A review of mental health conditions, autism and ADHD in England has rejected the idea that young people’s difficulties are mainly the result of ordinary stress being medicalised. Professor Peter Fonagy says the sharp increase in problems such as anxiety and depression is real, as are the distress and disruption they can cause.
The review links the rise to Covid disruption, financial and housing insecurity, competitive pressures at school and in social life, and the added strain of social media. It also points to the loss of support services such as Sure Start and youth clubs, alongside reduced belonging and greater loneliness.
Fonagy says the growing prevalence of mental illness, ADHD and autism is overwhelming public services, leaving people without care or support and creating costs the taxpayer cannot sustain. He acknowledges a risk of overdiagnosis but says there is no evidence that it is occurring at scale; he also criticises the growth and reliability of unregulated private diagnostic providers.
The review argues that diagnosis has too much influence over access to clinical care, special educational needs support and disability benefits. Because private assessments can be expensive, people who can afford them may have a better chance of securing support.
Fonagy proposes identifying and triaging people’s needs earlier, with support provided without relying so heavily on formal diagnosis. NHS diagnosis waiting times are 64 weeks.