.

"If someone is arrested or if someone who is in prison is regarded as someone who has a mental illness and needs to be assessed in the Royal Adelaide, they're taken to the emergency department," he said.

"At the moment, the Royal Adelaide Hospital is not a secure unit because of its duress alarm system not working properly.

"Because it's not a secure unit or a secure ward, the Department of Corrections requires them to be handcuffed and shackled.

"[The alarms] need to be fixed as an absolute priority so anyone entering there, whether as a forensic client or a prisoner who has become extremely unwell, [is] able to enter those units and be in a secure environment so they're not distressed for days and days on end when they're handcuffed and shackled to beds."

Mr Corcoran said he had repeatedly raised his concerns with the Health Department.

"The [new mental health] Minister is very much aware of this [and] I've raised this with [multiple executive-level staff].

"My understanding is that this does not happen in other jurisdictions [because] they have better mental health facilities within the correctional services area, so people do not have to be taken to emergency departments."

Health Minister Stephen Wade said he was told last week about the prisoner who had been shackled at Royal Adelaide Hospital and had worked with SA Health to resolve the issue.

"It does highlight the ongoing challenge," he said.

"We've got a whole series of concerning situations ... we recognise there are significant problems and we're working with our frontline health professionals to try and deliver the care that people need."

He also said problems with the hospital's duress alarms were an "urgent priority" but admitted it would take some time to fix.