Ms Kate Mitchell:

We know there are programmes in existence, for example, the Preparing for Life programme in Coolock. It is a very positive programme. Certainly, we advocate that there should be a national roll-out of such programmes and that programmes should be made more widely available.

I referred to the national guidance on promoting mental health promotion and well-being. Guidance has been published for primary and post-primary schools. The Children's Mental Health Coalition very much welcomes the guidelines. We are concerned about their implementation. To ensure the translation of the guidelines into action, there needs to be appropriate resourcing and training of teachers.

Deputy Ó Caoláin referred to the absence of a psychiatrist within CAMHS teams and how, at times, this can lead to new referrals not being made as a result. Dr. D'Alton may be able to answer the question better but it seems that in the majority of teams, the psychiatrist remains the clinical lead. We know of some CAMHS teams where that is not the case. In those cases the lead may be a nurse or a professional from a different discipline. Anyway, that needs to be looked at. The question is whether the psychiatrist should be the lead and how to integrate other professionals into the role. We have heard of cases where children who access CAMHS may need referral to a psychiatrist later. There are concerns over referring or admitting a child when, it transpires later, the child requires psychiatric input. That issue needs to be examined for future reference as well.

Deputy Mitchell O'Connor raised the question of where parents need to go for support. From the bottom up, we advocate the one-good-parent or one-good-adult model. This is something Headstrong strongly advocates and recommends. The ethos is that every child or adolescent should have one good parent or one good adult who he or she can talk to and for that person to listen to his or her concerns.

There is also an issue over having capacity built up across the mental health system. A Vision for Change recommended the need for capacity across the continuum of mental health care from primary care level to specialist support services. This goes back to what Professor Nugent said. He referred to the need to capture mental health difficulties before they develop. There is a place for mental health promotion at the earliest stages from perinatal and infant mental health right up to child and adolescent stages. There is also the question of building capacity at each level through primary care. If a family member, child or adolescent goes to the doctor, then the doctor has the capacity to refer the patient or intervene or provide care. However, there must also be clear referral points into specialist services as well.

We need to see the development of lower level community mental health supports. We have seen the establishment of Jigsaw programmes and the benefits they bring to a number of children and adolescents. This is something the Children's Mental Health Coalition strongly advocates for. We need to see development of more lower-level community mental health supports and alternative supports to specialist services.