Rozina Sini
BBC Your Voice

Christine Adams from Tameside has shared her seven-year-old grandson's struggles with the BBC.

She says he's been waiting for an autism and ADHD assessment for more than four years. While he has an education, health and care plan (EHCP) in place at mainstream school, the school's special educational needs coordinator thinks they can no longer meet his needs.

"Everyday life can be very stressful and difficult, but without a diagnosis possible treatment and professional input cannot happen," Christine explains.

"The system is failing."

Image source, Christine Adams

Hazel Shearing
Education correspondent

Image source, Getty Images

The review shows the rise in mental health conditions is related to “greater educational pressures, social media, loneliness and insecure housing”, the general secretary of the National Education Union says.

Daniel Kebede says plans for Year 8 pupils in England to sit reading tests will “add to pressure at school”.

He says young people are “waiting too long” for mental health appointments and “missing vital education in the meantime”

“Teachers are not specialists and cannot carry on picking up the pieces," he says.

Nick Triggle
Health correspondent

When Wes Streeting claimed young people were being over-diagnosed with ill mental health, ADHD and autism, he caused controversy.

The review team is adamant the rise in mental distress is real – placing the blame at the economic uncertainty, impact of Covid and social media.

But the same is not true for ADHD and autism. It said the proportion of the people in the population with those neurodevelopmental conditions was broadly stable.

Instead the increase in diagnoses that had been seen was down to the fact many had remained undiagnosed. Greater awareness had seen more people come forward for help, but there was now a risk of over-diagnosis.

It said it could not say that was happening at scale currently, but the risk certainly going forward was real given the rates at which diagnoses were increasing.

This is particularly in younger age groups where they already appeared to be outstripping the expected number of cases in the population – although they said they could not be absolutely certain because of weakness in the data.

Joe McFadden
Health reporter

I’ve been speaking to Natasha, a 32-year-old airline worker who has been on an ADHD waiting list for over two years - which has left her in a state of limbo and adding to the stresses of everyday life.

Natasha suspects she has autism as well as ADHD but wants to get diagnosed through the NHS. This, alongside the already long wait for an ADHD diagnosis, has discouraged her from seeking further help.

“I don't want to tell people, 'oh, I have ADHD' if I don't know for sure that I actually do have ADHD.”

“It's really expensive to get a piece of paper that you don't trust," she says. “And because I also think I have autism, that's two diagnoses."

“If it's not thorough, it's just money down the drain,” she adds.

Compared to others, Natasha has lower support needs but says there are things that could be done to make it easier for her - and, as the report highlights, currently the main way to get help is through a diagnosis.

“I'm exhausted a lot of the time,” she says. “I mostly get stuff done but it just feels like I'm living my life on hard mode.”

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".

• For context: Broadly, it is now agreed that what was once referred to as Asperger syndrome is part of the autism spectrum. Some people who received a diagnosis of Asperger syndrome continue to use this terminology to refer to themselves.

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”.