Mr. Mark Smyth:

I will touch on the point on outcomes. Working in mental health services, the predominant outcome is bums on seats and reducing wait time for first appointments. Those are the key performance indicators. We do not have outcomes that look at how the systems work with each other. A meeting between representatives of Jigsaw, CAMHS and third-level education does not count in someone's work return. He or she is not encouraged to do that but is instead encouraged to see people for individual works.

The systems around young people include the services that work together and another piece we have not spoken about, that is, the families. Young people do not exist in isolation. We talk about the fact that we want to teach them resiliency skills. We do not want to put additional pressures on them because we know they have standards of expectation and think they must be all of these things. We tell young people they have to be resilient in the face of a parent who is unemployed or who is struggling for housing and that we will teach them the skill of being resilient when what we need to do is to give them those supports at home so they have predictability and financial support. We also need the different parts of the system to be able to talk to each other. We should be encouraged to have meetings about how we work together. That is not the case because we are expected to firefight. We are left to decide whether to cancel appointments and not meet with young people so we can work with a service to improve the systems or to meet the young people and not get that pressure. Invariably, clinicians will choose the latter. There needs to be a mandate that directs services to work together because otherwise we will continue what we have done before, which is to work in silos in isolation, and be restricted in opportunities such as this, where we actually get to talk to each other. The parts of the system need to come together to improve the experiences of the young people.