Government pledges earlier support to tackle mental health crises
Independent review into prevalence and support for mental health conditions, ADHD and autism published
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Government sets out move towards earlier, needs-led support for children, young people and adults, without long waits for clinical diagnosis
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Early support will keep young people in school, enable them to join the workforce, and continue playing a full part in their local communities
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Response to Fonagy Review will also see strengthening of regulation around ADHD and autism assessments, and review of advertising practices
Children, young people and adults experiencing mental distress will receive broader support and advice at the earliest opportunity, without having to wait for a clinical diagnosis, government has pledged today.
Responding to the findings of the Independent Review into prevalence and support for mental health conditions, ADHD and autism, the Government has committed to a major overhaul of mental health support in the forthcoming Mental Health Strategy. This will set out a renewed focus on prevention and early intervention, to make sure that people receive the right help, at the right time, in the right place, based on their needs.
The review published today (9 October), chaired by leading clinical psychologist Professor Peter Fonagy with the support of vice chairs Professor Sir Simon Wessely and Professor Gillian Baird, found that mental distress has increased substantially among children and young people. The findings show this has been driven by several factors, including social media, financial insecurity, increased uncertainty about the future, poorer sleep, and reduced feelings of connection and belonging. While referrals and diagnoses for ADHD and autism have risen significantly, the review found that population-level prevalence of these conditions appears broadly stable.
The interim report of Alan Milburn’s review of ‘Young People and Work’ also found that - among the 16 to 25-year-old age group not currently in education, employment or training - 24 per cent cited depression or anxiety as their main limiting condition, 22 per cent autism, and 18 per cent another mental illness.
The Government has responded by seeking to improve support at every stage of life. For children, young people and adults experiencing mental distress, greater support will be available in schools, colleges and communities with a focus on earlier intervention, reducing long waits and ensuring support is available before and without a diagnosis.
Where clinically appropriate, the system will continue to offer timely diagnosis and treatment, such as when someone may require medication.
As part of this work, the Health and Social Care Secretary has asked NHS leaders to urgently examine how people can access advice, assessments and treatment more easily.
These reforms will work alongside the Government’s new £4 billion package of support for children with special educational needs, backing schools to improve inclusion, widening access to specialist support, and rolling out training for every teacher.
The Government will also strengthen the oversight and regulation of ADHD and autism assessments, including working towards making all diagnostic assessments a CQC-regulated activity, so that people can be confident any diagnosis they receive, whether through the NHS or a private provider, is accurate and based on robust clinical practice.
Secretary of State for Health and Social Care Yvette Cooper said:
Professor Fonagy’s review has shown the importance of early intervention to address mental health and neurodevelopmental conditions and the huge distress these can cause. It is clear that 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. We will set out our response in a new Mental Health Strategy in the coming months, building on the new mental health services we are already providing in schools and in the community.
Based on the review findings, we will also take action to strengthen the oversight of mental health and neurodevelopmental services, and 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.
Professor Peter Fonagy, Head of the UCL Division of Psychology and Language Sciences, said:
Our findings show a system under immense strain, where diagnosis has increasingly become a very narrow pathway to finding support for distress caused by complex and wide-ranging factors. This Review’s recommendations offer a roadmap to shift from a diagnostic labelling model to a flexible, needs-led system.
Diagnosis 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. If we judge success by a person’s overall wellbeing and ability to take part in work, education, and staying connected to their community rather than by a narrow mechanism like diagnosis, we can shift to a system that intervenes early in communities and safeguards specialist capacity for those with severe needs.
Dr Nick Broughton, National Priority Programme Director for Mental Health, Learning Disability and Neurodevelopmental Conditions at NHS England and the Department of Health and Social Care:
This is a landmark moment for how we better understand the mental health needs across society, in particular the struggles many young people are now facing.
As Professor Fonagy’s review has found – there has been a genuine increase in the number of young people seeking help in recent years, and it’s our job alongside other sectors to ensure we are providing the best support to them when they need it.
We have taken important steps in addressing these challenges, with six million pupils now able to access NHS mental health support in schools, and we’re making it easier for people to get support for ADHD and autism conditions before and after diagnosis.
But collectively there’s much more to do to give young people the best chance at succeeding in a complex and ever-evolving society, while keeping pace with new technology and the pressures that can bring – the NHS is ready to play its part.
Improving confidence in ADHD and autism services
The review recommends overhauling the commissioning, funding, oversight and regulation of mental health and neurodevelopmental services, including making all diagnostic assessments for ADHD and autism a CQC-regulated activity and banning direct-to-public advertising of NHS-funded ADHD and autism assessments.
The Government is exploring ways to strengthen oversight and regulation to ensure people can have confidence that assessments are clinically robust and that services deliver high-quality care, including:
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Improved oversight of assessment services: working with NHS England and the Care Quality Commission to regulate diagnostic assessments for ADHD and autism. This will cover NHS-funded, non-NHS-funded and self-funding patients, and will sit alongside the requirement for all Integrated Care Boards to improve oversight of the ADHD and autism assessment services they commission. This will protect patients from substandard providers, giving people confidence that wherever they are assessed, the diagnosis they receive is accurate and based on robust clinical practice.
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Review of advertising practices: The Secretary of State will write to the Advertising Standards Authority on issues related to adverts for autism and ADHD services to ensure people receive accurate information and are not exploited by companies encouraging them to seek assessments they may not need.
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New national tariff: NHS England will consult on proposals for a national set of prices for NHS-funded autism and ADHD services to improve consistency, support high-quality care and ensure public money is used effectively. The tariff would support a fairer, more consistent and more transparent system for providing autism and ADHD services, covering assessment, post-diagnostic support and follow-ups. NHS England intends to introduce finalised new payment arrangements from April 2027. This would help reduce unwarranted variation in NHS-funded ADHD and autism services, giving patients greater confidence that they can access consistent, high-quality support.
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Review of clinical guidance: Working with the National Institute for Health and Care Excellence (NICE) to urgently consider the implications of the report for its guidance relating to autism and ADHD. We will work with the NHS to implement NICE recommendations to ensure every child, young person and adult has high quality, evidence-based care to support their needs, provided in a timely way. This will give patients and families confidence that, wherever they live, they are receiving care based on the most up-to-date clinical evidence, rather than inconsistent or outdated approaches.
Earlier help and action on waiting lists for children and young people
The Government is already taking action to ensure people can access support earlier, reduce long waits for help and strengthen support for children, young people and families. This includes:
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Supporting children’s very early years: Giving every family access to trusted, practical help throughout the critical 1,001 days from pregnancy to age two. Building on the Healthy Babies programme already established in 75 local authorities, this expansion will end the postcode lottery and ensure families across England can access enhanced support with infant feeding, parental mental health and forming strong attachments with their baby.
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Earlier support for children and young people: Rolling out Mental Health Support Teams to every school and college by 2029, reaching nearly 800,000 additional children and young people this year, alongside a £7 million investment in Early Support Hubs in 2026/27.
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Earlier and more timely identification and support in education: Transforming the SEND system so children and young people get the support they need, backing schools to embed inclusion, rolling out comprehensive training for all teachers, and investing £1.8 billion over three years in the new Experts at Hand offer, to bring speech and language therapists, occupational therapists, specialist teachers, educational psychologists and other professionals into mainstream schools, early years settings, and colleges, widening access to specialist support.
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Reducing waits and expanding access to support: With mental health spending forecast to reach a record £16.1 billion this year, the Government is expanding NHS Talking Therapies so 915,000 people can complete a course of treatment by March 2029, and rolling out 159 new mental health centres and mental health emergency departments in communities across the country, so people struggling with their mental health can access timely help and support before they reach a point of crisis. The Government will set out further action through its cross-government Mental Health Strategy later this year, bringing together immediate reforms and long-term action to improve mental health outcomes and ensure support is available earlier and more consistently across England.
Stakeholder response
Centre for Mental Health chief executive, Andy Bell, said:
There is no longer any doubt about the rising prevalence of mental ill health in England, or its impact on people’s lives. So it’s time to take effective action to turn it around.
The report contains a clear message to the Government and to us all. More people, and young people especially, are experiencing mental distress and ill health.
Major change is needed, starting today. The Government has a golden opportunity with its promise of a new mental health strategy to put the report’s recommendations into practice. The report is also a call to action for local government, the NHS, business and civil society to do their part to turn around the nation’s mental health.
Alexa Knight, Director of Policy and Influencing at the Mental Health Foundation, said:
The prevalence review findings could not be clearer - there has been a real, observable and substantial increase in mental distress across the UK. This crisis was never down to overdiagnosis. We now must move past unhelpful arguments about whether levels of poor mental health are real, and instead focus on reducing the preventing people are experiencing.
We warmly welcome this report and its recommendations, and look forward to working with the UK government to make sure they are delivered in full and prevention is prioritised. This must be the end of the UK’s mental health crisis, and the beginning of a country where poor mental health isn’t accepted as inevitable.
Future Minds campaign, Andy Bell, Chief Executive of Centre for Mental Health, said:
We welcome the Fonagy Review’s clarification that the huge rise in mental health problems among children and young people is real.
We must now move on from debates about the scale of the problem and focus on delivering solutions. Many children and young people who need help and support do not receive it, and many systems are overstretched and underfunded.
This is a national emergency and children in distress should not have to go on like this. The time for reviews is over. The Government must prioritise prevention and intervention, and reform and invest in children’s mental health so that every young person has access to mental health support in their community, when they need it.
It is also essential that autistic people and people with ADHD are able to get the support they need, including with mental health, without delay or denial of their needs.
The Chief Executive of the NHS Alliance, Sir Ciarán Devane, said:
The review strikes a welcome balance between strengthening prevention and early intervention while maintaining a clear focus on ensuring prompt access to high-quality specialist NHS mental health support.
Mark Winstanley, Chief Executive of Rethink Mental Illness, said:
The independent review led by Professor Fonagy is an important step towards ensuring people can get the right support at the right time. It is deeply concerning that too many people experiencing severe mental illness still face barriers to care, and the review is right to highlight that specialist services supporting people with the most complex and acute needs must not lose out as mental health support is strengthened and expanded.
The review recognises that rising mental distress, long waits and fragmented services can leave people without the help they need. Its focus on earlier, joined-up support based on need rather than diagnosis alone provides an opportunity to shift from discussion to action.
We hope its recommendations help shape a Mental Health Strategy that delivers timely support for everyone who needs it, and a workforce that is fit to deliver it inside and outside the NHS.
Jeremy Bernhaut, Director of Policy and Practice, Mental Health UK, said:
This independent review makes clear that rising mental distress is one of the defining challenges facing our society. It is a welcome step towards a system where people can access support earlier, without having to wait for their mental health to deteriorate or for a diagnosis before getting help.
The review rightly highlights the need for more joined-up support across health, education, employment and communities.
The findings on children and young people are particularly stark, underlining the importance of intervention at the earliest opportunity.
We welcome the review’s recognition that support should be based on people’s needs, not diagnosis alone, while ensuring timely assessment remains available where clinically appropriate. As the government develops its Mental Health Strategy, this is an important opportunity to turn the review’s recommendations into lasting change.
Victoria Hornby OBE, CEO of Mental Health Innovations, said:
Professor Fonagy’s Review confirms that the rise in mental ill-health among young people is real, and we welcome the move towards a system where diagnosis is not the only gateway to support. The conversation must now focus on delivering solutions that young people can access early and at scale.
Help should be available through schools, communities, specialist care and a national digital service. In the last year, we have supported over 300,000 young people through our digital services, Shout and The Mix. We know the need for digital provision is there, and alongside our partners in the sector, we have the experience and insight to deliver it.
Lynn Perry, Barnardo’s Chief Executive, said:
The mental health of children and young people in this country is at crisis point. Through our services at Barnardo’s, we see children and young people in distress while facing long waits for assessments, diagnoses and support. This unacceptable situation is holding children back - it’s weighing them down in the classroom and playground - and it’s having a profound, often life-long effect on their health, education, relationships and future opportunities.
We welcome today’s findings from the independent review into mental health conditions, ADHD and autism.
Through working closely with children, young people, and their families, we also know that the challenges they face are often interconnected. Poverty, insecure housing, special educational needs and disabilities, and other pressures on families often overlap - yet children and families are confronted with a divided and complicated system. That’s why we welcome the review’s call for better prevention, early intervention and bringing joined-up support into the community.
The government has committed to raising the healthiest generation of children, and we are calling for an action plan to make this a reality. The plan would incorporate this review’s findings and recommendations, and set clear, concrete metrics to hold different parts of the system to account. If we are serious about raising the healthiest generation ever, children’s health must be everyone’s priority.
Professor Subodh Dave, President of the Royal College of Psychiatrists, said:
Millions of people have had their lives turned upside down by poor mental health, including illnesses and neurodevelopmental conditions that are often severe, disabling and overlapping. The report makes it clear that we must reduce unacceptably long waiting lists for high-quality assessments and improve access to specialist treatments that are too frequently unavailable if we are to address this.
More children and young people are suffering significant distress because of a constantly changing world they have almost no control over. Those showing initial signs of distress shouldn’t need a diagnosis to access basic levels of support at school, work or within their communities.
We hope Professor Fonagy’s review will drive renewed focus on mental health at every level of society in England, particularly for people with severe and enduring mental illnesses. We need mental health services that are responsive, connected and consistent if we are to support people to be healthy and active, which must be backed by an expansion of the workforce and investment. Those with the most complex needs must have timely access to psychiatric expertise.