The independent review of the prevalence of mental health problems, autism and ADHD in England published its final report in October 2026. The report is over 600 pages long, and goes into detail in exploring why there are rising levels of need for support with both mental health and neurodivergence. It also makes some major recommendations for the UK Government and the NHS in England about how they can meet people’s needs more effectively.
This explainer provides a brief introduction to what the prevalence review says (and doesn’t say) and what this means. We focus mostly on the mental health aspects of the report, and their implications for people and for public services.
What is the prevalence review?
What is the prevalence review?In December 2025 the Department of Health and Social Care announced the launch of a prevalence review, led by Professor Peter Fonagy, to examine the reasons for rising referrals for mental health, autism and ADHD services, following a clear increase among both adults and children in recent years.
The review, published in October 2026, rightly distinguishes between mental health problems – such as depression, anxiety, and psychosis – and neurodevelopmental conditions – such as ADHD and autism. Whilst neurodivergent people in the UK are far more likely to experience mental health difficulties, the support and treatment are distinct and we must avoid conflating them.
Have rates of mental ill health really risen?
The review is clear in its assessment: the rise in common mental health conditions over the last two decades is real. It is a reflection of rising rates of distress and poorer wellbeing. It is most stark among young people, especially young women. It is not due simply to more help-seeking or awareness. The prevalence of depression and anxiety in particular has risen, and at a very high rate.
Rates of severe mental illness (conditions such as schizophrenia or bipolar disorder) have not changed over this time. But the need for support remains high, and specialist services are needed more than ever to ensure people get the right help.
What does the review say about claims of ‘overdiagnosis’ for mental health problems, autism or ADHD?
The review explicitly and directly refutes the notion of ‘overdiagnosis’ for mental health problems. It is clear that the rate of common mental health problems has increased markedly in England. If anything, the bigger issue is with ‘underdiagnosis’, where people’s mental health needs are not recognised and go unmet for long periods of time.
The picture is less clear-cut for autism and ADHD, and the review notes this is in part due to lack of data. But there is evidence that support for neurodivergence is inadequate and delays in accessing support are causing high levels of distress and difficulty for many.
The review concluded that the prevalence of autism and ADHD in the population has been stable over recent years. But while the number of people being diagnosed with autism and ADHD has risen sharply, it does not exceed the rate in the population as a whole and there is no persuasive evidence that too many people are being diagnosed with either condition.
Why are more young people experiencing mental health problems?
The review states that there is no single cause of the rapid rise in mental ill health among children and young people. The rise of digital and social media is at least part of the cause of the increase.
But the review identifies a toxic cocktail of risk factors that have harmed young people’s mental health over the last decade. These include pressures at school, the cost-of-living crisis, increasing social polarisation, and reduced job opportunities.
The review is also clear that girls and young women have been more affected by rising prevalence than boys and young men. Among young adults, women are now twice as likely as men to have a common mental health condition.
What does the review say about how diagnosis is used as a means to get access to support and treatment?
The review says that public services too often require a clinical diagnosis as a gateway to support, for both mental health and neurodivergence. It also says that services tend to see people through the lens of a single diagnosis.
This means that people who need support but don’t have a diagnosis miss out on help that could make a difference.
The review also confirms that diagnosis itself doesn’t guarantee support, as many people with a diagnosis still can’t access it.
It argues that services should respond to people’s needs, not use diagnosis as a barrier to support. And they should support people’s needs as a whole, not just one thing at a time. That will require wholesale change to the way a wide range of services are commissioned and run.
What does the review say should happen now?
- It makes a series of recommendations for wide-ranging changes to the ways mental health problems are prevented and treated, and how neurodivergent people’s needs are met.
- It calls on the Government to make its mental health strategy robust and effective, with a focus on prevention as well as treatment.
- It says prevention can’t rest on helping children cope with increasingly demanding environments and that action is needed to improve those environments. That means more inclusive schools; protected time for rest, play and belonging; stronger community infrastructure; reduced poverty and insecurity; practical support for parents and carers; and enforceable duties on digital platforms to protect children while preserving the connection and support they can provide.
- It says there should be a shift in mental health services towards earlier intervention, with faster access to community-based services that look at people’s needs in the round, rather than one thing at a time, and that don’t wait for a clinical diagnosis to meet people’s needs.
- It says that specialist mental health services need to be strengthened – that investing in earlier support should not be at the expense of support for people with higher levels of need.
- It calls for a national set of outcome standards and measures, and a workforce plan to ensure services can meet people’s needs long term.
- And it calls for greater investment in surveillance, monitoring and evaluation of what works to support further improvement.
What will happen if nothing changes?
If long waits for support continue, more young people will become more unwell while they are waiting for essential services. We recently calculated, for example, that if nothing changes in the next three years, 3.9 million children and young people will seek mental health support and be placed on already long waiting lists.
That means many thousands more young people experiencing distress, missing out at school and work, and facing a lifetime of disadvantage and ill health.
What will happen next?
The Government’s response to the report accepts its findings and welcomes its recommendations, at least in principle. The Government says it will begin making changes to the ways ADHD and autism assessments are carried out.
There are no specific promises from the Government about the report’s mental health recommendations. It says these will be dealt with in its new ten-year strategy, due to be published later this year.
It’s clear that the report’s recommendations will need investment in both mental health and neurodivergence support to bring about the necessary changes. Under-investment has left too many people without the right help to live their lives and thrive. We’ll be advocating for investment in mental health support that makes a difference, starting with prevention but at every level of the system so that no one is left behind or left out.
As the review identifies the economic, social, environmental and technological causes of rising mental ill health, by acting on those risk factors it’s possible to turn things around.
And by improving support for people with ADHD and autism, it’s possible for more people to have happier and more productive lives.
