An independent review of mental health, attention deficit hyperactivity disorder (ADHD), and autism in England has highlighted significant rises in distress among young people, alongside concerns about the current approaches to diagnosis and treatment. Chaired by Professor Peter Fonagy, a clinical psychologist and psychoanalyst, the review was commissioned in December 2025 by then-Health Secretary Wes Streeting in response to growing demand for related services.

The 607-page report, which included input from vice-chairs Professor Sir Simon Wessely and Professor Gillian Baird as well as a broader advisory group, emphasizes that the increase in mental health difficulties among youth is a genuine phenomenon rather than a product of cultural stereotypes such as “snowflake” accusations. Contributing factors include the lasting impacts of Covid-19 lockdowns, which intensified loneliness, and the pervasive use of smartphones and social media, which have been linked to reduced real-world interaction, diminished sleep quality, and lower physical activity. Additionally, economic insecurity around employment and housing has compounded feelings of despair. Professor Fonagy noted that for the first time since the Second World War, young people in England feel less optimistic about their futures compared to previous generations.

While the report acknowledges that ADHD and autism diagnoses were historically underreported, it warns that England is now at risk of misdiagnosis and overdiagnosis. It cites data indicating that autism diagnoses in boys aged 6 to 11 have risen sharply—from 0.4% in 2000 to over 6% in 2025—far exceeding medical estimates that place autism prevalence at around 1.2% of children. The review also points to an increase in self-identification of these conditions, with polling showing that approximately 18% of 16 to 29-year-olds consider themselves autistic, compared with just 1% of people aged 55 to 99. Private ADHD clinics received particular scrutiny for their role in potentially contributing to overdiagnosis, with the report recommending restrictions on their ability to advertise directly to the public.

The report stresses that while accurate diagnoses can be clinically important and personally beneficial, misdiagnosis can cause harm by limiting individuals’ identities to their difficulties rather than their strengths. It draws attention to research indicating that children diagnosed with ADHD are four times more likely to become NEETs (not in education, employment, or training), underscoring the broader economic and social consequences. The review suggests this pattern has implications for the UK’s productivity and welfare systems, areas slated for further examination in an upcoming review led by Alan Milburn.

Significantly, the report advocates for a shift away from a “diagnosis-dependent” model toward more timely psychological interventions based on observed need, such as self-harm or severe anxiety, rather than immediate diagnostic categorization. This approach prioritizes delivering help to those experiencing clear distress, with the aim of supporting recovery and resilience. The report underscores that young people should receive prompt treatment rather than being labeled in a way that could impact their long-term prospects.