The independent review into mental health conditions, ADHD and autism, published by the Department of Health and Social Care on 9 October 2026, concludes that diagnosis should no longer be the gateway to support.

The Secretary of State for Health and Social Care commissioned the review in December 2025 to understand why prevalence and demand are rising, and whether diagnosis and treatment improve outcomes. Professor Peter Fonagy chaired it, with Professor Sir Simon Wessely and Professor Gillian Baird as vice-chairs. Its interim report, published on 31 March 2026, set out the evidence so far, including its gaps and uncertainties.

The final report builds on that evidence and recommends a shift from a diagnosis-dependent system to a “needs-led plus diagnosis” model, in which support begins when need is recognised and diagnosis is used where it adds value.

The key points

Need and recognition are both rising, and a system built around diagnosis cannot keep pace. The review’s main findings:

Need is rising, especially among young people.

One in four 16–24-year-olds now has a recorded common mental health condition, up from one in six in 1993, although the same trend is not seen in severe mental illness. Social, cultural, environmental and system factors all contribute. Mental ill health costs around £300 billion a year.

Recognition has outpaced capacity.

By the end of 2025 there were 560,000 open ADHD referrals, 17 times the 2019 level, and 254,000 people had open autism referrals. Median waits reach over 1,000 days, close to three school years.

Needs are more complex.

More young people have multiple, interacting difficulties rather than a single condition.

Pressure brings new risks.

The review warns of a higher risk of both misdiagnosis and overdiagnosis, while noting the scale is hard to quantify. Either can delay the right support or lead to the wrong treatment.

The consequences are already visible.

Over the last decade, the share of 16–24-year-olds not in education, employment or training who report a work-limiting health condition rose from 26% to 44%. Mental health conditions and autism account for around 68% of these.

See our snapshot for a full breakdown (Click to enlarge).

What it means

If implemented, the review would shift the focus from clearing diagnostic waiting lists to meeting need earlier, across health, education and social care. Its 10 recommendations range from national prevention and integrated neighbourhood teams for people from birth to 25, to workforce, regulation, digital tools and data. A cross-government mental health strategy is due this year, with 12 to 24 months of actions and a 10-year reform plan.

For the NHS and its partners, the main implications are:

  • Support starts earlier and in more places. A “no wrong front door” approach brings schools, GPs, family hubs and employers closer to the point where support begins.
  • Diagnosis changes role. It remains available where it is needed, but is no longer the only route to help.
  • Commissioning and regulation change. The review proposes integrated, outcome-based commissioning, CQC regulation of ADHD and autism assessments, and a ban on public advertising of NHS-funded assessments.
  • Data becomes central. Regular national prevalence surveys and a minimum dataset for neurodevelopmental pathways would give a shared picture across health, education and social care.

The change will also need careful explanation. Families who have waited years for an assessment may see a needs-led model as diagnosis being rationed, so the promise of diagnosis “where needed” will matter as much as the new routes to support.

To read the DHSC’s full Independent Review, click here.

Sources: Department of Health and Social Care Independent review into mental health conditions, ADHD and autism: Final report

FAQ’S: Behind the report

It is an independent review commissioned by the Department of Health and Social Care in December 2025 and chaired by Professor Peter Fonagy. It looked at why prevalence and demand are rising and how support could better match need, and published its final report on 9 October 2026.

Support begins as soon as need is identified, through schools, GPs, family hubs, employers or self-referral, rather than after a diagnosis. Diagnosis remains available where it is needed, and support is reviewed and adapted over time.

The review makes 10 recommendations. They include a national prevention programme, a needs-led plus diagnosis system, integrated community support from birth to age 25, CQC regulation of ADHD and autism assessments, workforce investment, better digital tools and data, and a public information campaign.

The review calls for a cross-government mental health strategy to be published this year. It should set out 12 to 24 months of actions and a 10-year reform plan, with named lead departments and shared outcomes.

CF works with NHS commissioners, providers and their partners to understand need and demand, redesign services and pathways, and plan the workforce and investment to deliver them. CF recently built a dynamic model to support Surrey and Borders Partnership NHS Foundation Trust and Surrey Heartlands Integrated Care System with strategic planning for their adult mental health urgent and emergency care pathway. CF has also analysed the ADHD landscape in the UK and internationally, to understand the complexity of rising demand and what it means for how services are designed and how the private sector can support pathways.

To speak to one of our specialists about our mental health and ADHD services, contact us today.

Our insights

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ADHD Review: Interim findings lay bare the complexity of the ‘overdiagnosis’ debate