Health Secretary Wes Streeting has commissioned an independent review to examine the increasing demand for mental health, ADHD, and autism services throughout England.
The review will investigate potential over-diagnosis in these areas, while also identifying existing gaps in support services.
The government stated it is already investing in the expansion of these services, but acknowledged significant waiting times for therapy in numerous regions.
NHS data indicates a notable rise in the prevalence of mental health issues and ADHD over the past two decades, prompting government concerns that some individuals referred to waiting lists may not require treatment.
Earlier this year, Streeting indicated in an interview with the BBC’s Laura Kuenssberg that mental health conditions were potentially being over-diagnosed, leading to individuals being prematurely “written off.”
However, in an opinion piece published in the Guardian on Thursday, he admitted his previous statements “failed to capture the complexity of this problem” and were a misstep.
He stated that following the interview, he determined that “this issue was too important to be left unresolved and required a proper evidence base”.
In announcing the independent review, he emphasized, “We must look at this through a strictly clinical lens to get an evidence-based understanding… That’s the only way we can ensure everyone gets timely access to accurate diagnosis and effective support.”
This initiative comes as ministers seek solutions to a growing welfare bill, although the Department of Health and Social Care (DHSC) has clarified that the review is being conducted independently.
While certain benefits necessitate individuals to demonstrate the impact of a health condition on their ability to work, a formal diagnosis is not always a strict requirement.
Earlier in the year, the government reversed course on proposed cuts to disability benefits, including those for individuals with mental health conditions, following substantial opposition from over 100 Labour backbenchers.
However, on Monday, the prime minister pledged a renewed effort to reform the welfare system, arguing it had “trapped people in poverty” and prematurely deemed “young people… too ill to work.”
The review, led by clinical psychologist Prof Peter Fonagy, is expected to publish its findings in the summer.
Prof Fonagy stated that the goal is to “test assumptions rigorously and listen closely to those most affected, so that our recommendations are both honest and genuinely useful”.
NHS statistics indicate that 22.6% of adults aged 16 to 64 reported experiencing mental health problems in 2023-24, an increase from 17.6% in 2007.
These rates are higher among young people and the unemployed.
Concurrently, 14% of adults are reporting ADHD symptoms, up from 8% in 2007, although experts suggest that only approximately 5% meet the criteria for clinically diagnosable ADHD.
As of March, about four million working-age adults in England and Wales were receiving disability or incapacity benefits, a rise from almost three million in 2019, according to research by the Institute for Fiscal Studies.
The DHSC acknowledged that the escalating pressure on the NHS means that “for too long, people with acute needs have faced long waits, had to navigate overstretched services, experienced inequalities in care and felt abandoned when support was needed most”.
Jenny Tan, a 23-year-old student from Surrey, illustrates the challenges. It took her almost two years to receive a diagnosis of anorexia, by which point the hospital informed her that she had one of the most severe cases they had ever encountered.
She dismisses the idea of over-diagnosis in her situation as a “joke.” “I fought so hard for a diagnosis, it took years,” she emphasized.
The review will analyze the effectiveness of NHS services and explore avenues for earlier intervention and support.
Government sources indicated a desire to establish a benchmark for diagnoses and define high-quality care standards.
It is believed that one factor contributing to lengthy waiting times is the referral of individuals who may not require specialized treatment, but could benefit from practical support such as assistance with social or financial issues, or short-term talking therapy.
Investments are already being directed towards bolstering support in schools and expanding access to talking therapies.
London GP Prof Sir Sam Everington, president of the Royal College of GPs, reported a “sharply increased” workload related to mental health patients in recent years.
“There’s a lot of pressure from social media for people to have a diagnosis.
“So you give everyone a medical badge of anxiety or depression or medical diagnosis, when a lot of this is just the ups and downs of everyday life.
“I think the message we give all the time is, actually, we’ve got the answer to somebody’s problem and there’s a pill, there’s a silver bullet that actually is going to resolve all this. Well, it’s not”.
Mental health charity Mind has welcomed the government’s announcement and indicated its readiness to contribute to the review.
“This is a huge opportunity to really understand what is driving increasing levels of mental illness, especially among our young people,” stated chief executive Dr Sarah Hughes.
The National Autistic Society commented that “We need urgent action because, while we are currently seeing the number of people seeking an assessment levelling out, the average waiting time is rocketing.”
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