Children, young people and adults experiencing mental distress will be offered broader support much earlier, without needing to wait for a formal diagnosis, under plans unveiled by the Government as part of a wide-ranging reform of mental health services in England.
The commitment follows the publication of the Independent Review into the prevalence of and support for mental health conditions, ADHD and autism, which found a significant rise in mental distress among children and young people. The forthcoming Mental Health Strategy will place prevention and early intervention at its heart, ensuring people receive support based on need rather than solely on diagnosis.
Chaired by leading clinical psychologist Professor Peter Fonagy, with support from vice chairs Professor Sir Simon Wessely and Professor Gillian Baird, the review concluded that rising levels of mental distress are being driven by a combination of factors including social media use, financial insecurity, uncertainty about the future, reduced sleep quality, and declining feelings of connection and belonging.
While referrals and diagnoses for ADHD and autism have increased sharply in recent years, the review found that the overall prevalence of both conditions across the population has remained broadly stable.
The findings were reinforced by the interim report from Alan Milburn's review of Young People and Work, which highlighted the growing link between mental health challenges and economic inactivity among younger people. Among 16 to 25-year-olds not currently in education, employment or training, 24% cited depression or anxiety as their primary limiting condition, 22% cited autism, and 18% reported another mental illness.
The Government says it will reshape support across every stage of life, expanding assistance in schools, colleges and community settings to provide earlier interventions, reduce long waiting times and ensure help is available before a diagnosis is made.
Where clinically appropriate, access to diagnosis and treatment, including medication, will continue to be available.
As part of the reforms, NHS leaders have been asked to urgently review how patients can access advice, assessments and treatment more easily and efficiently.
The measures will complement the Government's recently announced £4 billion package for children with special educational needs and disabilities (SEND), which aims to improve school inclusion, increase access to specialist services and provide training for all teachers.
A key recommendation from the review is stronger regulation of ADHD and autism assessment services.
The Government has pledged to explore measures that would make all ADHD and autism diagnostic assessments a Care Quality Commission (CQC)-regulated activity, regardless of whether services are delivered through the NHS, privately funded or self-funded by patients.
Additional proposals include:
- Enhanced oversight of assessment providers through closer collaboration between NHS England and the CQC.
- A review of advertising practices for ADHD and autism services, including discussions with the Advertising Standards Authority to address concerns around potentially misleading marketing.
- Development of a national tariff for NHS-funded ADHD and autism services, creating greater consistency and transparency across assessments, follow-up care and post-diagnostic support.
- A review of clinical guidance with the National Institute for Health and Care Excellence (NICE) to ensure services reflect the latest evidence-based practice.
The proposed national tariff is expected to improve value for money and reduce variations in service quality, with NHS England aiming to introduce new payment arrangements from April 2027.
Secretary of State for Health and Social Care Yvette Cooper said:
“Professor Fonagy’s review has shown the importance of early intervention to address mental health and neurodevelopmental conditions and the huge distress these can cause. It is clear that 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. We will set out our response in a new Mental Health Strategy in the coming months, building on the new mental health services we are already providing in schools and in the community.
“Based on the review findings, we will also take action to strengthen the oversight of mental health and neurodevelopmental services, and 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.”
Alongside regulatory reforms, the Government highlighted several initiatives already underway to improve access to support and reduce waiting times.
These include:
Supporting Families in the First 1,001 Days
Building on the Healthy Babies programme currently operating in 75 local authorities, every family in England will gain access to enhanced support covering infant feeding, parental mental health and parent-child bonding during the critical period from pregnancy to a child's second birthday.
Expanding Mental Health Support in Education
Mental Health Support Teams will be rolled out to every school and college by 2029, with nearly 800,000 additional children and young people expected to benefit this year. A further £7 million will be invested in Early Support Hubs during 2026/27.
Transforming SEND Support
The Government will invest £1.8 billion over three years through its new Experts at Hand programme, bringing educational psychologists, specialist teachers, speech and language therapists, occupational therapists and other professionals into mainstream education settings.
Increasing Access to Community Mental Health Services
Mental health spending is forecast to reach a record £16.1 billion this year. Funding will support the expansion of NHS Talking Therapies, with the ambition for 915,000 people to complete treatment by March 2029. Ministers also plan to establish 159 new mental health centres and mental health emergency departments to improve access to urgent support closer to home.
The Government says further details will be included in its cross-government Mental Health Strategy, due later this year, bringing together immediate reforms and long-term measures designed to improve mental health outcomes and ensure support is available earlier and more consistently across England.
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