Ryan and his wife knew there was something different with their son Atlas when he was around 12 to 18 months old and missing development milestones.

But it took three years to get an autism assessment. As time passed, his needs became increasingly clear. Now nearly seven, Atlas is non-verbal, still wears nappies and relies on others for all aspects of daily care.

Despite this, Ryan says there was no fast-track route for children with the most complex needs. "You basically go on the list and wait however long until you get to the top."

The wait left the family racing against time to secure support before Atlas started school. Ryan and his wife feared he would be placed in a mainstream school.

"We were terrified," Ryan says. "Anyone who has a child like Atlas will have the same panic that they'll start in a mainstream school where it's not safe."

The strain was immense. "It was like I had two jobs," Ryan adds. "I was going to work and then coming home and dealing with these things."

Atlas was eventually diagnosed only months before starting school.

Image source, Getty Images

Children are distressed and the Fonagy review "highlights an urgent truth", the children's commissioner for England says.

"We must confront the difficult questions about changes in childhood, and we must build a world in which they can thrive," Dame Rachel De Souza says.

She points to the story behind the data, which is "children whose lives are on hold for months and, in some cases, years waiting for support they urgently need".

De Souza, who contributed to the review, says its findings on under-diagnosis, mis-diagnosis and over-diagnosis fit with what she hears from children and professionals.

She goes on to repeat calls for an overhaul of mental health, community health, social care and education systems so that they can "put the needs of [a] child above an insistence on diagnosis".

BBC Breakfast has been speaking to comedian Paul Whitehouse and Dr Mine Conkbayir, who host the podcast I'm ADHD, No You're Not.

Conkbayir says that getting diagnosed with ADHD "makes a fundamentally huge difference", citing her own experience and describing her diagnosis as "really helpful".

"I now understand where I trip up, where I struggle and I can tell people in advance."

Some of these struggles include following multi-step instructions and losing the thread of what she's being told, she says.

Whitehouse notes that while he's seen "a split" in whether people find a diagnosis helpful, it has helped many people "understand their behaviours much better" and "not just think of themselves as lazy - this is what they're labelled".

Image source, BBC Breakfast

Professor Peter Fonagy, who chaired the review, has outlined three key findings in an interview with BBC Breakfast:

• A "very real substantial rise in mental ill-health", particularly among young people - it increased by 50% between 1993 and the present day
• An increase in the "co-occurrence of different diagnoses", meaning more people have common mental disorders (like anxiety and depression) as well as ADHD and autism
• An increase in the number of diagnoses of people with ADHD and autism, rather than a rise in how many people have either condition

Erica Witherington
Disability affairs reporter

Image source, Handout

At school, Erin says it might have looked from the outside as though she was thriving. She was ambitious, sociable and getting good grades.

Inside, though, she says she was struggling to stay afloat.

She developed anorexia, became a young carer while her mother received palliative care, and later had to deal with her death.

When overwhelmed, Erin says she sometimes went into shutdown and couldn't speak.

"I could know exactly what I wanted to say, but I physically couldn’t get the words out," she says.

Erin, now 21, was diagnosed as autistic at college. She says it finally helped her to understand what sort of support she needed, and to stop asking herself, "Why can't I just cope?"

But she believes getting support shouldn't have to wait for an autism diagnosis.

"Waiting several years isn't simply waiting for a piece of paper," she says.

"Those are years in which a young person is still developing their identity, and potentially struggling without understanding why."

Nick Triggle
Health correspondent

This review was ordered 10 months ago by Wes Streeting after the then-health secretary claimed in an interview that young people were over-diagnosed and "written off".

It is likely to feed into government policies on everything from NHS services and benefits to support for young people who are not in education, employment or training – all of which have been the focus of intense scrutiny and debate.

The review touches on how NHS services are organised – it is critical of long waiting lists for assessment – but also wider support provided by society in places such as schools and workplaces.

It will have implications for access to benefits and special education needs provision.

The government is not making any firm promises at the moment beyond saying they will be looking to reform the way systems work.

Image source, Getty Images

Reacting to the review, Mind’s chief executive Dr Sarah Hughes says today’s findings confirm what her team has seen across their services “for years”.

“Young people are crying out for help with their mental health because of genuine life challenges, and it’s time to listen,” she says.

Early intervention prevents needs from escalating, Hughes says, as the charity calls on the government to adopt a same-day open access model in the Mental Health Strategy for England.

While welcoming the government’s commitment to provide “earlier, more open access support”, Hughes says that long term “we need to ensure people can get the help they need on the day they reach out”.

Image source, BBC Breakfast

Bridget Phillipson, the Labour Party's chair, is doing the government's media round this morning.

Appearing on BBC Breakfast, she's asked about the Fonagy review, and says "diagnosis should not be the only means by which we put in place support that children need".

Instead, she says, "we need to support families earlier... helping families and children where needs are starting to emerge including in areas like speech and languages support where we know we can do a lot sooner".

More generally, Phillipson says "better access to mental health services" is needed "in the community and also in schools" - adding that the government is working on this.

"We need to support young people's mental health early," report author Prof Peter Fonagy tells the Today programme, adding that this support should be available where they live.

He adds that diagnosis should not be "the only route" to accessing help, and that a lot of support has been "taken away" from young people and replaced with phones, social media and academic pressure.

"Rebuilding this support must be a priority," he says.

Fonagy wants to see "a reorganisation of the current system, which is incoherent".

He hopes the government will implement changes laid out in the report because it is "the only solution we think to a system that is currently not serving patients, not serving professionals and not serving society".

The author of today's report, Prof Peter Fonagy, has been speaking to Radio 4's Today programme.

He starts by saying that former Health Secretary Wes Streeting - who first commissioned the review - was "with respect, completely wrong" when he talked about an over-diagnosis of mental health disorders.

His findings show that "there has been a rise in distress and mental ill health amongst young people which is very, very real," he says, noting that one in five cases require treatment.

Fonagy says that mental health distress in 25-year-olds is up by 50% since 1993, particularly anxiety and depression.

He says that these "worsen the traits of ADHD and autism" so as awareness of these conditions has increased, "it's not surprising" that people are turning to diagnosis as an "explanation of what they feel".

"Properly done" diagnosis is "incredibly important and quite complicated", Fonagy says as he calls for "national standards in assessment".

While some independent providers "are excellent", Fonagy says the market is "quite easy to enter into" and is "unregulated".

Image source, PA Media

Health Secretary Yvette Cooper has welcomed the findings of the review, saying that they show "the importance of early intervention to address mental health and neurodevelopmental conditions".

Cooper says mental health services need to "change to focus more on the early support young people need to stay in education or work or keep their lives on track".

The government will be working on a new Mental Health Strategy, she adds, seeking to "make all diagnostic assessments for ADHD and autism CQC-regulated, so people can be confident that assessments are high quality and that the NHS is not being overcharged by independent or private providers".

Nick Triggle
Health correspondent

There is a lot of focus on the question of over-diagnosis – and what the review has to say about that.

But the authors were also concerned about the impact of diagnosis. They say there was a risk an ADHD, autism or mental health diagnosis ends up closing doors.

It can, they note, act as a label that defines them by their “difficulties” rather than “strengths and potential”.

This then hampers them in education, work and relationships.

Around a third of 16 to 24-year-olds not in education, employment or training (Neet) report their mental health or autism as a factor.

Those diagnosed with ADHD before the age of 17 are four times more likely to be a Neet than those without.

Addressing this, they say, would require better support post-diagnosis. Some of that is down to the NHS, but equally as important is the approach of schools, workplaces and wider society.

Image source, PA Media

The review published today was commissioned by former health secretary Wes Streeting, following reaction to comments he himself made to the BBC.

In March 2025, Streeting told the BBC's Sunday with Laura Kuenssberg programme that he believed there was an "over-diagnosis" of mental health conditions, with "too many people being written off".

"Mental wellbeing, illness, it's a spectrum and I think definitely there's an over-diagnosis but there's too many people being written off," he said, adding that there were also "too many people who just aren't getting the support they need".

In December of that year, he wrote an editorial for the Guardian acknowledging his comments had been "divisive" and that better evidence was needed.

"I was... deluged with messages and emails of both enthusiastic agreement and visceral disagreement – including from mental health clinicians on both sides of the argument," Streeting wrote.

"The truth is there has been a massive growth in mental health and behavioural issues and there isn't a consensus within the mental health clinical community on what is driving it," he added.

Gabriela Pomeroy
Live reporter

Image source, Mark Greenfield

I spoke to a Mark Greenfield, a child and adolescent psychotherapist who has worked with dozens of clients with either ADHD, autism or both, alongside other neurodivergent conditions - some as young as four years old.

Among his clients, he says he is seeing many young people who have "a weight on their shoulders with regards to inclusion" and feel like a "square peg in a round hole". He says they need to be "met, understood and supported".

"Attention deficit hyperactivity disorder - that is two very denigratory words that don't reflect the condition very well. We are facing the stigma of a condition that is badly named," he says and urges for it to be changed.

"But I do wonder if the name leads to medication, so calling something a disorder might be the way they can guarantee a medical or clinical intervention."

The question of overdiagnosis is "complex", he says. "There is a disparity between people with money who can get a fast diagnosis, and people who have to wait for years on the NHS.

"It might be argued that overdiagnosis is a feature of some clinics that maybe have a different way of assessing for neurodivergence," Greenfield tells me.

The independent review raised concerns over the "consistency and quality" of assessments carried out by private providers, which carry out more than half of NHS-funded ADHD and a third of autism assessments.

NHS figures, external show the number of children and young people in contact with mental health services in England has risen by 50% in the past five years.

Figures published in November last year, showed that the proportion of 16 to 24-year-olds with a common mental health condition rose from 17.5% in 2007 to 25.8% in 2023/4.

It found that younger adults were more likely to report self-harm and screen positive for disordered eating symptoms, PTSD and ADHD than older age groups.

But the figures did show a drop in "drinking at hazardous levels or above", with it halving among 16 to 24-year-olds – from 40.7% in 2000 to 18.1% in 2023/4.

Prof Peter Fonagy, who led the independent review, has dismissed the idea that young people are "a snowflake generation".

Fonagy told the BBC before the report was released that he is "in awe of the way they [young people] have adjusted to an environment that is far more difficult than I ever had to face".

Economic and employment uncertainty paired with the pressures of social media have created a "very toxic" environment for young people, the review's chief said last month.

"Adults have let them down. We're the first generation that probably collectively feels we had a better life than our children will have.

"So, to the person who says it's a snowflake generation, just try living 24 hours as a 16-year-old."

• We're expecting to hear from Fonagy a bit later on BBC Radio 4's Today programme about the findings of the review

Nick Triggle
Health correspondent

Mental ill health includes conditions such as anxiety, depression and eating disorders. They can arise at any stage and life and may come and go. They often respond well to treatment.

ADHD and autism are neurodevelopmental conditions, strongly genetically influenced and present from early life. They affect attention, communication and behaviour.

With the right adjustments, many people live full lives - although some face substantial difficulties and their condition is accompanied by a learning disability.

Traits relating to these conditions – inattention, social difficulties and emotional regulation – occur in varying degrees across the population, but that is not the same as having a diagnosable condition.

Image source, Getty Images

An official review in England has found there is a risk of people being over-diagnosed with ADHD and autism.

Experts say a rise in diagnoses over the past 25 years means cases now appear to be outstripping the expected number in the population for some younger age groups.

The review also says the rise in mental health problems that has been seen among young people is real and there needs to be better support in place.

Published overnight, the report by Prof Peter Fonagy was commissioned 10 months ago by then-health secretary Wes Streeting and applies to England only.

It comes as NHS figures, external show the number of children and young people in contact with mental health services in England has risen by 50% in the past five years.

Fonagy, a clinical psychologist and adviser to NHS England, told the BBC last month the review "dismisses the idea of a snowflake generation" and insisted "it's harder to be young now". He'll be speaking to Radio 4's Today programme from 07:50 BST.

Stick with us as we bring you the key findings from the review and analysis from experts.