Erica Witherington
Disability affairs reporter

Jasmine King, 23, has waited nearly five years for an NHS ADHD assessment and says the impact has been "unbearable".

"I don't want ADHD," she says. "I want help for whatever it is I'm struggling with."

She remembers sitting at the back of the exam hall at school with extra time and rest breaks, crying as other pupils completed their papers.

She believes people whose difficulties have the greatest effect on their daily lives should be assessed sooner.

"I am late everywhere and arrive at most places in tears from all the stress of trying to be on time," she says.

In one job, she says she was criticised for being "too slow" and not using initiative. Trying to keep up left her stressed and exhausted, she says.

"Everything in my life is on hold. I have no support, no medication and no full understanding of myself."

She can't afford a private assessment and says repeatedly contacting her local ADHD service has brought no answers.

"I don’t see the waiting ever ending," she says.

Image source, PA

Today's review forms part of the government's 10 Year Health Plan for England which was published last year under Keir Starmer's government. It's now a mantle that has been picked up by Andy Burnham's government.

The plan has three pillars: hospital to community, analogue to digital, sickness to prevention.

In August, the government announced a £343m expansion plan to open more than 150 NHS mental health centres in England - including centres for walk-in support and emergency departments - building on a previous initiative.

Health Secretary Yvette Cooper has welcomed the findings of Fonagy review and says they show "the importance of early intervention to address mental health and neurodevelopmental conditions".

The government will work on a new Mental Health Strategy that will regulate ADHD and autism diagnostic assessments and ensure they are "high quality", she says.

Dr Nick Broughton, who leads the national priority programme for mental health at NHS England, has called the review "a landmark moment" for our understanding of mental health needs across society, in particular among young people.

Broughton says the NHS is "ready to play its part" in giving young people the best chance of succeeding "in a complex and ever-evolving society".

He points to steps the health service has already taken to address challenges, such as ensuring six million pupils can access NHS mental health support in schools.

Broughton adds that NHS teams are also "making it easier for people to get support for ADHD and autism conditions before and after diagnosis".

Rozina Sini
BBC Your Voice

Heather Carpenter's son, now 17, is autistic. She recalls both of them feeling failed by services while they waited eight years for his formal diagnosis.

Carpenter recalls the suffering they both experienced until the diagnosis and the relief afterwards as "I realised he wasn't a bad kid and I wasn't a bad parent".

"Those years are still coming back to play in his declining mental health," she tells us. Carpenter highlights the risks of private diagnoses, but she understands why some parents might resort to that to jump the queue.

The answer, she adds, is a reform of NHS services to ensure proper assessments are done.

Image source, Heather Carpenter

The review shows successive governments have failed autistic people, the National Autistic Society says.

The charity’s Mel Merritt welcomes the government’s promise for action, noting that autistic people have a greater risk of poorer mental and physical health and it should be a priority to ensure they can “live a dignified life and be part of society”.

On autism diagnoses, Merritt says the report shows it has a “considerable positive impact” in most cases.

She points out that a reform can only happen with investment and building the NHS workforce capacity, which will take time.

“Any attempt to move to a needs-led system that abandons those who are currently waiting for an assessment will only increase harm,” Merritt adds.

Diagnoses of autism up in all age groups 6-24published at 10:35 BST

10:35 BST

The review shows that the rates of diagnosis of autism in England have risen significantly between 2000 and 2025 among all groups of young people.

Children aged six to 11 have risen the most sharply, with 4.6% of children diagnosed with the condition last year compared to 0.2% at the turn of the century.

Those between 12 and 17 are not far behind, rising from 0.1% recording a diagnosis in 2000 to 4.1% in 2025.

Diagnosis of young adults between 18 and 24 has risen less but still significantly, from almost zero to 2.5% over the 25-year period.

Radio 4's Today programme has been speaking to young people about their experience getting diagnosed with ADHD and autism.

Amy went to her doctor in 2017 for depression and anxiety. Then, with her GP, she started to pursue an ADHD diagnosis - which she got in 2023.

"A lot of specifically women are kind of under the radar and forgotten about," Amy says, suggesting it's because they don't "present in the normal way people assume... the naughty child at school".

She is hoping this review will lead to "support and guidance after the diagnosis" which she says is "the part that's forgotten".

Hassnat was diagnosed with ADHD at 14, but it wasn't until the age of 19 that he received a diagnosis of "Asperger's syndrome".

"Leading up to that stage it was horrible," he says. "Growing up, it was just demoralising living with it".

The diagnosis was "a relief", Hassnat says, but stresses that "receiving the diagnosis is one thing... having the right support is another".

ADHD diagnosis rates have risen in children and young peoplepublished at 10:14 BST

10:14 BST

The proportion of children and young people in England who have been diagnosed with ADHD has risen among all age groups of children and young people over the last 25 years, according to data published in the official review.

BBC Verify’s analysis of the figures shows these diagnosis rates have risen:

• From 0.5% to 2.7% in the 6-11 age range
• From 0.3% to 3.9% between 12-17
• From nearly zero to 3.1% between 18-24

Another point to note in the data is it shows the most significant rise in all three age groups since 2020, which you can see on the chart below.

Gabriela Pomeroy
Live reporter

Image source, Dr Salim Jakhra

I spoke to Dr Salim Jakhra, a consultant psychiatrist at Child and Adolescent Mental Health Services (CAMHS) in Brent in London - part of the Central & North West London NHS Trust.

He personally carries out the ADHD and autism assessments of young people.

"Demand has increased over the past 10 years - we are seeing a lot more referrals coming though for autism and ADHD - there is reduced stigma about neurodiversity."

"Over the past year we have been setting up a service called Shine – which stands for Specialist Hub for Integrated Neurodevelopmental Evaluation" to cope with the increased demand for assessments in the NHS.

He says this is to try to get the waiting lists down and to avoid postcode disparities in care.

He adds that the "assessment process is very thorough" and he doesn't think there is over-diagnosis.

"Neurodiversity assessments are complicated - we need to spend time with the patient and have a thorough developmental history from the parents and school to see if symptoms are pervasive. They take a quite a lot of time.”

Ryan and his wife knew there was something different with their son Atlas when he was around 12 to 18 months old and missing development milestones.

But it took three years to get an autism assessment. As time passed, his needs became increasingly clear. Now nearly seven, Atlas is non-verbal, still wears nappies and relies on others for all aspects of daily care.

Despite this, Ryan says there was no fast-track route for children with the most complex needs. "You basically go on the list and wait however long until you get to the top."

The wait left the family racing against time to secure support before Atlas started school. Ryan and his wife feared he would be placed in a mainstream school.

"We were terrified," Ryan says. "Anyone who has a child like Atlas will have the same panic that they'll start in a mainstream school where it's not safe."

The strain was immense. "It was like I had two jobs," Ryan adds. "I was going to work and then coming home and dealing with these things."

Atlas was eventually diagnosed only months before starting school.

Image source, Getty Images

Children are distressed and the Fonagy review "highlights an urgent truth", the children's commissioner for England says.

"We must confront the difficult questions about changes in childhood, and we must build a world in which they can thrive," Dame Rachel De Souza says.

She points to the story behind the data, which is "children whose lives are on hold for months and, in some cases, years waiting for support they urgently need".

De Souza, who contributed to the review, says its findings on under-diagnosis, mis-diagnosis and over-diagnosis fit with what she hears from children and professionals.

She goes on to repeat calls for an overhaul of mental health, community health, social care and education systems so that they can "put the needs of [a] child above an insistence on diagnosis".

BBC Breakfast has been speaking to comedian Paul Whitehouse and Dr Mine Conkbayir, who host the podcast I'm ADHD, No You're Not.

Conkbayir says that getting diagnosed with ADHD "makes a fundamentally huge difference", citing her own experience and describing her diagnosis as "really helpful".

"I now understand where I trip up, where I struggle and I can tell people in advance."

Some of these struggles include following multi-step instructions and losing the thread of what she's being told, she says.

Whitehouse notes that while he's seen "a split" in whether people find a diagnosis helpful, it has helped many people "understand their behaviours much better" and "not just think of themselves as lazy - this is what they're labelled".

Image source, BBC Breakfast

Professor Peter Fonagy, who chaired the review, has outlined three key findings in an interview with BBC Breakfast:

• A "very real substantial rise in mental ill-health", particularly among young people - it increased by 50% between 1993 and the present day
• An increase in the "co-occurrence of different diagnoses", meaning more people have common mental disorders (like anxiety and depression) as well as ADHD and autism
• An increase in the number of diagnoses of people with ADHD and autism, rather than a rise in how many people have either condition

Erica Witherington
Disability affairs reporter

Image source, Handout

At school, Erin says it might have looked from the outside as though she was thriving. She was ambitious, sociable and getting good grades.

Inside, though, she says she was struggling to stay afloat.

She developed anorexia, became a young carer while her mother received palliative care, and later had to deal with her death.

When overwhelmed, Erin says she sometimes went into shutdown and couldn't speak.

"I could know exactly what I wanted to say, but I physically couldn’t get the words out," she says.

Erin, now 21, was diagnosed as autistic at college. She says it finally helped her to understand what sort of support she needed, and to stop asking herself, "Why can't I just cope?"

But she believes getting support shouldn't have to wait for an autism diagnosis.

"Waiting several years isn't simply waiting for a piece of paper," she says.

"Those are years in which a young person is still developing their identity, and potentially struggling without understanding why."

Nick Triggle
Health correspondent

This review was ordered 10 months ago by Wes Streeting after the then-health secretary claimed in an interview that young people were over-diagnosed and "written off".

It is likely to feed into government policies on everything from NHS services and benefits to support for young people who are not in education, employment or training – all of which have been the focus of intense scrutiny and debate.

The review touches on how NHS services are organised – it is critical of long waiting lists for assessment – but also wider support provided by society in places such as schools and workplaces.

It will have implications for access to benefits and special education needs provision.

The government is not making any firm promises at the moment beyond saying they will be looking to reform the way systems work.

Image source, Getty Images

Reacting to the review, Mind’s chief executive Dr Sarah Hughes says today’s findings confirm what her team has seen across their services “for years”.

“Young people are crying out for help with their mental health because of genuine life challenges, and it’s time to listen,” she says.

Early intervention prevents needs from escalating, Hughes says, as the charity calls on the government to adopt a same-day open access model in the Mental Health Strategy for England.

While welcoming the government’s commitment to provide “earlier, more open access support”, Hughes says that long term “we need to ensure people can get the help they need on the day they reach out”.

Bridget Phillipson, the Labour Party's chair, is doing the government's media round this morning.

Appearing on BBC Breakfast, she's asked about the Fonagy review, and says "diagnosis should not be the only means by which we put in place support that children need".

Instead, she says, "we need to support families earlier... helping families and children where needs are starting to emerge including in areas like speech and languages support where we know we can do a lot sooner".

More generally, Phillipson says "better access to mental health services" is needed "in the community and also in schools" - adding that the government is working on this.

"We need to support young people's mental health early," report author Prof Peter Fonagy tells the Today programme, adding that this support should be available where they live.

He adds that diagnosis should not be "the only route" to accessing help, and that a lot of support has been "taken away" from young people and replaced with phones, social media and academic pressure.

"Rebuilding this support must be a priority," he says.

Fonagy wants to see "a reorganisation of the current system, which is incoherent".

He hopes the government will implement changes laid out in the report because it is "the only solution we think to a system that is currently not serving patients, not serving professionals and not serving society".

The author of today's report, Prof Peter Fonagy, has been speaking to Radio 4's Today programme.

He starts by saying that former Health Secretary Wes Streeting - who first commissioned the review - was "with respect, completely wrong" when he talked about an over-diagnosis of mental health disorders.

His findings show that "there has been a rise in distress and mental ill health amongst young people which is very, very real," he says, noting that one in five cases require treatment.

Fonagy says that mental health distress in 25-year-olds is up by 50% since 1993, particularly anxiety and depression.

He says that these "worsen the traits of ADHD and autism" so as awareness of these conditions has increased, "it's not surprising" that people are turning to diagnosis as an "explanation of what they feel".

"Properly done" diagnosis is "incredibly important and quite complicated", Fonagy says as he calls for "national standards in assessment".

While some independent providers "are excellent", Fonagy says the market is "quite easy to enter into" and is "unregulated".

Image source, PA Media

Health Secretary Yvette Cooper has welcomed the findings of the review, saying that they show "the importance of early intervention to address mental health and neurodevelopmental conditions".

Cooper says mental health services need to "change to focus more on the early support young people need to stay in education or work or keep their lives on track".

The government will be working on a new Mental Health Strategy, she adds, seeking to "make all diagnostic assessments for ADHD and autism CQC-regulated, so people can be confident that assessments are high quality and that the NHS is not being overcharged by independent or private providers".