Some 20 years ago I was asked by the Home Office to carry out an assessment of a large young offenders institution in the south of England. During this thoroughly depressing experience, I recall a comment from the governor. Did I realise, he said, that more than 90 percent of the 300 boys - all of whom had serious criminal records - had emotional and behavioural problems traced back to their primary schools?

The debate about what to do with problem youngsters and their families is yet again under the spotlight. Our latest responses look depressingly familiar: more intensive management training for teachers, punishment for the parents, American-style policing of schools to deal with truants.

The priority is containment, effected through punitive rapid-response strategies. There is a continuing failure to understand fully the crucial need for early intervention, and the need for involvement of the health service, the one government department that has maintained a stony silence on the issue.

It is useful to make a distinction between children who are merely naughty and those who have serious social or mental health problems. With naughty, indisciplined children schools could certainly do more to help themselves. The conventional curriculum needs to be more flexible and tailor-made to suit individual interests; highly motivated children tend to behave. More emphasis should be put on personal success, less on comparative exam performance grades. We need to consider specialist behavioural support teams within schools to take some of the pressure off the overloaded teacher. But we should also actively encourage schools - especially at primary level - to support parents.

As a headteacher I found it really effective to offer vulnerable parents an out-of-hours emergency visiting arrangement to help deal with out-of-control youngsters, calming them down, setting and insisting on limits and building home-school relationships.

Too many schools find suspension is a convenient option. Too many parents think that disciplining their child leads to social services knocking at the door, and give up the effort. The result can be an explosive burst of emotional distress at out-of-control behaviour, wild inconsistency in managing the child, and sometimes real abuse. A long-term aim might be to offer a mentor to every vulnerable child, able to offer rapid intervention whenever required.

More important still, we must get better at identifying children at serious risk, many of whom are profoundly anti-social and have serious mental health disorders. Such children, advancing into adulthood, account for 50 per cent of all prison inmates.

Our child and adolescent mental health services are chronically under-resourced. Currently, only 2 per cent of the mental health budget is spent on children and adolescents, who make up 25 per cent of the population.

Too many schools and local authorities see the delaying of proper diagnosis of need as a virtue. Expulsion at secondary school age (in some places 25 times more common than at primary level) frequently indicates a failure of primary intervention.

Health Secretary Alan Milburn needs to reassess priorities in this field. The new Primary Health Trusts need to plan a comprehensive health service from birth to 16, with proper attention to children’s mental health provision. Local health, social service and education teams must work closely together instead of running on separate, parallel tracks.

We must recognise that health visitors and nursery nurses are key workers in supporting families in the critical early years. Targeted interventions should be the right of youngsters displaying problems, helping them develop confidence, and long-term coping strategies.

We have been debating the problems of disaffected youth in different ways for decades. It is surely time for a comprehensive cross-professional re-think of policy all round. It requires dramatically increasing our attention to the early and primary years of family and childhood experience, with back-up resources, intelligently focused, on a scale hitherto unimagined. Can we afford, yet again, to fail?

Sir David Winkley is president of the National Primary Trust and former head of Grove primary school, Birmingham