England's Mental Health Review: The Rise Is Real, and Access to Help May Change
Professor Peter Fonagy's independent review of mental health conditions, autism and ADHD in England concludes the steep rise in anxiety and depression is real.
Commissioned by Health Secretary Wes Streeting, the review warns that higher rates of mental illness, ADHD and autism have left public services overwhelmed, left people without care or support, and made costs to the taxpayer unsustainable, according to reporting on the final document The Guardian. Waits for an NHS diagnosis stand at 64 weeks.
Fonagy points to cultural and social drivers behind more mental health problems among young people. He names Covid disruption, financial and housing insecurity, and competitive pressures at school and in social life made worse by social media. The argument is that greater awareness alone does not explain the trend. Young people with mental health problems are not a 'snowflake generation', Fonagy said in remarks reported last month BBC.
On diagnosis, the review sees a risk of overdiagnosis, where a label is given where it may not fit, but finds no evidence of it happening at scale. It criticises the growth and reliability of unregulated private firms offering assessments, a market that has grown as NHS waits have lengthened. Streeting had previously said mental health conditions were being "overdiagnosed" in a discussion about disability benefit cuts, a remark he later apologised for.
The main recommendation is to depend less on a formal diagnosis as the entry point for help. Instead, services would identify needs early and sort, or triage, them to swift support. Triage works like sorting in an emergency department, sending each person to the right help first. The review's original mandate asked why more people are turning to the NHS and other services, and what part diagnosis should play in getting help GOV.UK. The government published terms of reference on 4 December 2025, followed by an interim report on 10 June 2026. Streeting asked Fonagy to lead the work almost a year ago.
The broader context here is financial as well as medical. A system based on need would change eligibility rules, staffing needs and how services are planned and paid for across mental health, primary care, education and social care in England. It would also affect debates that tie a diagnostic label to benefits, school support and workplace adjustments.
Looking at what this would mean in practice, much depends on detail. Early help without a diagnosis needs tested sorting tools, clear referral routes, limits on unregulated assessments, and funding for support that does not require a formal label. Without that capacity, waits could reappear under a different name.
