In this conversation, Dr Elaine Lockhart speaks with Dr Lade Smith, President of the Royal College of Psychiatrists, about the critical importance of early intervention in mental health, the impact of social determinants and structural racism on mental health services, and the need for psychiatrists to champion community-based solutions. She stresses the urgency of addressing the treatment gap, particularly for children and young people, and highlights the importance of a motivated workforce within the field of psychiatry. Later, Elaine talks to Professor Bernadka Dubika about her extensive work in child and adolescent mental health, focusing on behavioural activation, the role of antidepressants, and the importance of training staff in CAMHS. She emphasises the need for a biopsychosocial approach to understanding young people's mental health challenges and the significance of fundamental clinical care in practice.