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ADHD and autism overdiagnosis debate

Far more people in England are diagnosed with ADHD and autism than 25 years ago. People disagree over whether ordinary difficulties are being given medical labels, or people who were missed for years are at last being recognised. A government review reported on 9 October 2026 that it could not show overdiagnosis on a large scale, partly because the data are out of date. It wants help to be given on need, without waiting for a diagnosis.

Updated 12 October 2026 (5 minute read)

AutonomyBeneficenceNon maleficenceJustice
  1. Health Secretary agrees mental health problems are overdiagnosed
  2. Government orders an independent review
  3. Review publishes its interim report
  4. Final report and the government's reply

Summary

  • ADHD (attention deficit hyperactivity disorder) and autism are conditions present from early life that affect attention, communication and behaviour.
  • No blood test or scan confirms either one. A specialist judges whether the traits last, appear in more than one setting and disrupt daily life.
  • The argument compares two kinds of figure:
    • GP records count diagnoses. Among 12 to 17 year olds in England, the share with an autism diagnosis rose more than 40 times over, from 0.10% in 2000 to 4.06% in 2025.
    • Surveys estimate how many people have a condition, diagnosed or not. The last, in 2017, put autism at about 1.2% of young people.
  • People read that gap in two ways:
  • Wes Streeting, then Health Secretary, agreed on television on 16 March 2025 that mental health problems are overdiagnosed.
  • That December the government ordered an independent review, chaired by the psychologist Professor Peter Fonagy.
  • Its final report on 9 October 2026 said "we cannot conclude that overdiagnosis is occurring at scale", partly because the survey data are so old.
  • It warned that if the trend continues, wrong or unnecessary diagnosis will become the bigger risk. It also found that a diagnosis has become the main way to get help.
  • The government replied the same day that support will come earlier and without a diagnosis, with diagnosis kept where it is clinically needed.
  • The detail is due in a mental health strategy later in 2026.
Fakenham Medical Centre, Norfolk

Dig deeper

  • The review separated three failures that can sit in one system together:
    • underdiagnosis, where a condition is missed
    • misdiagnosis, where the label is wrong or incomplete
    • overdiagnosis, where the label is for a condition the person does not have, or one that would not have harmed them if left undiscovered
  • An editorial by 32 specialists in the British Journal of Psychiatry argued in March 2026 that UK data point to ADHD being underdiagnosed.
  • It noted that no rigorous figures exist from after the pandemic.
  • By the end of 2025 more than 560,000 referrals for an ADHD assessment in England were still open, over 17 times the 2019 number.
  • A patient in England whose GP refers them has a legal right to choose any provider that holds an NHS contract for the service.
  • The review found that many people have used that right to reach providers outside the NHS, where waits are shorter.
  • Those providers now carry out more than half of the ADHD assessments the NHS pays for, and the review found no consistent check on their quality.
  • The review wants every assessment regulated by the Care Quality Commission (CQC), which inspects health services, and a ban on advertising NHS funded assessments to the public.
  • The government promised to work towards CQC regulation.
  • On advertising it offered a review. The Health Secretary, Yvette Cooper, will write to the Advertising Standards Authority, which rules on whether adverts are honest.
  • In May 2026 the same regulator banned adverts claiming that self swab DNA kits give evidence usable in court.
  • The National Autistic Society said the report shows that successive governments "have failed autistic people", and that a diagnosis helps most people who receive one.
  • The charity also warned that a system which "abandons those who are currently waiting for an assessment will only increase harm".

Ethical issues

PrincipleHow it applies here
AutonomyAn adult with capacity can ask to be assessed, parents usually ask for a child, and in England either can choose the provider. Whether the criteria are met is the clinician's judgement, and NICE says ADHD symptoms should cause at least moderate impairment in two or more settings. The advertising ban would limit what patients hear about their options, so that clinical need decides who is assessed.
BeneficenceThe review calls diagnosis "clinically necessary, personally meaningful and essential to treatment" for many people. It also found that a diagnosis is too often followed by no timely offer of treatment or support, and 40% of clinicians surveyed reported no ongoing support after an autism diagnosis.
Non maleficenceThe review cites evidence that difficulties get worse for more than 7 in 10 people who wait over six months. A wrong or unnecessary diagnosis does harm as well, through treatment the person did not need. The two can pull against each other, because the review found misdiagnosis more likely when an assessment is brief or not face to face.
JusticeThe review wants clinicians to reorder waiting lists by need, which pulls against autonomy because some people who want an assessment will wait longer. It found services often respond best to those "best able to navigate complex systems or pay for alternatives". The Equality Act 2010 requires no diagnosis before adjustments are made, though the review found schools often treat one as proof of need.

Interview questions

  • What do you know about the debate over ADHD and autism diagnosis?
  • Recorded autism diagnoses in teenagers have risen more than 40 times over since 2000. What might explain that?
  • What is the difference between overdiagnosis and misdiagnosis?
  • A friend is sure she has ADHD after watching videos online, and has been told the NHS waiting list is long. What do you say to her?
  • What are the arguments for and against giving support at school without a diagnosis?
  • Should people with the greatest need be assessed first, even if others who joined the list earlier wait longer?
  • Should private clinics be allowed to advertise ADHD assessments that the NHS pays for?
  • Can a diagnosis ever do harm?

Sources

  1. GOV.UKgov.uk/…/independent-review-into-mental-health-conditions-adhd-and-au
  2. mentalhealth.org.ukmentalhealth.org.uk/…/mental-health-foundation-responds-health-secretarys-overdiag
  3. GOV.UKgov.uk/…/review-launched-into-mental-health-autism-and-adhd-services
  4. GOV.UKgov.uk/…/independent-review-into-mental-health-conditions-adhd-and-au
  5. GOV.UKgov.uk/…/government-pledges-earlier-support-to-tackle-mental-health-c
  6. cambridge.orgcambridge.org/…/core-reader
  7. GOV.UKgov.uk/…/the-nhs-choice-framework-what-choices-are-available-to-me-in
  8. assets.publishing.service.gov.ukassets.publishing.service.gov.uk/…/independent-review-into-prevalence-and-support-for-mental-he
  9. autism.org.ukautism.org.uk/…/our-response-to-the-final-report-of-the-independent-review-i
  10. NICEnice.org.uk/…/Recommendations
  11. legislation.gov.uklegislation.gov.uk/…/6

Photo: Hugh Venables, CC BY-SA 2.0, via Wikimedia Commons, colour altered.

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