Mr. Andrew Jackson:

I will speak briefly about our experience as a service and about prevention and early intervention. The testimony today and what we heard earlier illustrates the level of frustration felt by parents and young people when it comes to accessing services. I could go through anecdotal cases, but there is no need to echo what was said earlier because it was illustrated perfectly.

It shows the level of crisis management happening with our services. This relates back to the adage that prevention is always better than cure, which is something that is very true for mental health services and for services in general which relate to children who might have behavioural or emotional difficulties.

There are a huge amount of service available at the moment, including our own child and family support service, the area-based childhood programme, SPECS. The list is quite long. Often there is a referral issue. People often do not know who to go to, how to be referred or what supports to actually seek. This plays into the frustration levels that parents and young people feel. An informational route needs to be introduced so that everyone knows from a very early stage how to access the correct levels of supports when necessary. The level of public health nursing needs to be massively increased so that once any person becomes a parent for the first time they are well armed with the knowledge of how to access supports if an issue arises. We need to try to get away from the level of crisis management that seems to be dogging the entire system currently. We have heard the statistics from Lucena and from CAMHS. We see the statistics ourselves when we look at our own Childline figures. Tusla does not see itself as a crisis management agency. It sees itself as a preventive agency, although it does deal with crisis management. Within its own founding legislation Tusla states that it is an agency that provides preventive family support services. It is very clearly defined and yet it is dogged with crisis management. That becomes problematic. Tusla's budget is sizeable. The figures thrown about are quite large, but less than 1% of its budget focuses on preventive works. That needs to increase. We need to focus on preventive steps. As my colleague, Ms. Nicholson, said, there are many cases which do not need to get to CAMHS. If the correct work is put in at the correct stage we can prevent that so that it does not become overburdened with work that need not have arisen.

When we look at prevention as opposed to crisis management, we also look at the very nature of economies of scale and what investment can really improve. Research completed by the National Economic and Social Forum stated that if Ireland was to invest appropriately, for every €1 it invests in a preventive piece of work its savings would be between €4 and €7 in the outcomes. The cost base analysis is reduced, and that is a massive saving. For every €1 spent we would save between €4 and €7 if we avoid the crisis management work. We need to focus on that preventive piece of work again. If we do not we might end up on the same path as other agencies in other jurisdictions. The American system is particularly bad at focusing on preventive steps. It is very crisis-oriented. For its cost base analysis, it costs the US tax payer $18, compared to just $1 of investment if it focused on preventive measures.

Focus needs to be brought back to this prevention and early intervention model. There are many great services out there, including our own, and if we can reduce crisis management - although some crisis management will always happen - crisis management agencies can work successfully and remove the necessary bogged-down status that we seem to be in at the moment.