Understand
Major review on autism, ADHD and mental health highlights over-diagnosis risks and NHS failings
Overview
A comprehensive 600-page review commissioned by the health secretary examines support for mental health conditions, ADHD, and autism in the UK. The report warns of increasing risks of over-diagnosis for ADHD and autism among younger age groups, while firmly rejecting the idea of over-diagnosis for mental health conditions. It also highlights severe system failures, lengthy NHS waiting times, and fragmented support across education, employment, and care, calling for urgent reforms over the next 12 to 24 months.
Key points
- The review warns of an increasing risk of ADHD and autism over-diagnosis, with over 4% of children aged six to 17 diagnosed with autism, well above the estimated true level of 1-2%.
- Experts reject the idea of mental health over-diagnosis, noting that real mental distress has risen significantly—affecting one in four 16 to 24-year-olds—driven by anxiety, depression, self-harm, and eating disorders.
- Data weaknesses and a lack of recent population surveys mean experts could not conclude that autism over-diagnosis is happening at scale, though society is shifting from under-diagnosis to over-diagnosis.
- The review highlights that diagnoses can act as limiting labels that hinder young people in education, work, and relationships, with diagnosed individuals facing higher risks of being NEET.
- NHS waiting times are described as excessively long, with a third of young people waiting over a year for mental health services and 90% of the 900,000 waiting for ADHD or autism checks waiting over three months.
- Support across care, education, employment, and welfare is described as fragmented, forcing individuals to jump through hoops to access help.
- The report recommends reassessing everyone currently on waiting lists to prioritise those most in need rather than using a first-come, first-served approach.
- Calls are made to improve the quality and consistency of private-sector ADHD and autism assessments conducted on behalf of the NHS and to ban direct-to-public advertising of assessments.