We respond to findings from the national review into mental health conditions, autism and ADHD

Last year, former Health Secretary Wes Streeting launched an independent clinical review into the diagnosis of and support for mental health conditions, autism and attention deficit hyperactivity disorder (ADHD).

The review - led by Professor Peter Fonagy - aimed to look at the factors driving rising mental health, autism and ADHD prevalence, take stock of services and determine what gaps in support exist.*

Interim findings from March concluded that psychological distress, particularly among younger generations has been rising over time. Read our response to Peter Fonagy's interim report.

What the review found

The final review was published today (Friday 9 October) and key findings include:

Mental distress is rising among young people

The rise in mental distress is real and cannot be explained by greater awareness alone. Among 16 to 24-year-olds, the proportion meeting criteria for a common mental health condition rose from around one in six in 1993 to one in four in 2024. Young adults now report the highest levels of distress of any age group, reversing the historic pattern where distress peaked in midlife.

Support should not depend on a diagnosis

Support is too often locked behind a diagnosis. The review calls for a shift from a 'diagnosis-dependent' system to a 'needs-led plus diagnosis' one, with help available before, during and after assessment.

Neurodevelopmental differences should be understood

Neurodevelopmental difference is not a problem to be eliminated. The review highlights the importance of moving beyond deficit-based labels and recognising people's individual strengths, needs, identities and aspirations. This also means recognising and removing the barriers that limit opportunities, choice and wellbeing.

Lived experience must shape the future of support

People with lived experience must help shape what comes next. The review says services should be designed with the people they are meant to help, and that lived experience must be embedded in everything that follows – 'not consulted once and then set aside'. It calls for key reforms, including the new needs assessment and a national information campaign, to be co-designed with people with lived experience.

Ten recommendations for government

The review sets out ten recommendations for government. These include full national coverage of Mental Health Support Teams in schools and colleges, an ambitious approach to prevention and early intervention, and a cross-government mental health strategy published this year.

Our response

Here, we share reflections from, Claire Evans, Acting CEO of Anna Freud.

This major review must herald a transformation in how we deliver mental health care for children and young people. It confirms what we've heard from research and young people for years: many are experiencing real and rising distress. This demands an urgent and ambitious national response. As part of this, we need to put to bed once and for all dismissive narratives about a ‘snowflake generation’ and instead use language that recognises the scale of the issue, with a focus on solutions and empowering young people.

Putting prevention first

Along with properly resourcing our stretched specialist services, central to this reimagining must be a much greater focus on prevention and early intervention. This is about creating the conditions young people need to thrive, from trusting relationships and safe homes to inclusive education and job opportunities, along with safety nets - like extending Mental Health Support Teams in schools - for when things start to become challenging.

It also means building much greater capacity to prevent problems and respond earlier in the places where young people already spend their lives. This is the thinking behind Prevention First, a collaboration between Anna Freud and Centre for Mental Health launching in 2027, which will equip professionals young people meet every day - like youth workers, coaches and teachers - with practical, evidence-based tools and skills to help prevent mental ill health.

Impact on neurodivergent people and their families

Some of the recommendations, including proposed changes to ADHD and autism assessment pathways, may understandably cause concern for many neurodivergent people and their families, particularly those already waiting for an assessment. Families need reassurance that no one will be removed from waiting lists without an appropriate assessment and that a needs-led approach will mean earlier access to meaningful support, not another barrier to care. These commitments must be backed by adequate funding, clear accountability and practical action, ensuring support is available to everyone who needs it, not only those with the most complex or visible needs.

Moving away from a system where support is so closely tied to diagnosis is an important opportunity, but it must not undermine anyone's right to seek a diagnosis or access specialist support. It will require coordinated change across health, education and wider services, informed by people with lived experience, so that individual needs are recognised, understood and supported without unnecessary delays.

Our priorities

Finally, this review will only deliver what children, young people and families need if they are part of shaping what happens next. For example, we want to see young voices at the heart of the new cross-governmental mental health strategy, which must lay out a radical change to the system. This should include:

• Making early intervention and prevention a fully funded national priority - we can no longer just respond to crisis and we need a commitment to sustained, ringfenced investment from the early years through to adolescence.

• The guarantee of timely and needs-led support for every child, young person and family - this would ensure access to appropriate and evidence-based support in school or community settings for those with or without a diagnosis. It requires committed integration across health, education, social care and the voluntary sector.

• Investment in the workforce and making the system accountable - the government needs to fund a cross-sector evidence-based workforce programme with measurable outcomes. Reporting should not just be measured by referral and diagnosis numbers but by children's wellbeing and functioning.

Find out more 

Read about Prevention First, a programme that equips the adults who support young people every day with free evidence and tools to prevent mental ill health.