{"id":26748,"date":"2026-10-10T22:23:14","date_gmt":"2026-10-10T21:23:14","guid":{"rendered":"https:\/\/visegradpost.com\/?p=26748"},"modified":"2026-10-10T22:23:14","modified_gmt":"2026-10-10T21:23:14","slug":"fonagy-review-adhd-and-autism-help-should-not-wait-for-a-diagnosis","status":"publish","type":"post","link":"https:\/\/visegradpost.com\/en\/2026\/10\/10\/fonagy-review-adhd-and-autism-help-should-not-wait-for-a-diagnosis\/","title":{"rendered":"Fonagy review: ADHD and autism help should not wait for a diagnosis"},"content":{"rendered":"<p>England\u2019s independent review of mental health, ADHD and autism concludes that the two neurodevelopmental conditions face a rising risk of overdiagnosis, yet it stops short of saying overdiagnosis is already widespread. Its answer is structural rather than clinical: help should follow a person\u2019s needs, with a diagnosis remaining available but no longer acting as the only key to support in health care, schools, welfare and work.<\/p>\n<section aria-labelledby=\"hpd-nfnmyipv-inrtzyj-hlesdml-zofjqh\" class=\"auk-zvimcvi-inrtzyj\" lang=\"en\">\n<h2 id=\"hpd-nfnmyipv-inrtzyj-hlesdml-zofjqh\">In brief<\/h2>\n<ul>\n<li>Its answer is structural rather than clinical: help should follow a person\u2019s needs, with a diagnosis remaining available but no longer acting as the only key to support in health care, schools, welfare and work.<\/li>\n<li>Here it rejects any notion of overdiagnosis: genuine illness has grown, driven by anxiety, depression, self-harm and eating disorders, while severe conditions such as schizophrenia and bipolar disorder have not increased.<\/li>\n<li>NHS England\u2019s director for mental health, Dr Nick Broughton, said: \u201cThe NHS is ready to play its part.\u201d<\/li>\n<\/ul>\n<\/section>\n<p>The review was chaired by Professor Peter Fonagy, with Sir Simon Wessely and Gillian Baird as vice-chairs. It was appointed in December 2025 and published on 9 October, and its conclusions bear on decisions well beyond the clinic.<\/p>\n<h2>Two kinds of prevalence, and a gap between them<\/h2>\n<p>The central distinction in the report is between population prevalence, meaning how many people actually have a condition, and administrative prevalence, meaning how many come forward to services. According to the <a href=\"https:\/\/www.manchestereveningnews.co.uk\/news\/health\/people-misdiagnosed-adhd-autism-review-34739063\" rel=\"nofollow noopener noreferrer\" target=\"_blank\">Manchester Evening News<\/a>, the review found the first has stayed broadly stable while the second has risen steeply. Its best estimates put ADHD at 3.8% of children aged 5 to 15 and autism at 1.2% of those aged 5 to 19.<\/p>\n<p>Recorded diagnoses tell a different story. Research behind the review puts diagnosed autism among boys aged six to 11 at 0.4% in 2000 and 6.3% in 2025. That is the kind of divergence that led the authors to speak of an increasing risk. Wessely framed the moment this way: \u201cWe are moving away from a period of underdiagnosis into a kind of tipping point in which other things might be happening as well.\u201d<\/p>\n<p>The evidence has limits the review itself acknowledges. Surveys measuring the true level of autism have not been carried out for nine years, so the team could not conclude that overdiagnosis is occurring \u201cat scale\u201d.<\/p>\n<h2>Demand, waits and a real rise in distress<\/h2>\n<p>Whatever the debate over neurodevelopmental labels, pressure on services is not in dispute.<\/p>\n<div class=\"auk-kmrcibp\">\n<div class=\"auk-fsnsbv\"><strong class=\"auk-fsnsbv__fvtkh\">560,000+<\/strong><span class=\"auk-fsnsbv__ppkniutc\">Open ADHD referrals in England at the end of 2025, over 17 times the 2019 level<\/span><\/div>\n<div class=\"auk-fsnsbv\"><strong class=\"auk-fsnsbv__fvtkh\">254,000+<\/strong><span class=\"auk-fsnsbv__ppkniutc\">Open autism referrals in December 2025<\/span><\/div>\n<\/div>\n<p>The review draws a sharp line between ADHD and autism on one side and mental illness on the other. Here it rejects any notion of overdiagnosis: genuine illness has grown, driven by anxiety, depression, self-harm and eating disorders, while severe conditions such as schizophrenia and bipolar disorder have not increased.<\/p>\n<figure class=\"hpd-nfnmyipv-imzntj-gogcn\"><img decoding=\"async\" alt=\"Un gar\u00e7on \u00e0 lunettes et n\u0153ud papillon \u00e9crit dans un cahier \u00e0 son pupitre, dans une salle de classe, avec un livre jaune et une \u00e9querre verte pos\u00e9s devant lui.\" loading=\"lazy\" src=\"https:\/\/visegradpost.com\/wp-content\/uploads\/2026\/10\/un-garcon-lunettes-et-noeud-papillon-ecrit-dans-un-cahier.jpg\" \/><figcaption>Un \u00e9l\u00e8ve \u00e0 lunettes \u00e9crit dans un cahier \u00e0 son pupitre, dans une salle de classe, avec un livre jaune, une \u00e9querre et des crayons pos\u00e9s devant lui. <span class=\"auk-gogcn-ertkm\" data-provider=\"pexels\">Source: <a href=\"https:\/\/www.pexels.com\/photo\/a-boy-wearing-eyeglasses-sitting-at-a-desk-writing-8618022\/\" rel=\"nofollow noopener noreferrer\" target=\"_blank\">Pexels<\/a>. Credit: <a href=\"https:\/\/www.pexels.com\/@yankrukov\" rel=\"nofollow noopener noreferrer\" target=\"_blank\">Yan Krukau<\/a>. License: <a href=\"https:\/\/www.pexels.com\/license\/\" rel=\"nofollow noopener noreferrer\" target=\"_blank\">Pexels License<\/a>.<\/span><\/figcaption><\/figure>\n<table>\n<thead>\n<tr>\n<th>Indicator<\/th>\n<th>Finding<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>People waiting for ADHD or autism checks<\/td>\n<td>900,000, of whom 90% have waited more than three months<\/td>\n<\/tr>\n<tr>\n<td>Young people referred to mental health services<\/td>\n<td>A third wait more than a year<\/td>\n<\/tr>\n<tr>\n<td>Mental illness among 16 to 24-year-olds<\/td>\n<td>Up from about one in six to one in four<\/td>\n<\/tr>\n<tr>\n<td>Yearly price tag of mental ill health in England<\/td>\n<td>About \u00a3300bn, of which \u00a3110bn is borne by the economy and \u00a360bn by the NHS<\/td>\n<\/tr>\n<tr>\n<td>Local example, West Yorkshire: routine assessments by independent NHS providers<\/td>\n<td>Minimum two-year wait, urgent cases possibly sooner<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>Support that no longer waits for a label<\/h2>\n<p>The core recommendation, as reported by the <a href=\"https:\/\/www.mirror.co.uk\/news\/health\/adhd-autism-fonagy-mental-health-37750704\" rel=\"nofollow noopener noreferrer\" target=\"_blank\">Mirror<\/a>, is a move from a diagnosis-dependent system to a needs-led one. People on waiting lists would be actively reviewed so that those with higher needs are assessed sooner, while those with moderate needs receive help in the meantime. Fonagy put the principle plainly: \u201cDiagnosis remains essential and must be protected, what has to change is that it is no longer the only door through which help can be reached.\u201d<\/p>\n<p>A diagnosis does not currently guarantee much afterwards. Among clinicians surveyed for evidence the review considered, 40% said no ongoing autism support followed diagnosis, and only 12.6% described anything beyond a single session, figures reported by <a href=\"https:\/\/www.loveballymena.online\/post\/adhd-autism-four-year-waits-in-northern-trust-as-landmark-review-calls-for-earlier-help\" rel=\"nofollow noopener noreferrer\" target=\"_blank\">loveballymena.online<\/a>. Baird argued that \u201cdiagnosis doesn\u2019t tell you very much about a person\u2019s needs and what level of support they require. You need more than a diagnosis.\u201d<\/p>\n<p>Private and other non-NHS providers now perform roughly half of NHS-funded ADHD assessments and a third of autism ones. The review questioned their quality and consistency and noted that the cost of private ADHD provision rose by about 252% in three years. The Government has said it will bring these providers under Care Quality Commission regulation and is looking again at how they advertise; the authors would go further and stop assessments being marketed straight to the public.<\/p>\n<h2>Welfare, schools, work and a political dispute<\/h2>\n<p>The stakes extend into the labour market. About a third of young people aged 16 to 24 who are outside education, work and training say their mental health or autism plays a part, and young people diagnosed with ADHD before turning 17 are four times as likely as peers without the diagnosis to be in that group. Health Secretary Yvette Cooper responded that \u201cmental 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.\u201d<\/p>\n<p>The commissioning itself was contested. Wes Streeting, health secretary at the time, commissioned the review having voiced concern about over-diagnosis among the young; Fonagy has since called that view \u201ccompletely wrong\u201d where mental health is concerned. The BBC notes the findings could reshape NHS services, benefits, schools and employment support.<\/p>\n<ol class=\"auk-ofbnbzso\">\n<li><time>December 2025<\/time> Fonagy appointed to lead the review.<\/li>\n<li><time>9 October<\/time> Report published.<\/li>\n<li><time>End of the year<\/time> Government response expected in a new Mental Health Strategy.<\/li>\n<li><time>Next 12 to 24 months<\/time> Period over which the review wants action.<\/li>\n<\/ol>\n<p>NHS England\u2019s director for mental health, Dr Nick Broughton, said: \u201cThe NHS is ready to play its part.\u201d<\/p>\n<p class=\"media-credit auk-gogcn-ertkm\" data-provider=\"pexels\"><small>Featured image. Source: <a href=\"https:\/\/www.pexels.com\/photo\/a-doctor-talking-to-a-patient-while-holding-a-tablet-4266935\/\" rel=\"nofollow noopener noreferrer\" target=\"_blank\">Pexels<\/a>. Credit: <a href=\"https:\/\/www.pexels.com\/@cedric-fauntleroy\" rel=\"nofollow noopener noreferrer\" target=\"_blank\">Cedric Fauntleroy<\/a>. License: <a href=\"https:\/\/www.pexels.com\/license\/\" rel=\"nofollow noopener noreferrer\" target=\"_blank\">Pexels License<\/a>.<\/small><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Fonagy review finds demand for assessment soaring while true prevalence holds steady, and asks the NHS to stop making a diagnosis the price of support.<\/p>","protected":false},"author":11,"featured_media":26750,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30],"tags":[1159,1160,1162,1163,424,1161,1164],"class_list":["post-26748","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-adhd","tag-autism","tag-england","tag-fonagy-review","tag-mental-health","tag-nhs","tag-public-policy"],"_links":{"self":[{"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/posts\/26748","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/comments?post=26748"}],"version-history":[{"count":2,"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/posts\/26748\/revisions"}],"predecessor-version":[{"id":26756,"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/posts\/26748\/revisions\/26756"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/media\/26750"}],"wp:attachment":[{"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/media?parent=26748"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/categories?post=26748"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/visegradpost.com\/en\/wp-json\/wp\/v2\/tags?post=26748"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}