Life has become harder for young people, a leading expert said (Image: Getty)
Mental health services are failing patients and must be radically reformed to stop using diagnosis as a gateway to support, according to experts. A major review found that recognition of autism and ADHD had “risen dramatically” in recent years, leaving more than 900,000 people on waiting lists at the end of 2025.
It warned that young people were spending years waiting for diagnostic assessments before receiving care that should be available much earlier.
An expert panel led by UCL’s head of psychology and language sciences, Professor Peter Fonagy, recommended moving from a diagnosis-dependent model to one based on need.
They also called for people on waiting lists to have clinical reviews that look at all the possible causes of mental ill health and prioritise the right support, rather than focusing on assessment of a single condition.
Prof Fonagy said: “The current system is failing people. It asks people to qualify for help rather than simply giving to them. A diagnosis at the end of a four-year wait is not a help, it’s an explanation arriving too late.”
Experts said people should be able to access support without a diagnosis (Image: Getty)
The review found that population prevalence rates — which estimate how many people have a condition, regardless of diagnoses — for ADHD and autism have “remained broadly stable” over recent decades.
The experts said they could not “conclude that overdiagnosis is occurring at scale” but warned of an increased risk of people being labelled with conditions that limit their life chances. Getting a diagnosis, though, can help people understand and address the difficulties that impair their functioning, and access medication or practical support.
Prof Sir Simon Wessely, vice chair of the review and professor of psychological medicine at King’s College London, said: “One of the dangers of diagnosis is defining [you] by your difficulties and not your strengths, circumstances and potential.”
The 607-page report found that levels of mental distress had increased substantially and now cost England an estimated £300 billion. This includes significant increases in anxiety and depression across all age groups, eating disorders and self-harm.
Prof Fonagy said “life has become harder” for young people because it is “more uncertain, more relentlessly observed and appraised, with less belonging and fewer opportunities to take time out, to recuperate and recover”.
He also noted the influence of social media and said its main harm came from displacing other things in people’s lives, such as face-to-face encounters and sleep.
Responding to the report, the Government pledged to offer people experiencing mental distress broader support and advice at the earliest opportunity, without having to wait for a clinical diagnosis.
It said the upcoming Mental Health Strategy would set out a renewed focus on prevention and early intervention, including greater support in schools, colleges and communities.
Health Secretary Yvette Cooper said: “It is clear that mental health services need to change to focus more on the early support young people need to stay in education or work or keep their lives on track.
“Based on the review findings, we will also take action to strengthen the oversight of mental health and neurodevelopmental services, and make all diagnostic assessments for ADHD and autism CQC-regulated.”
Dr Nick Broughton, national priority programme director for mental health, learning disabilities and autism at NHS England, said: “This is a landmark moment for how we better understand the mental health needs across society, in particular the struggles many young people are now facing.
“As Professor Fonagy’s review has found, there has been a genuine increase in the number of young people seeking help in recent years, and it’s our job alongside other sectors to ensure we are providing the best support to them when they need it.
“We have taken important steps in addressing these challenges, with six million pupils now able to access NHS mental health support in classrooms, and we’re making it easier for people to get support for ADHD and autism conditions before and after diagnosis.
“But collectively there’s much more to do to give young people the best chance at succeeding in a complex and ever-evolving society, while keeping pace with new technology and the pressures that can bring — the NHS is ready to play its part.”
