The UK government has announced plans to reshape mental health services in England, with a stronger emphasis on early intervention and access to help based on individual needs rather than waiting for a formal diagnosis.
The commitment follows the publication on October 9 of an independent review led by Professor Peter Fonagy, which examined mental health conditions, attention deficit hyperactivity disorder (ADHD) and autism.
The government intends to outline its response in a forthcoming Mental Health Strategy, aiming to reduce waiting times, improve access to community-based support and help people remain in education, employment and social life.
Review Finds Growing Mental Distress Among Young People
The Fonagy Review found that mental distress has increased substantially among children and young people.
It identified several possible contributing factors, including social media use, financial insecurity, uncertainty about the future, poor sleep and declining feelings of connection and belonging.
Although referrals and diagnoses for ADHD and autism have risen significantly, the review found that the overall prevalence of these conditions in the population appears broadly stable.
The findings highlight the need to distinguish growing demand for assessments and support from changes in the underlying prevalence of neurodevelopmental conditions.
Young People Face Barriers to Education and Employment
The review’s findings also raise concerns about the impact of mental health difficulties on young people’s ability to study and work.
An interim report from Alan Milburn’s review of young people and employment found that, among 16 to 25-year-olds not in education, employment or training, 24 per cent identified depression or anxiety as their main limiting condition.
A further 22 per cent cited autism, while 18 per cent identified another mental illness.
The government says earlier support could help young people remain in education, enter the workforce and participate more fully in their communities.
Diagnosis Will Not Be the Only Route to Help
Under the proposed approach, people experiencing mental distress would be able to access advice and appropriate support without first completing a clinical assessment.
Schools, colleges and community services are expected to play a greater role in identifying difficulties early and connecting people with assistance before their circumstances deteriorate.
However, the government has stressed that clinical diagnosis and treatment will remain important where medically appropriate, including when medication or specialist intervention is required.
Professor Fonagy said diagnosis must be protected but should no longer be the only gateway to support. He argued that services should focus more broadly on wellbeing, participation in education and work, and maintaining connections with local communities.
Government Plans Tighter Regulation of ADHD and Autism Assessments
Alongside the wider mental health reforms, ministers intend to strengthen oversight of ADHD and autism assessment services.
The government is working with NHS England and the Care Quality Commission (CQC) towards making all diagnostic assessments for the two conditions a regulated activity. The proposed approach would cover NHS-funded assessments, other publicly funded services and people paying privately.
The aim is to improve clinical standards, protect patients from poor-quality providers and give families greater confidence in the accuracy of diagnoses.
Health and Social Care Secretary Yvette Cooper said stronger oversight would also help ensure the NHS is not overcharged by independent or private providers.
Advertising Practices and Clinical Guidance Under Review
The government plans to raise concerns about advertising for ADHD and autism services with the Advertising Standards Authority.
The proposed review is intended to help ensure that promotional material provides accurate information and does not encourage people to seek assessments they may not need.
NHS England will also consult on a national pricing system for NHS-funded ADHD and autism services. The proposed tariff would cover assessments, follow-up appointments and post-diagnostic support, with finalised payment arrangements intended to begin in April 2027.
Ministers will work with the National Institute for Health and Care Excellence (NICE) to consider whether its clinical guidance on ADHD and autism needs updating in light of the review.
Schools and Communities Set for Expanded Support
The government has outlined several existing and planned measures intended to improve access to help for children, young people and families.
Mental Health Support Teams are due to be rolled out to every school and college by 2029. The government says nearly 800,000 additional children and young people are expected to be reached this year, alongside £7 million for Early Support Hubs during the 2026/27 financial year.
A separate programme will extend practical support for families during the first 1,001 days from pregnancy until a child reaches two years old. Building on the Healthy Babies programme already operating in 75 local authorities, the expansion is intended to improve access to infant-feeding advice, parental mental health support and help with forming secure attachments.
£1.8 Billion Education Investment Targets Specialist Support
The mental health plans will operate alongside the government’s wider £4 billion package for children with special educational needs and disabilities.
As part of the reforms, £1.8 billion will be invested over three years in the Experts at Hand initiative, bringing professionals such as speech and language therapists, occupational therapists, specialist teachers and educational psychologists into mainstream schools, early-years settings and colleges.
The government also intends to provide training for every teacher and strengthen inclusive education, with the aim of helping children receive appropriate support without unnecessary delays.
NHS Mental Health Services Set for Further Expansion
The government says mental health spending is forecast to reach a record £16.1 billion this year.
Its plans include expanding NHS Talking Therapies so that 915,000 people can complete a course of treatment by March 2029. It is also rolling out 159 new mental health centres and mental health emergency departments across communities.
According to Dr Nick Broughton, the national programme director for mental health, learning disability and neurodevelopmental conditions at NHS England and the Department of Health and Social Care, six million pupils can already access NHS mental health support in schools.
He said the NHS would need to work with other sectors to respond to growing demand and ensure young people receive help as societal pressures and technology continue to evolve.
Mental Health Organisations Call for Action
The review has received support from several organisations, although their representatives have stressed that announcements must lead to practical improvements.
Andy Bell, chief executive of the Centre for Mental Health, said rising distress among young people required decisive action and called on the government, local authorities, businesses and civil society to contribute to the response.
The Mental Health Foundation also welcomed the review’s recommendations, with its director of policy and influencing, Alexa Knight, arguing that attention should now turn to prevention and reducing the pressures contributing to poor mental health.
Future Minds campaign representatives similarly called for stronger investment and intervention, saying that many children and young people still cannot access the help they need.
Charities Warn That Long Waiting Lists Remain a Serious Problem
Barnardo’s chief executive, Lynn Perry, said children and families were frequently left dealing with lengthy waits for assessments, diagnoses and support.
She highlighted how mental health difficulties can overlap with poverty, insecure housing and special educational needs, leaving families to navigate fragmented services.
Rethink Mental Illness chief executive Mark Winstanley also warned that people with severe and complex conditions must not lose access to specialist care as earlier support is expanded.
The Royal College of Psychiatrists president, Professor Subodh Dave, called for shorter assessment waiting lists, better access to specialist treatment and a larger workforce capable of responding to complex needs.
Digital Services and Joined-Up Care Form Part of the Response
Mental Health Innovations chief executive Victoria Hornby welcomed the proposed shift away from making diagnosis the only route to assistance.
She said digital services could complement support provided through schools, communities and specialist services, noting that the organisation’s Shout and The Mix platforms had supported more than 300,000 young people over the previous year.
The NHS Alliance’s chief executive, Sir Ciarán Devane, also welcomed the review’s emphasis on prevention and early intervention while maintaining access to high-quality specialist NHS care.
New Mental Health Strategy Expected to Set Direction
The government says its forthcoming Mental Health Strategy will bring together immediate reforms and longer-term measures to improve access to services across England.
The central aim is to create a system in which people can receive appropriate help earlier, while preserving timely diagnosis and specialist treatment for those who need them.
The review has established a broad direction for change, but charities and professional bodies say its success will depend on implementation, sustained investment, shorter waiting times and better coordination between health, education, employment and community services.
