An independent review into mental health conditions, ADHD and autism has published its interim report, finding that rising diagnoses and service demand are not always matched by increases in underlying population prevalence.
The review, commissioned to address mounting pressure on services across England, found that while diagnoses for ADHD and autism have surged in recent years, population surveys suggest the underlying prevalence of these conditions has remained relatively stable. For common mental health conditions such as anxiety and depression, however, prevalence has increased significantly – particularly among young people.
The report, which does not yet offer conclusions or recommendations, aims to clarify how changes in population prevalence, psychological distress, recorded diagnoses and service demand relate to one another.
For ADHD, NHS England data shows the number of children and young people waiting for an assessment surged from around 21,000 in April 2019 to approximately 270,000 by December 2025. Diagnoses among women aged 20 to 24 more than doubled compared with pre-pandemic trends. Yet population surveys suggest ADHD prevalence has remained stable at around 5% in children and 2 – 3% in adults.
A similar pattern emerges for autism. While parent-reported autism rose by around 25% between 2022 and 2024, and diagnoses in primary care increased sharply, particularly among females and young people without learning disability, population surveys suggest adult autism prevalence has remained broadly stable at around one in a hundred.
The review found that psychological distress has increased most clearly among younger people, marking a significant shift in age-based patterns. Historically, distress tended to be higher in midlife; now young adults report higher levels than older age groups.
The largest increases among young people are seen in emotional symptoms, loneliness, sleep problems and difficulty concentrating. The report notes that functional impairment has also increased over time, meaning these difficulties are not only more frequently reported but also more disruptive to daily life.
The review concludes that rising demand for mental health and neurodevelopmental support cannot be explained by a single narrative. While psychological distress has increased among young people, rising ADHD and autism diagnoses appear to outpace underlying prevalence, reflecting improved recognition, changing help-seeking, and system pressures.
It suggests that current pathways are too dependent on formal diagnosis, leading to long waits and fragmented support. The next phase will explore how to organise support around functional need alongside diagnosis, enabling earlier, more proportionate interventions while ensuring specialist services remain available for those with the most complex needs.
There are also plans to deepen analysis of inequalities across age, ethnicity and deprivation, and to examine who is still being missed by services. A final report with recommendations is expected to follow.
The interim report can be accessed here.
Photo: Tara Winstead
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