A government review warns of possible over-diagnosis of ADHD and autism in England, urging tighter assessment rules while calling for faster, needs-based support…reports Asian Lite News Desk
A government review has warned that rising diagnoses of ADHD and autism in England risk outstripping expected prevalence among some younger age groups, calling for tighter regulation of private assessment providers and better support for people waiting for help.
The review found that recorded diagnoses of attention deficit hyperactivity disorder (ADHD) and autism have risen sharply over the past 25 years, raising concerns about whether some people are being over-diagnosed or misdiagnosed.
However, the experts stressed that the evidence does not establish that over-diagnosis is occurring on a widespread scale. Improved recognition of previously overlooked conditions, changing help-seeking behaviour and growing pressure on health services may also explain the increase.
The findings are expected to influence government policy on NHS services, education, benefits and employment support for young people who are not in education, employment or training.
The review, led by Professor Peter Fonagy, was commissioned in December 2025 following concerns raised by then Health Secretary Wes Streeting about the growing number of young people receiving diagnoses and the risk of them being written off.
It examined mental health conditions alongside ADHD and autism, with particular attention to children and young people, who have the highest rates of diagnosis.
The experts warned that diagnoses could become labels that define people by their “difficulties rather than their strengths and potential”, affecting their prospects at school, in employment and in relationships.
They called for stronger oversight of private companies carrying out assessments for the NHS, citing concerns about the quality and consistency of assessments. The review also recommended a ban on advertising by providers.
Waiting lists leave families struggling
The concerns about possible over-diagnosis come alongside evidence that many people with genuine needs face lengthy waits for assessment and support.
According to NHS England data cited in the government’s interim review, the number of children and young people waiting for an ADHD assessment rose from about 21,000 in April 2019 to around 270,000 by December 2025. The review also found that recorded diagnoses accelerated sharply after 2020, particularly among adolescent girls and young women.
Yet population surveys suggest the underlying prevalence of ADHD symptoms has remained comparatively stable. The review said this contrast points to a complicated picture in which improved recognition, changing public awareness and pressure on services may all play a part.
The report also highlighted the experience of families waiting for autism assessments.
Ryan Watson and his wife became concerned about their son Atlas when he was between 12 and 18 months old and missing developmental milestones. They waited three years for an assessment, during which his support needs became increasingly apparent.
Now nearly seven, Atlas is non-verbal, still wears nappies and depends on others for all aspects of daily care. His father said the family had been left anxious about whether he would receive appropriate support when starting school.
The review called for people on waiting lists to be reassessed so that those with the most complex needs could be prioritised. Others could be offered alternative forms of help while waiting, including adjustments at school or work and support for difficulties such as anxiety and sleep problems.
Professor Fonagy said diagnosis remained essential but should no longer be the only route to assistance.
“Diagnosis remains essential and must be protected,” he said. “What has to change is that it is no longer the only door through which help can be reached.”
Social media and economic pressures
The review also examined the wider forces contributing to rising demand for mental health support, including economic insecurity, educational pressures, social media and changing public awareness of neurodevelopmental conditions.
Online information and communities can help people recognise difficulties that might previously have gone unnoticed. But the review warned that social media can also spread misleading information and influence how people interpret their experiences.
The experts said more work was needed to understand how these factors affect referrals, self-identification and the threshold for diagnosis.
They also cautioned against assuming that rising diagnoses necessarily mean that more people have developed the underlying conditions. At the same time, the evidence suggests some people, including adults and groups historically under-recognised, may still be missing out on diagnosis and support.
Children diagnosed with ADHD or autism before the age of 17 are around four times more likely to be not in education, employment or training between the ages of 16 and 24, according to figures cited in the review. The experts said better support after diagnosis could help improve their prospects and quality of life.
Govt faces pressure to reform support
The government has said the findings will inform its plans for mental health and neurodevelopmental services, with a focus on earlier intervention and more appropriate support.
The review argued that help should be based more closely on a person’s needs, the effect of their difficulties on daily life and the level of support required, rather than depending entirely on securing a formal diagnosis.
Charities representing autistic people and young people with mental health difficulties have also stressed that rising demand reflects serious gaps in existing services.
The National Autistic Society said the findings highlighted longstanding failures to provide autistic people with the support they need. YoungMinds said young people should not be blamed or accused of exaggerating their distress when the systems around them are failing.
