A major government-commissioned review in England has warned that ADHD and autism are at risk of over-diagnosis, while also finding a system that leaves many people waiting years for help and support locked behind a formal label.
The review, led by clinical psychologist Professor Peter Fonagy, examined why demand for assessments has risen so sharply. It said society may be moving from an era of under-diagnosis toward one of over-diagnosis or misdiagnosis, and warned against blurring the line between a diagnosable condition and normal variation in attention, anxiety and social behaviour.
The numbers behind the report are stark. Government figures cited in coverage show disability-benefit recipients with autism recorded as their main condition rising from under 80,000 in early 2019 to about 269,000 by July 2026. For ADHD, the rise was from roughly 24,000 to about 106,000. Waiting lists tell a parallel story: hundreds of thousands of people were waiting for ADHD assessment by late 2025, alongside more than a quarter of a million open autism referrals.
The reviewers questioned whether linking support too tightly to diagnosis creates unintended incentives. When education help, workplace adjustments and financial assistance require a medical label, families understandably pursue one. Private assessment providers have expanded to meet demand, and the review called for tougher regulation of assessment quality.
The report does not say rising diagnoses are simply invented. Greater awareness, reduced stigma and better recognition of people previously missed, including women and older adults, all contribute. Its caution is that inaccurate diagnosis can do harm by sending someone toward the wrong treatment or hiding social causes of distress. A lonely student, the authors suggested by example, may need connection more than medication.
Charities responded carefully. The National Autistic Society said the report showed successive governments had failed autistic people and stressed that distress is real and widespread. YoungMinds said young people have long felt blamed for their difficulties and hoped the review would shift attention to failing systems. Those responses highlight the political sensitivity: discussing over-diagnosis can sound like denying need.
The government welcomed the review and promised a new support model in its forthcoming mental-health strategy, along with stronger regulation of assessments. Health Secretary Yvette Cooper emphasised early intervention. The test will be whether support can be offered earlier without making diagnosis the only key that opens the door.
For families, the immediate reality remains queues. A review can redefine the problem, but a child waiting for assessment needs help this term. The report’s central challenge is to build services that respond to need before a label, while still diagnosing accurately the people for whom a label is the right explanation.
The review’s most practical proposal may be its least headline-worthy: offer help before diagnosis. Speech support, classroom adjustments, mental-health care and workplace flexibility do not always require a medical label, and providing them earlier could shorten queues for the people who genuinely need specialist assessment. That shift requires money and training in schools and clinics, not only tighter rules for private assessors. The charities’ cautious welcome reflects the balance the government must strike. Ministers say they accept the diagnosis problem is real in both directions: some people labelled too quickly, others still waiting unseen. Policy that fixes only one side will fail.
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