A major review of NHS England's mental health, ADHD and autism services, led by Prof Peter Fonagy, warns that services will be overwhelmed without a radical overhaul, finding that mental distress has risen substantially.
Key facts
- Prof Peter Fonagy's review runs to 607 pages and was published on Friday.
- The review was commissioned in 2025 by then health secretary Wes Streeting.
- It warns mental health and neurodiversity services will be overwhelmed without a radical overhaul.
- The report says mental distress has increased substantially and cannot be explained by greater awareness alone.
- It found the NHS is at risk of 'system failures' as demand for ADHD and autism care soars.
A wide-ranging review of NHS England’s mental health, ADHD and autism services has concluded that the system will be overwhelmed unless it undergoes a radical overhaul, according to the Guardian. The 607-page report, led by Prof Peter Fonagy, was published on Friday and sets out a series of findings and recommendations on how the health service handles rising demand for assessment, diagnosis and care.
The review was commissioned in 2025 by Wes Streeting, who was then the health secretary. It was launched in response to growing concerns that spiralling waiting lists for assessment, diagnosis and care threatened the NHS’s ability to meet demand, the Guardian reports.
One of the report’s central conclusions is that mental distress has increased substantially. The review is described as categoric that this rise ‘cannot be explained by greater awareness alone’, pushing back against the idea that growing numbers simply reflect increased recognition of mental health conditions.
The report also addresses concerns about young people, with the Guardian noting the review’s finding that today’s youth face harder circumstances and that the harms they experience are real. The analysis rejects the notion that young people are ‘snowflakes’, instead treating their distress as genuine.
On neurodiversity, the inquiry found that the NHS is at risk of ‘system failures’ as demand for ADHD and autism care soars. The review warns that without significant change, services for these conditions could be stretched beyond their capacity.
Taken together, the review paints a picture of a system under strain and argues that incremental change will not be enough. It calls for a radical overhaul to prevent mental health and neurodiversity services from being overwhelmed, according to the Guardian.
Why it matters
Mental health, ADHD and autism services affect large numbers of people who rely on the NHS for assessment and care, and long waiting lists have been a persistent concern. The review's warning that services could be overwhelmed without major reform signals significant pressure on both patients and policymakers.
Frequently asked questions
Who led the NHS mental health review?
The review was led by Prof Peter Fonagy, whose report runs to 607 pages, according to the Guardian.
Why was the review commissioned?
It was commissioned in 2025 by then health secretary Wes Streeting, in response to concerns that spiralling waiting lists for assessment, diagnosis and care threatened the NHS's ability to meet demand.
What does the review say about rising mental distress?
The report is categoric that mental distress has increased substantially and says this 'cannot be explained by greater awareness alone'.