Streeting orders review into mental health and ADHD diagnosis

Health Secretary Wes Streeting is launching an independent review into rising demand for mental health, ADHD and autism services in England.

It will look at both whether there is evidence of over-diagnosis and what gaps in support exist.

The government said it was already investing in expanding services, but there are long waits for therapy in many areas.

NHS figures show rates of mental health problems and ADHD have increased significantly over the past two decades and the government believes there are people being referred on to waiting lists who do not need treatment.

Previously, Streeting warned mental health conditions were being over-diagnosed and too many people "written off".

Announcing the new review, he said: "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."

It comes as ministers are seeking to tackle a growing welfare bill although the Department of Health and Social Care (DHSC) has stressed this review is running separately.

While some benefits require people to demonstrate how a health condition is affecting their ability to work, a formal diagnosis is not strictly necessary for many.

Earlier this year, the government was forced to climb down on planned cuts to disability benefits, including for those with mental health conditions, after facing a major backlash from more than 100 of Labour's own backbenchers.

But on Monday, the prime minister promised a renewed push on reforming the welfare system, which he said had "trapped people in poverty" and written "young people off as too ill to work".

Led by clinical psychologist Prof Peter Fonagy, the new review's findings will be published in the summer.

Prof Fonagy said the aim was to "test assumptions rigorously and listen closely to those most affected, so that our recommendations are both honest and genuinely useful".

NHS figures show that the number of adults aged 16 to 64 reporting mental health problems reached 22.6% in 2023-24, up from 17.6% in 2007.

Rates are higher among the young and the unemployed.

Meanwhile, 14% of adults are reporting ADHD symptoms, up from 8% in 2007, although experts believe only around 5% or just under have clinically-diagnosable levels of ADHD.

As of March, around four million working-age adults in England and Wales claimed either disability or incapacity benefit - up from almost three million in 2019, according to research from the Institute for Fiscal Studies.

The DHSC said the increased pressure on the NHS meant that "for too long, people with acute needs have faced long waits, had to navigate overstretched services, experienced inequalities in care and felt abandoned when support was needed most".

The review will look at how NHS services are working and what support people could be given earlier.

Government sources said they wanted to establish a baseline for diagnosis and what good quality care looked like.

It is thought one of the factors in long waits was that people who did not necessarily need treatment were ending up being referred on to waiting lists when practical support, such as help with social or financial issues or a short burst of talking therapy, could provide the solution.

Investment is already being made in increasing support in schools and expanding talking therapy services.

London GP Prof Sir Sam Everington, who is president of the Royal College of GPs, said his workload with mental health patients has "sharply increased" in the last few years

"There's a lot of pressure from social media for people to have a diagnosis.

"So you give everyone a medical badge of anxiety or depression or medical diagnosis, when a lot of this is just the ups and downs of everyday life.

"I think the message we give all the time is, actually, we've got the answer to somebody's problem and there's a pill, there's a silver bullet that actually is going to resolve all this. Well, it's not".

Mental health charity Mind welcomed the government's announcement and signalled their willingness to contribute to the review.

"This is a huge opportunity to really understand what is driving increasing levels of mental illness, especially among our young people," chief executive Dr Sarah Hughes said.

The National Autistic Society said: "We need urgent action because, while we are currently seeing the number of people seeking an assessment levelling out, the average waiting time is rocketing."