A recent government-commissioned review has highlighted concerns about potential overdiagnosis and misdiagnosis of attention deficit hyperactivity disorder (ADHD) and autism in England, while also underscoring the urgent need for systemic reform amid growing demand and extended waiting times for assessments.
The review, initiated by former health secretary Wes Streeting and published in October 2026, found that the existing diagnostic system struggles to meet demand, with waiting lists reaching unprecedented levels. In December 2025, approximately 560,000 people were awaiting ADHD assessments—more than 17 times the number recorded in 2019—and more than 254,000 individuals had open referrals for autism evaluations. The authors noted that this dependence on diagnosis for accessing support often leads to prolonged delays, sometimes measured in years.
While the review did not conclusively determine that overdiagnosis is widespread, it identified an increased risk of both misdiagnosis and overdiagnosis. The report stressed that possessing ADHD or autism-related traits does not necessarily equate to having a diagnosable condition, warning that inaccurate diagnoses can lead to inappropriate treatment, including the over-medicalisation of individuals whose needs might be better addressed through alternative forms of support. For example, a student experiencing significant loneliness but not major depression might be prescribed antidepressants when social support interventions could be more effective.
Experts involved in the review called for a move away from a diagnosis-dependent system for accessing education, welfare, and clinical services, advocating instead for a model that prioritizes individuals’ needs regardless of formal diagnosis. They recommended clinical reassessment of those on waiting lists to identify those with the most urgent requirements.
The report also raised issues regarding private providers, which conduct a substantial portion of NHS-funded ADHD and autism assessments. Concerns include the soaring cost of private ADHD diagnoses—up 252 percent over three years—and a lack of consistent oversight, transparency, and quality assurance in this sector.
In a broader context, the review noted a considerable rise in common mental health disorders among working-age adults over the past three decades. The proportion of adults aged 16 to 64 diagnosed with conditions such as anxiety and depression increased from 15.5 percent in 1993 to 22.6 percent in 2024. The authors attributed this increase to real societal pressures affecting daily functioning, including financial uncertainty and housing challenges, particularly among young people.
Reactions from mental health and neurodiversity experts have generally welcomed the report's recommendations but emphasized the complexity of implementation. Thea Stein, chief executive of The Nuffield Trust, supported the shift toward needs-based support but cautioned that such a system requires adequate resourcing to identify and assist those who genuinely need clinical care. She highlighted the risk that the report's extensive recommendations might not be acted upon without government commitment to funding new service models.
Conversely, Dr. Rachel Moseley, a principal academic in psychology, warned against prioritizing only those with the most severe needs for diagnosis and support. She highlighted concerns about individuals with less obvious but still significant difficulties—such as neurodivergent people who manage mainstream education or sustained employment yet face high risks of morbidity and mortality, including suicide. Dr. Moseley stressed that diagnosis can be "lifesaving" for many in providing critical explanations and pathways to support.
The review underscores growing challenges in balancing accurate diagnosis, timely access to care, and the need for a more flexible support system amid increasing demand for mental health and neurodevelopmental services.