Four years for a diagnosis. Today's review says help should not wait that long
What happened
On 9 October 2026, the government published the Independent Review into prevalence and support for mental health conditions, ADHD and autism, along with its own response. It was chaired by Professor Peter Fonagy, who heads the Division of Psychology and Language Sciences at University College London, with Professor Sir Simon Wessely and Professor Gillian Baird as vice chairs. Its main conclusion is short. At the moment, you usually have to wait for a diagnosis before you get help. The review says that is the wrong way round. Professor Fonagy put it plainly. "A diagnosis at the end of a four-year wait is not a help," he said. The review found that mental distress has risen a lot among children and young people. It pointed to several reasons, including social media, money worries, uncertainty about the future, poorer sleep, and feeling less connected to other people. It also looked at the sharp rise in ADHD and autism referrals and diagnoses. Here it was careful. Referrals and diagnoses have gone up a long way, but the share of the population who actually have these conditions looks broadly steady. The review said it could not "conclude that overdiagnosis is occurring at scale". The government's main commitment is that people should be able to get advice and support for distress without first needing a clinical diagnosis. A full Mental Health Strategy is due later this year. Four other commitments matter: - All ADHD and autism diagnostic assessments are to become an activity regulated by the Care Quality Commission, covering NHS-funded, non-NHS-funded and self-funded patients alike. - The Health and Social Care Secretary is writing to the Advertising Standards Authority about adverts for these services. The review recommended banning direct-to-public advertising of NHS-funded assessments. - NHS England will consult on a national set of prices for NHS-funded autism and ADHD services, with final payment arrangements intended from April 2027. - The government will work with NICE to "urgently consider the implications of the report for its guidance". Yvette Cooper MP, the Secretary of State for Health and Social Care, said it was "clear that mental health services need to change to focus more on the early support young people need".
Why this matters
Think about what a waiting list actually does to a family. A child is struggling at school. Perhaps they cannot sit still, cannot cope with noise, or have stopped wanting to go in at all. The family asks for help, and is told they need an assessment first. Then they are told how long the queue is. Nothing happens in that gap. Everyone waits for a letter. That gap is what the review is aiming at. Its argument is not that diagnosis does not matter. Professor Fonagy was clear on this too: "Diagnosis remains essential and must be protected." The argument is that help should not be locked behind it. The second reason this matters is money and trust. Long NHS queues have created a large private market for these assessments. Some of that is good, honest practice. Some of it is not. Bringing every assessment under Care Quality Commission regulation sets one quality bar for all of them, and national prices are meant to stop the NHS being overcharged when it pays a private provider. The numbers are not small. Mental health spending in England is forecast to reach a record £16.1 billion this year. An interim report by Alan Milburn found that among 16 to 25-year-olds not in education, employment or training, 24% gave depression or anxiety as their main limiting condition and 22% gave autism. That is a lot of young lives, and a lot of public money, organised around a queue.
What the evidence actually says
This story can easily be over-read in either direction, so a few distinctions are worth making. This is a review plus a government response. It is not a change in the law, and not a new entitlement you can claim this week. The review has advised; the government says it agrees with the direction. What actually changes depends on what gets implemented, and when. Be careful with the overdiagnosis question. The review did not say ADHD and autism are being overdiagnosed. It also did not say they definitely are not. It said referrals and diagnoses have risen significantly, that underlying prevalence looks broadly stable, and that it could not conclude overdiagnosis is happening at scale. That is more cautious than most headlines on this subject, and the caution is the point. The authors were also open about a gap in their own work. They said they did not know how much investment the changes would need, and were not asked to examine costs. That is the biggest open question in the announcement. Several figures quoted alongside the review are existing programmes, not new money announced today: Mental Health Support Teams in every school and college by 2029; NHS Talking Therapies expanding so 915,000 people can complete treatment by March 2029; 159 new community mental health centres and emergency departments; and £7 million for Early Support Hubs in 2026/27. Real commitments with real dates, but not all brand new today. Charities were broadly positive, not uncritical. The Centre for Mental Health, Mental Health Foundation, Rethink Mental Illness, Mental Health UK, Barnardo's and the Royal College of Psychiatrists all welcomed the direction. Several added the same two warnings: it needs funding, and people with severe needs must not lose specialist care as the system shifts towards early help. Both are fair.
Qurexa perspective
We are a healthcare logistics company in Lincolnshire, not a mental health service, so we will stick to the part we actually see. Plenty of the people we deliver to take medication every day, and some take ADHD medication. Those medicines come with stricter rules than most. Supplies have been tight at times in recent years, prescriptions can need more checks, and a missed repeat is more disruptive than it sounds. Whether people get help earlier is not our department. What happens once a prescription exists is: making sure it arrives on time, without someone taking a morning off work to collect it.
Practical advice
Nothing announced today changes what you can do this week. These routes already exist. **You do not need a diagnosis to ask for help.** This is the most useful thing to take from the review. If you or your child are struggling, you can ask for support now, without waiting for an assessment. **Start with your GP.** They can refer you, and point you to local services you may not know about. **In England, you can refer yourself to NHS Talking Therapies.** No GP needed first. It covers common problems like anxiety, low mood and depression for adults. **Ask the school.** Mental Health Support Teams are already in many schools and colleges, and six million pupils can now access NHS mental health support in school. Ask who the pastoral or mental health lead is, and what is available without a referral. **If you are already on a waiting list, stay on it.** Getting earlier support does not mean losing your place in the queue. The review was explicit that diagnosis still matters. **If you are paying privately, check the provider.** Assessments are set to come under Care Quality Commission regulation. Until then, it is reasonable to ask who regulates them, what the assessment includes, and whether your GP can work with the result. A good provider will not mind being asked. **Keep taking prescribed medication.** Do not stop or change a dose because of a news story. Speak to your prescriber or pharmacist first. **If things are urgent, do not wait.** NHS 111 can direct you to urgent mental health help. Samaritans is free, day or night, on 116 123, or text SHOUT to 85258. If someone is in immediate danger, call 999.
What to know
A major independent review, published on 9 October 2026 and chaired by Professor Peter Fonagy, has told the government that help for mental distress should not be locked behind a diagnosis. The government agrees with that direction. The commitments: support without needing a clinical diagnosis first; all ADHD and autism diagnostic assessments to become regulated by the Care Quality Commission; a letter to the Advertising Standards Authority about adverts for these services; an NHS England consultation on national prices, with final arrangements intended from April 2027; and a review of NICE guidance. A full Mental Health Strategy is due later this year. The review did not find that overdiagnosis is happening at scale, and it did not cost its own recommendations. The practical message is simpler than the policy. You do not have to wait for a diagnosis to ask for help, and the people who can help are reachable now. Sources: Department of Health and Social Care, "Government pledges earlier support to tackle mental health crises", 9 October 2026, https://www.gov.uk/government/news/government-pledges-earlier-support-to-tackle-mental-health-crises | Fiona McDonald, Healthcare Leader, "Government commits to mental health, ADHD and autism support overhaul", 9 October 2026, https://healthcareleadernews.com/news/government-commits-to-mental-health-adhd-and-autism-support-overhaul/ | Department of Health and Social Care, "Independent review into mental health conditions, ADHD and autism: terms of reference", GOV.UK, https://www.gov.uk/government/publications/independent-review-into-mental-health-conditions-adhd-and-autism-terms-of-reference This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. If you are worried about your mental health, or about a child's, please speak to your GP or another healthcare professional.
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