A new official review in England has identified a significant risk that people are being over-diagnosed with ADHD and autism. Experts involved in the study observed that a sharp rise in diagnoses over the past 25 years has resulted in case numbers that now appear to be outstripping the expected prevalence within the population for certain younger age groups. The review, which was commissioned 10 months ago by Wes Streeting following his public comments that young people were being over-diagnosed and "written off," examined individuals of all ages while focusing heavily on children and young people, who currently experience the highest rates of diagnosis.
The findings indicate that a combination of economic uncertainty and the influence of social media is driving an increase in mental health problems among young people. The review, led by prominent doctors in the field, argued that diagnoses for ADHD, autism, and other mental health conditions are too frequently becoming labels that define individuals by their "difficulties rather than their strengths and potential." This labeling process can have detrimental effects on a person's prospects in education, employment, and personal relationships. According to the report, children diagnosed with autism or ADHD before the age of 17 are approximately four times more likely to end up not in education, employment, or training between the ages of 16 and 24.
While the report highlights the dangers of over-diagnosis, it also emphasizes the harm caused by long waiting times for assessments. The Watsons, a family who shared their experience, noted that they knew their son Atlas had different needs when he was between 12 and 18 months old. Despite this, it took three years to secure an autism assessment. Now nearly seven, Atlas is non-verbal, still wears nappies, and requires full-time care. Ryan, his father, described the lack of a fast-track route for children with complex needs as a source of immense strain, noting that the family lived in constant fear that Atlas would be placed in an unsafe mainstream school environment. The review calls for a reassessment of current waiting lists to prioritize those with the highest needs and suggests that some individuals could be better supported through non-medical interventions, such as school or workplace adjustments and lifestyle support for sleep and anxiety.
Professor Peter Fonagy, the chair of the review, stated that the system is "under immense strain" and argued that it is time to move away from the current model where a diagnosis acts as a "very narrow pathway" to support. He emphasized that while diagnosis remains essential, it should no longer be the only door through which help can be accessed. The report warned that society might be shifting from an era of under-diagnosis to one of over-diagnosis or mis-diagnosis, pointing to data showing that more than 4% of children aged six to 17 are now diagnosed with autism, which is well above the 1-2% level suggested by research. However, the report acknowledged that because some of these figures are nearly a decade old, it is not possible to conclude with absolute certainty that over-diagnosis is occurring at scale today.
The review also called for tougher regulation of private firms offering assessments for the NHS, citing concerns about quality and consistency, and recommended a ban on advertising. In response, the government welcomed the report and promised to introduce stricter regulations for ADHD and autism assessments. Health Secretary Yvette Cooper stated that the review highlights the importance of early intervention for mental health and neurodevelopmental conditions. The government intends to set out a new model for providing support in its forthcoming mental health strategy, which is expected before the end of the year. Advocacy groups also weighed in, with Mel Merritt of the National Autistic Society stating that the report shows successive governments have "failed autistic people," while Abigail Ampofo of the charity YoungMinds expressed hope that the review would show young people their distress is not their fault, though she emphasized that major systemic reform is required.
