Matthew Stone manages the East Sussex primary mental health worker team, which has a key role in joined-up working as part of the wider child and adolescent mental health services offered by Sussex Partnership trust

The role of the team is to develop more coherent pathways and relationships of support and care between the universal children's services and specialist child and adolescent mental health services.

This in turn is set within the national service framework and the programme that aids its delivery, the white paper Every Child Matters, and a specifically local children and young people's plan.

The framework and Every Child Matters promote a comprehensive approach to child and adolescent mental health, in which the responsibility for a young person's emotional well-being lies across all services, including education, employment and health.

The primary mental health worker accelerates some of that process, identifying where partnership work can be taken forward more quickly, tapping into existing resources and helping agencies develop capability and competencies to support emotionally vulnerable young people.

A potential downside to the comprehensive agenda is that staff in universal services can become anxious about the level of expertise they feel they should acquire. But I believe that, although there are times when specialist services might be needed, much of this preventive work centres on skills in engagement and understanding the human condition.

Helping release the latent capability that we find in teachers, youth workers and others has been fairly smooth and the take-up of training that we offer has been huge.

Striking a balance

Universal service workers, however, are not twiddling their thumbs. They all have day jobs and in-service training to attend and, what's more, are being asked to be the point of distribution for an increasing number of competing agendas. While the emotional well-being of children and adolescents is a central plank to their work, we have to be sensitive to the balance between priority and extra roles.

The multi-agency work required to build bridges and create resources to back up the universal services has never been easy but the nascent children's trusts are bringing more strategic coherence to this approach.

Individual practitioners know the work that lies ahead. They also know the outcomes are not immediate but understand the steps to be taken in the context of a long-term local children and young people's plan.

Too many central policy initiatives, however, appear to be knee-jerk responses and come with short-term funding. In time, these posts may be positively evaluated, but the public sector budgets that people look to for mainstream funding are already being pulled in a variety of different ways.

The tensions created by pressures of available time and finances mean that, although there is progress with a comprehensive approach to child and adolescent mental health, some difficult conversations are still to be had.