The fabric of childhood is changing – we have a responsibility to respond with imagination and ambition

Many of the interim findings from this landmark review*, which were published by the Department of Health and Social Care (DHSC) this week (31 March 2026), reflect what young people, families and professionals have been telling us for years. They also challenge how we interpret what we are seeing, and how we choose to respond.

Psychological distress, particularly among younger generations, has been rising over time and this is not simply a post-pandemic phenomenon. Meanwhile, the systems designed to support young people, across health, education and social care, are not currently configured to respond effectively to this changing need.

What is especially striking is the shift in who is most affected. Distress, historically higher in older groups, is now most pronounced among young people. This marks a reversal of long-standing patterns, and represents a significant change in the landscape of mental health, one that requires a coordinated societal response, with far greater emphasis on prevention and early intervention.

The report also makes important progress in unpacking the complexity behind these trends. It shows clearly that increases are not uniform. Emotional difficulties such as anxiety, low mood and sleep problems are rising most sharply, while patterns vary across different groups depending on gender, ethnicity and socioeconomic context. Understandably, these difficulties can increasingly affect young people’s ability to function in everyday life, including their engagement with education, work and relationships.

At the same time, the findings highlight a more complex picture for autism and ADHD. Population-level prevalence appears relatively stable, while diagnoses, referrals and self-identification have increased significantly. This divergence is important. It suggests that several complex processes are occurring at once. Instead, these trends are often presented in overly simplistic or polarised ways, especially in the media. In reality, they are likely to reflect a combination of improved recognition, changing help-seeking, and continued unmet need, alongside wider social and institutional factors. It is essential that public debate, and media reporting, reflects this nuance, rather than reinforcing stigma or undermining the experiences of those who need support.

What is clear is that the current system is under significant strain and is not working as well as it should. Too often, access to support depends on securing a diagnosis, rather than responding to need earlier and more flexibly. When access to support is tied tightly to diagnosis (and not level of need), systems can unintentionally drive demand for diagnosis itself. As the review highlights, this risks creating delays, increasing pressure on services and leaving many young people without timely help.

The fabric of childhood is changing before our eyes, and we have a responsibility to respond with imagination and ambition. This is not simply a challenge for services, but for society as a whole.

We need to forge a new social contract with our young people. One that responds to the profound changes in their social and digital worlds, with holistic, sustainable, and flexible models that provide opportunity and support. One that is as much about building the foundations of lifelong wellbeing and resilience as about addressing current problems and symptoms.

This means less focus on a medical model driven by diagnosis and more on building the social infrastructure that best supports healthy development, in families, schools and communities, and across digital spaces. This includes investment in the environments where young people grow and connect, such as playgrounds, sports fields and parks, as well as schools and community centre's. We also need to support and invest in the adults who work with and alongside our children and young people, from nursery workers and health visitors to teachers and sports coaches. Mental health is not only about treating problems, but about creating the conditions in which young people can fulfil their potential.

At Anna Freud, we see every day the consequences of systems that are too slow, too fragmented and too dependent on diagnosis as the gateway to support. We also see the difference that earlier, more flexible and more relational forms of support can make.

We look forward to the final phase of the review, which will be critical in translating these insights into practical recommendations for a more coherent, responsive and sustainable system of support.

*The independent review into mental health conditions, ADHD and autism is being led by Professor Peter Fonagy, who was the previous CEO of Anna Freud and now holds the position of Honorary President.