Children, young people and adults experiencing mental distress will be offered earlier support without the need for a clinical diagnosis under sweeping reforms announced by the Government.
Responding to the findings of the Independent Review into the prevalence of mental health conditions, ADHD and autism, ministers have committed to a significant overhaul of mental health services through a new Mental Health Strategy due later this year.
The review, chaired by leading clinical psychologist Professor Peter Fonagy, with vice chairs Professor Sir Simon Wessely and Professor Gillian Baird, found rates of mental distress among children and young people have risen sharply in recent years. Factors identified include social media use, financial pressures, uncertainty about the future, poor sleep and weaker feelings of belonging and connection.
While referrals and diagnoses for ADHD and autism have increased substantially, the review concluded that the overall prevalence of both conditions across the population appears to have remained broadly stable.
The findings echo concerns highlighted in the interim report from Alan Milburn's review of Young People and Work, which found that among 16 to 25-year-olds who are not in education, employment or training, 24 per cent cited depression or anxiety as their main limiting condition, 22 per cent cited autism and 18 per cent another mental illness.
The Government said future reforms will prioritise prevention and early intervention, ensuring people can access the right support based on need rather than diagnosis.
Under the plans, schools, colleges and community services will play a greater role in supporting people experiencing mental distress. The aim is to reduce waiting times and provide help earlier, while ensuring timely diagnosis and treatment remain available where clinically necessary.
Health leaders have been instructed to urgently examine how people can access advice, assessments and treatment more easily, with a particular focus on removing barriers to support.
The reforms will sit alongside a recently announced £4 billion package for children with special educational needs and disabilities (SEND), which includes support for schools to improve inclusion, increased access to specialist services and additional teacher training.
A key recommendation of the review is greater oversight of ADHD and autism assessment services, particularly within the independent and private sectors.
The Government has committed to working towards making all ADHD and autism diagnostic assessments a regulated activity overseen by the Care Quality Commission. This would apply regardless of whether a patient is assessed through the NHS, privately or on a self-funded basis.
Ministers also plan to strengthen commissioning oversight through Integrated Care Boards and review advertising practices around ADHD and autism assessments.
As part of this work, the Secretary of State will write to the Advertising Standards Authority to raise concerns about the promotion of assessment services and ensure vulnerable individuals are not encouraged to seek assessments unnecessarily.
NHS England will also consult on introducing a national tariff for NHS-funded ADHD and autism services. The proposed pricing framework would cover assessment, post-diagnostic support and follow-up care, with implementation planned from April 2027.
In addition, the Government will work with the National Institute for Health and Care Excellence to review the implications of the report and consider whether clinical guidance requires updating.
The Government outlined several measures already underway to improve access to support and reduce waiting times.
These include:
- Expanding Mental Health Support Teams to every school and college in England by 2029.
- Reaching nearly 800,000 additional children and young people with school-based support this year.
- Investing £7 million in Early Support Hubs during 2026/27.
- Extending the Healthy Babies programme nationally to support families during the first 1,001 days from pregnancy to age two.
- Investing £1.8 billion over three years in the new Experts at Hand initiative, bringing specialist professionals into mainstream schools, colleges and early years settings.
- Expanding NHS Talking Therapies, with 915,000 people expected to complete treatment programmes by March 2029.
- Establishing 159 new community mental health centres and mental health emergency departments nationwide.
Mental health spending is forecast to reach a record £16.1 billion this year as ministers seek to reduce pressure on services and improve outcomes.
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.”
For local authorities, NHS bodies, schools, colleges and wider public sector organisations, the reforms signal a significant shift away from diagnosis-led support and towards earlier intervention models.
The strategy is also likely to drive greater collaboration between health, education and community services, with increased expectations around prevention, inclusion and early identification of mental distress.
If delivered successfully, the measures could help reduce waiting lists, improve access to support and prevent more people from reaching crisis point before receiving help.
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