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The Health Secretary Wes Streeting has announced an independent review into rising demand for mental health, ADHD, and autism services in England. While the review aims to investigate “over-diagnosis” and identify gaps in support, organisations working at the frontline—such as Private ADHD—see a very different reality: a national crisis of underdiagnosed neurodevelopmental conditions and unprecedented NHS waiting lists.
For thousands of adults, children, and families across the UK, accessing ADHD assessment or mental-health support is not easy. It is a battle that often takes years.
A Review Triggered by System Pressures—but Missing the Bigger Picture
Streeting has suggested that some mental-health conditions may be over-diagnosed, noting earlier this year that people were potentially being “written off.” He has since acknowledged that his initial comments failed to capture the complexity of the issue, calling his remarks “foot-in-mouth syndrome”.
The new review—led by clinical psychologist Prof Peter Fonagy—will examine:
- whether diagnoses are being made too frequently
- how NHS services are functioning
- what early support is missing
- where thresholds for diagnosis should sit
But while the government claims some individuals may be referred unnecessarily, the data tells a different story.
The Evidence: ADHD Is Not Overdiagnosed — It Is Under-Recognised and Often Missed for Years
1. NHS ADHD waiting lists are at an all-time high
Across England:
- Children often wait 2–4 years for an ADHD assessment
- Adults are frequently waiting 3–8 years or longer
- Some regions have closed waiting lists entirely due to demand
This is not what “overdiagnosis” looks like.
This is what unmet need looks like.
2. Masking and coping strategies hide ADHD symptoms
Research has shown that ADHD often goes undetected because people learn to mask symptoms, especially:
- girls
- high-achieving pupils
- adults juggling work and family
- individuals with inattentive-type ADHD
- people who internalise symptoms rather than act out
Many people are not diagnosed until crises arise—burnout, anxiety, depression, academic decline, or workplace struggles.
3. ADHD has historically been significantly under-diagnosed
Studies consistently show lower diagnosis rates among:
- women
- ethnic minorities
- individuals from deprived backgrounds
- adults (especially those misdiagnosed with anxiety or depression)
Rising referrals reflect greater awareness, not inappropriate labelling.
Why People Are Seeking Help: A System Under Strain
NHS figures show mental-health disorders have risen from 17.6% in 2007 to 22.6% in 2023-24, with young people particularly affected.
As of this year, around four million working-age adults are on disability or incapacity benefits. But crucially, a formal diagnosis is not needed for most benefits—meaning ADHD assessments are not being pursued simply for welfare support.
Instead, families and adults are turning to the NHS because they cannot cope without answers.
A 23-year-old student interviewed in the BBC report described waiting nearly two years for an eating-disorder diagnosis—by which time she was one of the “worst cases” her hospital had seen. Her view on “over-diagnosis”?
“A joke.”
For many with ADHD, the sentiment is the same.
What’s Really Filling NHS Waiting Lists? Not ‘Overdiagnosis’—but Lack of Early Support
Government sources suggest that people who don’t need clinical treatment are being referred, adding pressure to services. But charities, clinicians, and patients report a different experience:
- Mental-health and ADHD symptoms become crises because help is not available early
- Teachers cannot diagnose or offer neurodevelopmental assessments
- Local authorities are overwhelmed, unable to meet rising SEND demand
- Waiting lists are so long that symptoms worsen before support is offered
Even GPs—who are often the first point of contact—report their workload with mental-health patients has “sharply increased.”
Some have suggested social media is influencing help-seeking behaviour. But increased awareness does not equate to inappropriate diagnosing. It means people now recognise lifelong struggles that were previously dismissed as “laziness”, “bad behaviour”, or “anxiety”.
The National Autistic Society warns that waiting times are now at crisis point, even as requests plateau.
Private ADHD’s View: We See the Real Crisis Every Day
At Private ADHD, we work closely with adults, children, and families seeking assessments not because diagnoses are “trendy”, but because their mental health, academic wellbeing, employment, and relationships are suffering.
We see:
- patients who have waited 4–7 years on NHS lists
- adults misdiagnosed for decades
- children struggling in school without formal recognition
- parents exhausted from navigating a failing system
- individuals masking symptoms until burnout or breakdown
A clinical ADHD assessment is not handed out casually. It includes:
- detailed developmental history
- validated assessment tools
- functional impact analysis
- differential diagnosis
- evaluation of comorbidities
- structured interviews
- risk assessment
The idea that these are given “too easily” is simply not reflected in evidence or practice.
The Real Crisis: Underdiagnosis + Overwhelmed NHS Services
If the government is committed to addressing the root issues, the review must focus on:
✓ Shortening NHS waiting lists
✓ Improving early intervention and school support
✓ Recognising hidden and masked ADHD presentations
✓ Increasing diagnostic capacity
✓ Funding SEND services properly
✓ Ensuring diagnostic pathways are evidence-based—not politically driven
Blaming “overdiagnosis” risks stigmatising neurodivergent individuals and deterring families from seeking help.
Conclusion: Focus on Solutions, Not Stigma
The launch of this review is an opportunity—but only if it acknowledges the truth:
ADHD is not being overdiagnosed in the UK. It is being missed.
The overwhelming number of people living with untreated, unsupported ADHD reflects a system under extreme pressure—not a population seeking unnecessary labels.
To support those most affected, what we need is:
- faster, accessible assessments
- timely intervention
- properly funded NHS and SEND services
- clinical accuracy, not political soundbites
- empathy and evidence-based care
The crisis is not people seeking diagnosis.
The crisis is the millions waiting years to receive one.
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