Government review warns of over-diagnosis risk for ADHD and autism
A 10-month official review in England has found that people are at risk of being over-diagnosed or mis-diagnosed with ADHD and autism.
A 10-month official review in England has found that people are at risk of being over-diagnosed or mis-diagnosed with ADHD and autism.
An official review in England has warned that there is an increased risk of over-diagnosis and mis-diagnosis of ADHD and autism. The report, led by Professor Peter Fonagy and Sir Simon Wessley, suggests that society may be moving from an era of under-diagnosis to one of over-diagnosis or mis-diagnosis.
The authors stated they cannot conclude that over-diagnosis is currently occurring at scale because some data is nearly a decade old. However, the review suggests that the lines between diagnosable conditions and normal human variation are blurring.
Professor Peter Fonagy, the review chair, said: "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."
The report calls for a shift toward a needs-led support system to address rising demand and long waiting lists. It argues that access to help should be based on a person's needs rather than being locked behind a formal diagnosis.
Experts noted that diagnoses can sometimes act as labels that define people by their difficulties rather than their strengths, which could potentially harm prospects in school and work. This follows a 2014 change that meant children needed an autism or ADHD diagnosis for their parents to secure extra support at school.
The review recommends tougher regulation of private firms providing assessments for the NHS and a ban on direct-to-public advertising. It found that the cost of private ADHD diagnosis has increased by 252% in three years.
Private providers currently conduct more than half of NHS-funded ADHD assessments and a third of autism assessments.
The review highlights that many young people face mental health struggles due to economic uncertainty, financial pressures, and unaffordable housing. It notes that up to a fifth of secondary school pupils self-identify as neurodivergent.
The report warns that if current trends continue, the number of children suffering from high psychological distress could reach 4.5 million by 2030. It also notes that 2.5 million under-18s are projected to self-harm by 2030.
The scale of the waiting lists is significant. According to The Guardian, there are 800,000 total people waiting for ADHD or autism assessments. The Independent reports that 560,000 people were waiting to be assessed for ADHD in December 2025, while 254,000 had an open autism referral at the same time.
The review was ordered 10 months ago by former health secretary Wes Streeting. The health secretary, Yvette Cooper, has asked NHS England to establish how to provide faster advice, assessments, and treatment.
The government is expected to release a new mental health strategy before the end of the year. The findings may influence government policies regarding NHS services, benefits, and support for young people not in education, employment, or training.