If you have spent months on a waiting list for an ADHD or autism assessment, or you have felt anxious and low for a long time without knowing where to turn, a major new report puts your situation at its centre.
The Independent Review into prevalence and support for mental health conditions, ADHD and autism, chaired by Professor Peter Fonagy with Professor Gillian Baird and Professor Sir Simon Wessely, published its final report in October 2026. More than 120 clinicians, researchers, teachers and people with lived experience worked on two questions: why far more people now ask for help, and whether the system is set up to respond.
Their answer is careful and, in places, uncomfortable reading. Here is what the review found, what it recommends, and what to do in the meantime if you need support now.
What the review found
Distress has risen, especially among young people
The review is clear the increase in mental distress is real. Greater awareness and less stigma explain part of the rise, but not all of the rise. Among adults aged 16 to 64, the proportion meeting criteria for a common mental health condition such as anxiety or depression went from 15.5% in 1993 to 22.6% in 2024. Among 16 to 24 year olds, the figure rose from around one in six to one in four, and young women now report the highest rates of any group, at 36.1%.
Not everything has gone up. Rates of schizophrenia and bipolar disorder have stayed broadly stable, and hazardous drinking has fallen. The rise sits mainly in anxiety, low mood, self-harm and difficulties with concentration.
Recognition of ADHD and autism has grown much faster than the conditions themselves
The review finds little evidence the underlying rate of ADHD or autism in the population has changed much. What has changed is how often people are recognised, referred and diagnosed. Monthly referrals for suspected ADHD rose from around 5,000 in 2019 to around 17,000 in 2024. By the end of 2025, more than 560,000 people had an open ADHD referral, and more than 254,000 were waiting for an autism assessment, with over nine in ten waiting longer than the recommended 13 weeks.
Much of this reflects better recognition of groups long overlooked, particularly girls, women and adults whose difficulties were missed in childhood. The review treats this as progress. As numbers keep climbing, the authors also warn the risk of misdiagnosis and overdiagnosis now deserves as much attention as the older problem of underdiagnosis.
Most people have more than one thing going on
One of the clearest findings concerns overlap. Among 16 to 24 year olds with a common mental health condition, 57% screened positive for ADHD traits and 61% for autistic traits in 2024. Screening is not diagnosis, but the pattern matters. Anxiety, low mood, attention difficulties, trauma and social pressures often arrive together, and services built around one condition at a time struggle to see the whole person.
Why diagnosis has become the bottleneck
Help has been locked behind a label
The central argument of the review is diagnosis has become the main gateway to support at school, at work and in the NHS. Families seek an ADHD or autism assessment partly to understand what is happening, and partly because a diagnosis is often the only reliable route to adjustments, an education plan or treatment. The result is long queues and little help for the people standing in them.
Waiting does harm
National survey data cited in the review show the share of people whose mental health worsened while waiting rose from around one in four among those waiting under two weeks, to more than seven in ten among those waiting over six months. Reaching a diagnosis does not always end the wait either. In a survey for the review, 40% of autism clinicians said their service offered no ongoing support after diagnosis.
Concerns about some private assessments
Independent providers now carry out more than half of NHS-funded ADHD assessments and over a third of autism assessments. The review stresses this is no criticism of people who turn to them after long NHS waits. The authors do raise concerns about inconsistent quality and oversight, and recommend making all ADHD and autism diagnostic assessments regulated by the Care Quality Commission, along with a ban on direct-to-public advertising of NHS-funded assessments.
What the review recommends
The review sets out ten recommendations for government. Four matter directly to anyone looking for help now.
1. Support based on need, alongside diagnosis
The headline proposal is a shift from a “diagnosis-dependent” system to a “needs-led plus diagnosis” one. Support, adjustments and therapy should start when someone is struggling, not after a label arrives. Diagnosis still matters for treatments such as ADHD medication, and the review is firm about not weakening diagnosis, but assessment should run alongside help rather than stand in front of help.
2. No wrong front door
Wherever you first ask for help, whether a GP, a school, a college or a community service, you should get a proper look at your needs and a clear route onwards, without having to pick the right service in advance.
3. A wider range of matched talking therapies
The review argues for therapy matched to the person rather than a single default model. The authors point to evidence for cognitive behavioural therapy, psychodynamic psychotherapy, family and systemic therapy, interpersonal therapy and others. In one major trial with depressed adolescents, CBT, short-term psychoanalytic psychotherapy and a brief psychosocial intervention produced broadly similar results. The review also calls for therapy adapted for autistic people and people with ADHD, so a neurodevelopmental condition is never a reason to be turned away.
4. Participation as the measure of success
Services should be judged by whether people are back at school, in work, in relationships and part of their community, not by how many assessments were completed.
What this means for you, and what therapy does and does not do
Government reform takes years. If you are struggling today, the logic of the review still applies to you. You do not need a diagnosis to deserve help, and you do not need to wait for one before speaking to someone.
Who therapy suits while you wait
Talking therapy with a qualified counsellor or psychotherapist suits people dealing with anxiety, low mood, relationship strain, stress at work or university, loneliness, or the frustration of a long wait. A good therapist works with what is in front of them: how you are sleeping, coping, relating to people and getting through the week. Many therapists also have experience with clients who are autistic, have ADHD, or are wondering whether they do, and will adapt how they work.
What therapy does not replace
A counsellor or psychotherapist does not diagnose ADHD or autism and does not prescribe medication. If you want a formal assessment, keep your place on the NHS list and talk to your GP about your options, including your right to choose a provider in England. The NICE guidance on ADHD sets out what a proper assessment involves. Therapy sits alongside this, not in place of it.
If you are in crisis or worried about your safety, private therapy is not the right first step. Use the NHS guide to urgent mental health help, call 111, or contact Mind for information and support. NHS Talking Therapies also offers free help for anxiety and depression, often by self-referral.
Questions worth asking a therapist
Ask about their training and professional membership, for example with the BACP, UKCP or BPC. Ask whether they have worked with clients who are neurodivergent or waiting for an assessment, and how they would adapt sessions. Ask how they would approach your situation, rather than which single method they use for everyone.
Find a verified therapist in London
The Fonagy Review makes a simple point: help should follow need, not paperwork. The Therapist Finder lists independent, qualified therapists across London and online, and every profile is checked before going live. We are not a platform or a corporate aggregator. You contact the therapist directly, and you do not need a diagnosis to get in touch.
Search for a therapist on The Therapist Finder by area, approach or the difficulty you want help with.
