Katie Williams
Live reporter

Image source, Getty Images

An official review in England has found young people are at risk over being over-diagnosed with ADHD and autism.

Review chair Peter Fonagy says that, "properly done", diagnosis is "incredibly important and quite complicated", as he calls for "national standards in assessment".

However, he tells the BBC that "there has been a rise in distress and mental ill health amongst young people which is very, very real", noting that one in five cases require treatment.

Health Secretary Yvette Cooper has welcomed the review, saying that mental health services need to change to focus more on "early support".

We've been hearing from people with diagnoses throughout the day, as well as those waiting for an assessment.

Caitlin Labonte says her journey to an ADHD diagnosis was "long-winded" before she ultimately turned to a private clinic - and doesn't accept that private clinics are over-diagnosing patients.

Meanwhile, 32-year-old Natasha suspects she has autism as well as ADHD but wants to be diagnosed through the NHS. "If it's not thorough, it's just money down the drain," she says.

Many have voiced frustration as they wait in limbo, with one grandmother saying her seven-year-old grandson has been waiting for an assessment for more than four years.

We are now bringing our live coverage to a close, you can read more in our news story here.

Rozina Sini
BBC Your Voice

Mary in Suffolk was diagnosed with autism later in life.

She recalls being seen as a high achiever while at school, but "had few friends and lacked social skills".

Mary had little support from school while growing up, as she recalls the belief at the time was that "only boys could have Asperger's Syndrome, so when the school asked a psychologist to see me he said that I was just too mature for my age".

"Teachers 'helped' by telling me to smile more", she remembers. Despite challenges, she went on to have two successful careers, but says both unfortunately ended with her being "written off too sick to work after periods of selective mutism and awful meltdowns".

Receiving an autism diagnosis aged 58 meant she could finally make "sense of it all".

"I think the important part of my story is that there was a whole generation of women who were at the time written off as either badly behaved, wayward or completely lacking in social skills and as a result their professional and creative skills were often lost to society."

How many people with ADHD claim Pip?published at 16:24 BST 9 October

16:24 BST 9 October

By Tom Edgington

Earlier we referred to the debate surrounding young people on disability benefits, including for ADHD, with the prime minister having said he wants to help more young people into work.

More than 100,000 people with ADHD as their main condition receive Personal Independence Payments (Pip), data from the Department for Work and Pensions shows.

Pip is the working age benefit which helps individuals deal with the extra costs of having a physical or mental health condition or disability.

Official figures show that the number of people in England and Wales claiming Pip with ADHD as their main condition was around 106,000 in July.

That is up from around 70,000 when Labour took office in July 2024, an increase of just over 30,000 over that time.

An initial independent review for the Department of Health and Social Care this year found that the increase in people diagnosed with ADHD was likely due to a combination of factors, from an improved recognition of the condition to more people seeking help and changing expectations of support.

It also stated that, external "where access to support is closely linked to diagnosis, demand for diagnostic assessment may increase".

Read more of BBC Verify's analysis of how rising ADHD benefits claims is adding to welfare spending here.

While many have welcomed today's findings from the Fonagy review, the Matthew Lock ADHD charity has voiced its disappointment at recommendations - raising concerns for those who don't yet meet the threshold for urgent intervention.

Not needing urgent attention "does not mean they do not need effective treatment", the charity says, adding: "What about the child struggling at school, the young person beginning to self-medicate with drugs or alcohol, or the adult whose relationships, employment and mental health are gradually deteriorating?"

It was involved in the review but withdrew due to "serious concerns about the proposed risk-based triage system".

The charity was set up by Richard and Christine Lock in memory of their son - Matthew Lock - who had ADHD and took his own life aged 19, in 2023.

It says the NHS should move beyond managing waitlists, adding: "We should not have to wait for someone to reach crisis point before giving them the treatment they need."

"A system that waits for people to become seriously unwell before providing effective treatment is not prevention. It is crisis management."

Malu Cursino
Live reporter

We've been speaking to a number of experts about how the government should go forward from today's report.

Dr Sarah Hughes, chief executive at UK mental health charity Mind, tells me that mental health, ADHD and autism assessments and support services should be "integrated", to ensure teams work together to provide "coordinated support" based on individuals' specific needs.

Hughes warns against seeing overdiagnosis as the problem, highlighting that the issue instead stems from "people being let down because of a lack of support".

"There is a very real and significant rise in distress, with the report rightfully highlighting that uncertainty around housing, employment and finances is contributing to an increase in mental health problems," she says.

"This is particularly stark among young people, with a concerning number now experiencing severe psychological distress and self-harm as a result."

Image source, Mind

Image source, Getty Images

As the number of people diagnosed with conditions such as autism and ADHD rises, so has the cost of supporting them.

The total bill for working age sickness and disability benefits currently stands at £58bn and has been projected to rise to £78bn by 2030, according to the Office for Budget Responsibility (OBR) - here's what politicians have said about getting the bill down:

Prime Minister Andy Burnham says he wants to encourage more people into work, while Chancellor John Healey said last week that cutting welfare spending was "more than an economic must - it's a moral duty".

Conservative leader Kemi Badenoch says we have seen an "explosion" in the number of people who are claiming benefits for "low-level conditions", such as ADHD, and that people "worked out how to game the system" during the Covid pandemic.

Reform UK says it would aim to cut about £50bn from the benefits bill and replace the disability payments system, Pip, if in government.

Last year, when the government announced plans to cut the benefits bill by £5bn a year, Liberal Democrat leader Sir Ed Davey did not say if he thought the cuts were too big or not big enough, but criticised ministers for creating uncertainty.

At the same time, the Green Party recommended scrapping the cuts and proposed increasing all disability benefits by five per cent instead.

Speaking to the BBC, Shimeon Lee from the TaxPayers' Alliance says the current system "was not designed to cope" with such a surge in mental health diagnoses.

He says that Britain has an "unusually generous disability benefit system" and that as more people are diagnosed with certain conditions, such as ADHD, the "system is increasingly getting overwhelmed and is struggling to deliver".

"It's not working for both the people who do need help and the taxpayers who pay for it," he says, adding the support for mental health conditions should become "a lot more targeted".

"That's the only way the system can remain fair, affordable, and sustainable in the long-run," he says.

Lee adds that some parents are incentivised to seek a mental health diagnosis for their children due the greater level of support that comes with it, in turn pushing up costs for taxpayers.

• Earlier, the chair of today's review, Prof Peter Fonagy, told the BBC "there has been a rise in distress and mental ill health amongst young people which is very, very real" - you can read more on his comments here

Katie Williams
Live reporter

Social media is one of the factors the review team blames for the rise in mental distress amoung young people.

Swansea University psychology lecturer Simon Williams tells me it's not just issues like cyber-bullying and disinformation, but also the "opportunity costs" that come with spending a vast amount of time online.

Children are "missing out on opportunities for face-to-face interaction", he says, adding that it's happening at an "increasingly young age".

The independent review published today found that young people are living in a world where there is "less belonging and more loneliness" than in the past.

Williams says in his view, it's partly social norms and "peer pressure" that are driving overuse of social media among young people.

• The government is introducing a social media ban for under-16s from March 2027. You can read more about that here

Recognition of ADHD and autism has risen dramatically, leading to hundreds of thousands of people awaiting diagnostic assessment, the report says.

Here are some of the figures it gives on waiting times for assessments:

• The report says that monthly referrals for ADHD assessments have "more than tripled from around 5,000 in 2019 to around 17,000 in 2024", according to data from NHS England
• By the end of 2025, open referrals for ADHD assessment sat at more than 560,000, which is more than 17 times the number recorded in 2019

Across the NHS, the average wait time for adults is currently eight years and four years for children.

• The report also points to a high demand for autismassessments. It notes - also citing NHS England data - that in December 2025 more than 254,000 people had an open autism referral, with 90% waiting longer than 13 weeks.

Eli from Sheffield was diagnosed with autism last year while she was in Year 13 at college, long after first pursuing an assessment.

She tells the BBC securing exam arrangements was the main hurdle for her: "I couldn't get a smaller room or anywhere because there was no evidence of me being autistic, and we needed the evidence".

Her teachers were understanding and knew she needed help, but she says "they were stuck in sort of a paperwork issue".

Eli voices her frustration at being "ping-ponged" between different mental health services, when she feels she should have gone "straight to the neurodiversity waiting list".

She is proud of her autism diagnosis and keen to tackle stigmas.

"I openly say to people that I am autistic, I act different...but I'm still human and I'm still there."

A short while ago, we heard from Nicola Lathey, who set up the Owl Centre which provides diagnoses for ADHD and autism.

She was asked whether concerns about private diagnoses are fair, after the independent review raised questions about the "consistency and quality" of assessments.

"It's very difficult to answer that outright," she tells Radio 4's World at One programme.

But she adds that existing guidance and protocols are "very rigid" and "don't leave gaps for your own interpretation".

"All providers should follow the same protocols, which adhere to the CQC [Care Quality Commission] standards," she says.

Asked whether there is a difference between these standards and actual regulation, Lathey says: "The problem has arisen because providers who don't offer a medication service for ADHD have been allowed to provide ADHD assessments".

She says the CQC only regulates those with a medication service attached.

The review also raises "strong concerns about the consistency and quality of ADHD and autism assessments being carried out by independent providers," as well as "the financial incentives" associated with these assessments

• Independent providers now carry out "more than half of all NHS-funded ADHD assessments and more than a third of autism assessments", it says, citing 2026 data from the Center for Health and the Public Interest
• Spending on independent-sector ADHD provision - this is the money the NHS pays independent providers of assessments and care - has risen by around 252%in three years

Though the report stresses that it is not criticising independent provision "in principle", it says that this process runs "without consistent oversight, transparency or quality assurance".

In response, the government has promised a new Mental Health Strategy to regulate ADHD and autism assessments to ensure they are "high quality".

Image source, Getty Images

Liberal Democrat MP Layla Moran tells Radio 4's World at One programme: "I really welcome this review."

She says the Health and Social Care select committee, which she is part of, has teamed up with the Education select committee and is doing a joint inquiry into children's mental health.

She says the "thesis question" they have come to is: are children and adult mental health services "frankly broken"?

Moran says the post bag in her constituency of Oxford West and Abingdon is "chocka full" of parents of children saying they can't get help they need and "just can't afford" to get a private diagnosis.

There is "very clearly a big problem here", she says.

Miya Chahal
BBC Newsbeat

Image source, Caitlin Labonte

Caitlin Labonte describes her journey to getting an ADHD diagnosis as "long-winded".

"Before I was diagnosed I really struggled with my sleep," she says. "I actually slept through one of my A-levels so I missed one of the exams."

Around the same time, she was diagnosed with depression and anxiety but spent a year on a waiting list to check for ADHD. When she turned to the NHS’s Right to Choose route, she says "within three months I was diagnosed and medicated".

Labonte doesn’t accept that private clinics are over-diagnosing and believes patients "won't get diagnosed if they don't have it".

"We're raising more awareness," she says.

"We should be celebrating that we're getting these incredible opportunities to help more children get diagnosed, to help more women get diagnosed, more people of diverse backgrounds diagnosed."

Kate McGough
Education reporter

A young person is considered "Neet" if they are aged between 16 and 24 and are not in education, employment or training.

They could be unemployed and looking for work, or what’s known as "economically inactive", which means they’re not looking for work – which could be because of caring responsibilities, or health reasons, for example.

Nearly a million young people (981,000) were Neet between April and June this year, according to the latest stats from the Office for National Statistics. That's about one in eight young people in the 16-24 age range.

The Fonagy review was ordered to look into the rise in mental health issues among young people, as well as referrals for conditions like ADHD and autism.

Both of those can be linked to difficulties during school, including persistent absence, which can then lead to a greater risk of a young person becoming Neet.

The review's recommendations could therefore have repercussions for government policies on how to intervene earlier in young people's lives to reduce that risk.

Another review looking specifically at why the number of Neets is so high, led by Alan Milburn, is due to be published later this year.

Beth Rose
Disability affairs reporter

The charity Young Minds, which supports young people with their mental health up to the age of 25, says "now is the time for action and investment".

"For years, young people have told us they feel blamed for their mental health or accused of making it up," says Abigail Ampofo, interim chief executive.

"We hope this review goes some way to show them their distress is not their fault and the systems around them are failing."

The national disability charity Sense, which supports people with autism, ADHD and mental health conditions, says it "strongly welcomes" the review's recommendation for more individual support, but says it is "vital" that disabled people with complex needs are not "overlooked" in any reforms.

Chief executive James Watson-O’Neill says success shouldn't be measured in the number of diagnoses or shorter waiting lists, but in "whether disabled people have a better quality of life".

Image source, PA Media

As we've been reporting, the review has pointed to a "a very real rise" in mental health problems in young people. It lays out multiple environmental factors that have contributed, including:

• Schools:Are "more focused on high-stakes assessment", with fewer chances for "unstructured time", or physical, creative and vocational learning
• Community infrastructure:Things like youth services - have "eroded" over the past 15 years
• Jobs and living situation:A "less secure labour market", a rise in student debt, an increase in private renting alongside a drop in home ownership, and a rise in the proportion of those living with parents into adulthood
• Covid: The pandemic "interrupted" experiences that "support belonging, competence, autonomy and confidence in the future"
• The digital world: While it stresses that it's "difficult" to estimate the effect of digital environments on mental health, many online experiences - including social comparison, body dissatisfaction, sleep disruption, cyberbullying, harmful content - chime with difficulties young people raised elsewhere in the review

The report also says that there has been a "changing understanding of mental health and neurodevelopmental conditions".

It points to a "greater awareness of" and "wider use" of psychological language, which has "reduced stigma, improved recognition" and "brought previously unrecognised needs into view".

A common theme among those with ADHD and autism who we've been hearing from this morning is a struggle with access to a diagnosis and additional support.

• It took eight years until Heather Carpenter'sson was formally diagnosed with autism, but she recalls the anguish as they waited and the relief afterwards as she realised "he wasn't a bad kid and I wasn't a bad parent"
• Twenty three-year-old Jasmine King says everything in her life is "on hold" while she waits for a diagnosis - "I have no support, no medication and no full understanding of myself"
• While Christine Adams, whose seven-year-old grandson has been waiting four years for an assessment, says teams at his primary school say they can no longer meet his needs
• Amy, who got an ADHD diagnosis in 2023, says a lot of women like her go under the radar and are "forgotten about" because they don't "present in the normal way people assume ... the naughty child in school"

• Ryan and his wife first realised their son Atlas was missing development milestones when he was around 12 to 18 months, but it took three years for them to get an autism assessment - he's now nearly seven, non-verbal and still wears nappies. Ryan's main frustration is the lack of a fast-track route for children, like Atlas, with more complex needs