Independent Review Launched into Rising Demand for Mental Health, ADHD & Autism Services in England

• Whether over-diagnosis is occurring
• Where gaps in clinical and social support exist
• What changes are needed to ensure patients receive timely, accurate, and evidence-based care

Why the Review Is Being Conducted

Key Drivers Behind the Review

• Growing waiting lists: Some regions report waits of 12–24 months for therapy or ADHD assessment.
• Concerns around over-diagnosis: Ministers fear some individuals may be referred unnecessarily, resulting in delays for those with genuine clinical need.
• High welfare costs: Although officially separate, the review aligns with government concern over the rising number of individuals receiving health-related benefits.
• Public and clinical backlash: Recent proposed cuts to disability benefits were reversed after pressure from MPs and charities.

Wes Streeting’s Position

“We must look at this through a strictly clinical lens to get an evidence-based understanding… That’s the only way we can ensure everyone gets timely access to accurate diagnosis and effective support.”

Is Over-Diagnosis Really Happening?

Arguments Suggesting Over-Diagnosis Might Be Occurring

• Increased awareness leads to higher self-referrals, including cases driven by online self-diagnosis.
• Some ADHD and autism assessments rely heavily on subjective questionnaires.
• School pressures and pandemic after-effects may lead to behavioural issues being misinterpreted as neurodevelopmental disorders.
• Private assessments with very short waiting times raise concerns about inconsistent clinical standards.

Arguments Suggesting Under-Diagnosis Remains a Serious Problem

• Many adults—especially women and minorities—historically went undiagnosed.
• Demand increases may reflect greater recognition, not inflation of diagnoses.
• Long waiting lists indicate insufficient capacity, not unnecessary referrals.
• Advocacy groups warn that claims of over-diagnosis may undermine support for people with genuine needs.

Table: Factors Contributing to Rising ADHD, Autism & Mental Health Referrals

What the Review Will Examine

1. Clinical Accuracy

• Are assessments using evidence-based criteria?
• Are diagnostic thresholds consistent nationally?

2. Service Capacity

• Can the NHS meet demand with the current workforce and funding?
• Where are the longest waits occurring?

3. Referral Quality

• Are people being referred who do not require specialist intervention?
• How can early intervention or community support reduce unnecessary referrals?

4. Support Pathways

• Are diagnosed individuals receiving appropriate post-diagnostic support?
• Where do gaps exist in therapy, education services, or workplace adjustments?

5. Equality & Accessibility

• Are underserved groups—such as minorities, women, and adults—facing barriers to diagnosis?

Government Position: Expansion vs. Efficiency

• Long waits for Cognitive Behavioural Therapy (CBT)
• Shortages in ADHD psychiatry
• Limited availability of Post-Diagnostic Autism Pathway Support

Impact on Disability Benefits & Welfare Reform

Recent Context

• Earlier this year, the government dropped proposed cuts to disability benefits after intense backlash from Labour MPs and disability advocates.
• The Prime Minister has committed to welfare reform, arguing the system has “trapped people in poverty” and “written young people off as too ill to work.”

Important Clarification

What This Means for Patients and Families

Short-Term Effects

• No immediate changes to diagnosis or benefits.
• Potential delays in new referrals as clinicians await guidance.

Long-Term Potential Benefits

• Faster, more accurate diagnoses.
• Reduced waiting lists.
• More standardised assessments across England.
• Better post-diagnostic support and early intervention pathways.

Potential Concerns

• Patients may worry the review will restrict access to diagnoses or invalidate lived experiences.
• Advocacy groups fear over-diagnosis claims may create stigma.

Table: What Patients Should Do While the Review Is Ongoing

Expert Tips for Navigating Mental Health & Neurodiversity Support During System Changes

• Document symptoms and functional impacts clearly—this strengthens both clinical assessment and workplace support.
• Use reputable sources (NHS, NICE, professional bodies) to avoid misleading online self-diagnosis.
• Seek early support such as counselling, support groups, or school SEN teams rather than waiting for formal diagnosis.
• Discuss concerns with your GP, who can provide interim care or signpost to local services.
• For parents, maintain communication with schools to ensure reasonable adjustments are in place.

Conclusion