A comprehensive review commissioned earlier in the year has examined support systems for mental health conditions alongside autism and ADHD diagnoses, presenting findings on diagnostic trends and recommendations for service improvements across the NHS and broader society.
The review identifies a pattern of increasing diagnoses for autism and ADHD over the past 25 years that appears to exceed expected population levels in some younger age groups. Among children aged six to 17, more than 4% have received an autism diagnosis, substantially higher than the 1-2% prevalence suggested by research studies. However, the review team notes significant limitations in available data, with key surveys having not been conducted for nine years. The experts acknowledge that certain age groups continue to experience under-diagnosis and stated they cannot yet conclude over-diagnosis is occurring “at scale.” They emphasize concern about blurring distinctions between diagnosable conditions and normal variation in brain function and behavior.
In contrast, the review finds mental health challenges are genuinely increasing rather than being over-diagnosed. Mental distress among 16 to 24-year-olds has risen to one in four, compared to one in six approximately 30 years ago. The review attributes this rise to factors including economic uncertainty, social media effects, and reduced youth services. The increase involves conditions such as anxiety, depression, self-harm and eating disorders rather than severe mental illnesses like schizophrenia and bipolar disorder, which have remained stable.
The review identifies significant barriers following diagnosis, noting that diagnostic labels can restrict opportunities in education, employment and relationships by emphasizing difficulties rather than strengths. Approximately one-third of young people aged 16 to 24 outside education, employment or training cite mental health or autism as contributing factors. Those diagnosed with ADHD before age 17 are four times more likely to face such circumstances than those without diagnosis.
Major concerns include excessive waiting times throughout the system. One-third of young people referred to mental health services wait more than a year for assessment, while 90% of the 900,000 people awaiting ADHD or autism evaluations have waited more than three months. The review emphasizes that support infrastructure remains fragmented across healthcare, education, employment and welfare systems. It recommends prioritizing assessments by clinical need rather than order received, improving quality controls for private-sector assessments, and implementing restrictions on direct-to-public advertising of diagnostic services. The government has committed to addressing these recommendations within 12 to 24 months and is expected to present further details in a forthcoming mental health strategy by year-end.
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