It has been called a "generational opportunity" to rethink support for both mental health conditions and ADHD and autism. The review, commissioned by then-health secretary Wes Streeting 10 months ago after saying young people were being "over-diagnosed" and "written off", could have major implications for NHS services, the benefits system, schools and employment support. Its 600-plus pages contain a host of conclusions and recommendations.
Here are the key takeaways. The report is clear that there is an increasing risk of over-diagnosis, but only when it comes to ADHD and autism. Experts said a rise in diagnoses over the past 25 years meant cases now appear to be outstripping the expected number in the population for some younger age groups.
They gave the example of children aged six to 17 – more than 4% have been diagnosed with autism. That's well above the 1-2% that studies suggest is the true level. But this comes with a big caveat.
There are weaknesses in the data. Evidence about the true level of autism relies on surveys that have not been done for nine years, so the review team have had to estimate what has happened since. And there are some age groups where these conditions are still being under-diagnosed, and that should not be overlooked.
It is why the review team said it could not yet conclude over-diagnosis was happening "at scale". But there is certainly evidence to suggest we are moving from an era of under-diagnosis to one of over-diagnosis, the experts said. They warn not every difficulty requires a medical response and there is a risk of blurring the lines between diagnosable ADHD and autism and what should be considered the "normal human variation in brain function, cognition and behaviour".
Where the review team very clearly rejects the idea of over-diagnosis is with mental health. In fact, the chair, Prof Peter Fonagy, has said Streeting was "completely wrong" on that. He said the increase in mental distress is real – one in four 16 to 24-year-olds are now thought to experience it, up from one in six 30 years ago.
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