Issued by: Department of Health and Social Care

Independent review into prevalence and support for mental health conditions, ADHD and autism published

• Government sets out move towards earlier, needs-led support for children, young people and adults, without long waits for clinical diagnosis

• Early support will keep young people in school, enable them to join the workforce, and continue playing a full part in their local communities

• Response to Fonagy Review will also see strengthening of regulation around ADHD and autism assessments, and review of advertising practices

Children, young people and adults experiencing mental distress will receive broader support and advice at the earliest opportunity, without having to wait for a clinical diagnosis, government has pledged today.

Responding to the findings of the Independent Review into prevalence and support for mental health conditions, ADHD and autism, the Government has committed to a major overhaul of mental health support in the forthcoming Mental Health Strategy. This will set out a renewed focus on prevention and early intervention, to make sure that people receive the right help, at the right time, in the right place, based on their needs.

The review published today (9 October), chaired by leading clinical psychologist Professor Peter Fonagy with the support of vice chairs Professor Sir Simon Wessely and Professor Gillian Baird, found that mental distress has increased substantially among children and young people. The findings show this has been driven by several factors, including social media, financial insecurity, increased uncertainty about the future, poorer sleep, and reduced feelings of connection and belonging. While referrals and diagnoses for ADHD and autism have risen significantly, the review found that population-level prevalence of these conditions appears broadly stable.

The interim report of Alan Milburn’s review of ‘Young People and Work’ also found that - among the 16 to 25-year-old age group not currently in education, employment or training - 24 per cent cited depression or anxiety as their main limiting condition, 22 per cent autism, and 18 per cent another mental illness.

The Government has responded by seeking to improve support at every stage of life. For children, young people and adults experiencing mental distress, greater support will be available in schools, colleges and communities with a focus on earlier intervention, reducing long waits and ensuring support is available before and without a diagnosis.

Where clinically appropriate, the system will continue to offer timely diagnosis and treatment, such as when someone may require medication.

As part of this work, the Health and Social Care Secretary has asked NHS leaders to urgently examine how people can access advice, assessments and treatment more easily.

These reforms will work alongside the Government’s new £4 billion package of support for children with special educational needs, backing schools to improve inclusion, widening access to specialist support, and rolling out training for every teacher.

The Government will also strengthen the oversight and regulation of ADHD and autism assessments, including working towards making all diagnostic assessments a CQC-regulated activity, so that people can be confident any diagnosis they receive, whether through the NHS or a private provider, is accurate and based on robust clinical practice.

Secretary of State for Health and Social Care Yvette Cooper said:

"Professor Fonagy’s review has shown the importance of early intervention to address mental health and neurodevelopmental conditions and the huge distress these can cause. 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. We will set out our response in a new Mental Health Strategy in the coming months, building on the new mental health services we are already providing in schools and in the community.

"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, so people can be confident that assessments are high quality and that the NHS is not being overcharged by independent or private providers."

Professor Peter Fonagy, Head of the UCL Division of Psychology and Language Sciences, said:

"Our findings show a system under immense strain, where diagnosis has increasingly become a very narrow pathway to finding support for distress caused by complex and wide-ranging factors. This Review’s recommendations offer a roadmap to shift from a diagnostic labelling model to a flexible, needs-led system.

"Diagnosis remains essential and must be protected - what has to change is that it is no longer the only door through which help can be reached. If we judge success by a person’s overall wellbeing and ability to take part in work, education, and staying connected to their community rather than by a narrow mechanism like diagnosis, we can shift to a system that intervenes early in communities and safeguards specialist capacity for those with severe needs."

Dr Nick Broughton, National Priority Programme Director for Mental Health, Learning Disability and Neurodevelopmental Conditions at NHS England and the Department of Health and Social Care:

"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 schools, 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."

Improving confidence in ADHD and autism services

The review recommends overhauling the commissioning, funding, oversight and regulation of mental health and neurodevelopmental services, including making all diagnostic assessments for ADHD and autism a CQC-regulated activity and banning direct-to-public advertising of NHS-funded ADHD and autism assessments.

The Government is exploring ways to strengthen oversight and regulation to ensure people can have confidence that assessments are clinically robust and that services deliver high-quality care, including:

• Improved oversight of assessment services: working with NHS England and the Care Quality Commission to regulate diagnostic assessments for ADHD and autism. This will cover NHS-funded, non-NHS-funded and self-funding patients, and will sit alongside the requirement for all Integrated Care Boards to improve oversight of the ADHD and autism assessment services they commission. This will protect patients from substandard providers, giving people confidence that wherever they are assessed, the diagnosis they receive is accurate and based on robust clinical practice.

• Review of advertising practices: The Secretary of State will write to the Advertising Standards Authority on issues related to adverts for autism and ADHD services to ensure people receive accurate information and are not exploited by companies encouraging them to seek assessments they may not need.

• New national tariff: NHS England will consult on proposals for a national set of prices for NHS-funded autism and ADHD services to improve consistency, support high-quality care and ensure public money is used effectively. The tariff would support a fairer, more consistent and more transparent system for providing autism and ADHD services, covering assessment, post-diagnostic support and follow-ups. NHS England intends to introduce finalised new payment arrangements from April 2027. This would help reduce unwarranted variation in NHS-funded ADHD and autism services, giving patients greater confidence that they can access consistent, high-quality support.

• Review of clinical guidance: Working with the National Institute for Health and Care Excellence (NICE) to urgently consider the implications of the report for its guidance relating to autism and ADHD. We will work with the NHS to implement NICE recommendations to ensure every child, young person and adult has high quality, evidence-based care to support their needs, provided in a timely way. This will give patients and families confidence that, wherever they live, they are receiving care based on the most up-to-date clinical evidence, rather than inconsistent or outdated approaches.

Earlier help and action on waiting lists for children and young people

The Government is already taking action to ensure people can access support earlier, reduce long waits for help and strengthen support for children, young people and families.

This includes:

• Supporting children’s very early years: Giving every family access to trusted, practical help throughout the critical 1,001 days from pregnancy to age two. Building on the Healthy Babies programme already established in 75 local authorities, this expansion will end the postcode lottery and ensure families across England can access enhanced support with infant feeding, parental mental health and forming strong attachments with their baby.

• Earlier support for children and young people: Rolling out Mental Health Support Teams to every school and college by 2029, reaching nearly 800,000 additional children and young people this year, alongside a £7 million investment in Early Support Hubs in 2026/27.

• Earlier and more timely identification and support in education: Transforming the SEND system so children and young people get the support they need, backing schools to embed inclusion, rolling out comprehensive training for all teachers, and investing £1.8 billion over three years in the new Experts at Hand offer, to bring speech and language therapists, occupational therapists, specialist teachers, educational psychologists and other professionals into mainstream schools, early years settings, and colleges, widening access to specialist support.

• Reducing waits and expanding access to support: With mental health spending forecast to reach a record £16.1 billion this year, the Government is expanding NHS Talking Therapies so 915,000 people can complete a course of treatment by March 2029, and rolling out 159 new mental health centres and mental health emergency departments in communities across the country, so people struggling with their mental health can access timely help and support before they reach a point of crisis. The Government will set out further action through its cross-government Mental Health Strategy later this year, bringing together immediate reforms and long-term action to improve mental health outcomes and ensure support is available earlier and more consistently across England.

Stakeholder responses can be viewed here: [https://tinyurl.com/5enb8dks]

Tags

More Like This

Funding boost for young people’s mental health services

Key target hit with 8,500 extra mental health workers in the NHS

Record numbers of children with mental health support in schools

Boost to mental health services from thousands of extra staff

£50 million boost for groundbreaking mental health research

Major expansion of community mental health support across England

Digital platform to tackle ADHD waiting list timebomb

More support for neurodivergent children in mainstream schools