A 607-page review of NHS England’s mental health, ADHD and autism services warns that rising demand and long waits could overwhelm services without major changes. Commissioned in 2025 by then-health secretary Wes Streeting, the review says mental distress has increased substantially and cannot be explained by greater awareness alone. About one in four people aged 16 to 24 are estimated to have a common mental disorder, compared with one in six in 1993.
ADHD diagnoses increased more than sixfold among children aged six to 11 and more than 15-fold among those aged 12 to 17 over five years. More than 560,000 people were waiting for an ADHD assessment and more than 254,000 for an autism assessment. The review says the changing balance between underdiagnosis, misdiagnosis and overdiagnosis may require greater caution, while noting that this does not establish overdiagnosis on a large scale.
Spending on independent-sector ADHD services rose 252% over three years, and private providers conducted more than a third of NHS-funded autism assessments in 2025-26. Health secretary Yvette Cooper said all ADHD and autism diagnostic assessments would be brought under Care Quality Commission regulation. She also said the Advertising Standards Authority would review public advertising for these assessments, without committing to a ban.
Review chair Prof Peter Fonagy called for support to be available through schools, GPs, community services, mental health services, social care, employers and family hubs, rather than making diagnosis the sole gateway to help. The review recommends prioritising people with the highest needs, including those experiencing self-harm, multiple difficulties or an imminent risk of exclusion from school or work. It says no one should be removed from a diagnostic pathway without appropriate assessment, communication and discussion.