Key facts
- A review of NHS England's mental health, ADHD, and autism services found that young people face unprecedented and growing levels of distress.
- The report states that about one in four 16- to 24-year-olds have a common mental disorder, up from one in six in 1993.
- Current trends suggest that 4 million children in serious distress could reach 4.5 million by 2030.
- The review warns that continuing with current service models is unsustainable due to long waiting lists and the inability to meet demand.
- While ADHD and autism diagnoses have risen significantly, the report notes that overdiagnosis is not yet widespread but is a growing risk.
- The review recommends a shift from a diagnostic labelling model to a flexible, needs-led system for mental health and neurodevelopmental support.
A comprehensive review of NHS England’s mental health, ADHD, and autism services, commissioned in 2025 by then-health secretary Wes Streeting, has concluded that young people face unprecedented and growing levels of distress. The 607-page report, led by Prof. Peter Fonagy, warns that current services are overwhelmed and unsustainable, recommending a radical overhaul.
The review found that mental distress has increased substantially across the population and is real, affecting everyday functioning. Approximately one in four 16- to 24-year-olds are now thought to have a common mental disorder, a significant rise from one in six in 1993. The report also noted increases in self-harm, eating disorders, OCD, PTSD, and drug dependence, with an estimated 4 million children currently in serious distress, a figure projected to reach 4.5 million by 2030.
Despite the rise in diagnoses, particularly for ADHD, the report suggests that overdiagnosis is not yet widespread but poses a growing risk. It highlights that the proportion of children aged six to 11 with an ADHD diagnosis has increased more than sixfold in five years. The review calls for a shift from a diagnostic labelling model to a flexible, needs-led system, where help is accessible without a formal diagnosis. The Department of Health and Social Care has committed to overhauling services to ensure earlier, needs-led support.
The report also recommends that private companies should be regulated more closely regarding advertising ADHD and autism assessments, with the Advertising Standards Authority asked to review current practices. The health secretary, Yvette Cooper, stated that all diagnostic assessments would be regulated by the Care Quality Commission to ensure quality and prevent overcharging by private providers.