England pledges earlier mental health support as Fonagy review calls for tighter ADHD and autism assessment

Responding to an independent review chaired by Professor Peter Fonagy, the Department of Health and Social Care has set out a move towards earlier, needs-led mental health support in England, so that a formal diagnosis is not the only route to help. It also plans to strengthen oversight of ADHD and autism diagnostic assessments, including by NHS and private providers.

What happened

The independent review of the prevalence of, and support for, mental health conditions, ADHD and autism was chaired by Professor Peter Fonagy, with Professor Sir Simon Wessely and Professor Gillian Baird as vice-chairs. It found that mental distress has risen substantially among children and young people, driven by factors including social media, financial insecurity, uncertainty about the future, poorer sleep and reduced connection. It also found that referrals and diagnoses for ADHD and autism have risen sharply while the prevalence of these conditions appears broadly stable.

The government said children, young people and adults in distress should receive support and advice at the earliest opportunity, based on their needs, without a formal diagnosis being the only way to get help. Diagnosis remains part of the system where it is clinically needed.

The review recommends making all ADHD and autism diagnostic assessments a Care Quality Commission (CQC) regulated activity and banning direct-to-public advertising of NHS-funded assessments. The department said it will work with NHS England and the CQC on regulating these assessments, covering NHS-funded, non-NHS-funded and self-funding patients, and with the Advertising Standards Authority on adverts for ADHD and autism services.

NHS England will consult on national pricing for NHS-funded ADHD and autism services, with payment arrangements intended from April 2027. The government also restated its plan for mental health support teams to reach every school and college by 2029.

Why it matters

For psychologists and counsellors working in England, the direction is towards earlier support in schools, colleges and communities, alongside closer scrutiny of who carries out diagnostic assessments and how they are marketed. Private assessment providers would fall within CQC regulation if the plans proceed.

These are commitments and proposals, not reforms already in force. They apply to England’s health and education systems, not to the rest of the UK or other countries.

What happens next

The government says it will publish a cross-government mental health strategy in the coming months, setting out its approach to prevention and early intervention. The CQC regulation, advertising review and pricing consultation are still to come.

Source

• Department of Health and Social CareGovernment pledges earlier support to tackle mental health crises