The UK government’s interim review into mental health conditions, autism, and ADHD has already sparked significant debate among researchers, clinicians, and academics. While the report presents itself as a balanced and evidence-led assessment, responses highlight a number of critical tensions—particularly around diagnosis, data interpretation, and the lived realities of neurodivergent people. Many of the themes below concurr with the themes and discussions emerging from the NCAMH consultation event held with practitioners on one of the BPS Approve Autism and Mental Health Training Courses – these themes have been summarised in a White Paper, “Improving Mental Health Services for Autistic and Neurodivergent People.”
A summary of the key themes and concerns arising from the Governmen’t Interim Report are as follows:
- A Central Dispute: Underdiagnosis vs Overdiagnosis
One of the most prominent themes is a fundamental disagreement with the review’s implied concern about overdiagnosis. Responses argue that the real issue remains widespread underdiagnosis, particularly among:
- Women and girls
- Older adults
- Ethnic minority groups
Critics point out that the report relies heavily on data such as the Adult Psychiatric Morbidity Survey (APMS), which estimates autism prevalence at around 1%. However, more recent research suggests this figure may be closer to 2%, with hundreds of thousands of people potentially undiagnosed in the UK.
This discrepancy matters: prevalence data directly shapes funding, service provision, and policy priorities. If large groups remain statistically “invisible,” their needs risk being systematically overlooked.
- Bias in Diagnostic Tools and Systems
Closely linked is concern about structural bias in diagnostic methods. Screening tools commonly used in research and clinical settings are said to:
- Under-detect autism in women
- Miss presentations in people of colour
- Over-rely on historically male-centric diagnostic criteria
This contributes to a skewed picture of who is autistic, reinforcing outdated assumptions and perpetuating inequality in access to diagnosis and care.
- The Danger of Misleading Public Narratives
Several responses strongly criticise how the review—and media coverage—frames the issue. Headlines suggesting people are being “incentivised” to seek diagnoses are described as:
- Oversimplified
- Stigmatising
- Detached from lived experience
In reality, diagnosis often comes with limited support and significant stigma, not advantage. More concerningly, such narratives risk undermining public trust and discouraging people from seeking help.
- Self-Identification: Misconception vs Reality
The review appears to reflect a belief that self-diagnosis may be inaccurate or driven by social media. However, emerging research challenges this assumption.
Findings suggest that individuals who self-identify as autistic:
- Show comparable levels of autistic traits to diagnosed individuals
- Often experience higher distress and unmet needs
- Use online platforms more for community and validation than misinformation
This raises questions about whether the system itself—rather than individuals—is failing to provide accessible, timely diagnosis.
- Diagnosis as a Gateway to Support
A recurring concern is that the report underestimates the functional importance of diagnosis. In practice, a formal diagnosis is often the key to:
- Educational support (e.g. EHCPs)
- Workplace adjustments
- Access to healthcare and services
- Personal understanding and identity
By casting doubt on diagnostic trends, the review risks weakening one of the few mechanisms people have to access support.
- Neglecting Systemic and Social Drivers of Distress
Another major critique is that the review shifts focus toward diagnostic legitimacy rather than addressing root causes of mental distress, such as:
- Long-term underfunding of services
- Austerity policies
- The impact of the COVID-19 pandemic
- Rising economic insecurity
Increasing distress and demand for services should be understood within this broader social context—not reduced to questions about over-medicalisation.
- A Call for a Whole-System Approach
Despite criticisms, there is some agreement with the report’s broader message: mental health cannot be addressed by the NHS alone.
There is a clear call for a whole-system response, involving:
- Schools
- Families
- Workplaces
- Communities
Importantly, this approach must prioritise those with the highest levels of need—particularly individuals who are less visible or less able to advocate for themselves.
- High Stakes: Human and Economic Costs
Underlying all responses is a stark warning: failure to recognise and support neurodivergent people has serious consequences.
Evidence links unmet needs to:
- Higher rates of mental illness and suicide
- Unemployment and economic disadvantage
- Homelessness and social exclusion
- Increased long-term pressure on public services
In this context, debates about diagnosis are not abstract—they have real, and sometimes life-threatening, implications.
Conclusion: A Politicised Debate with Real-World Consequences
Ultimately, responses to the government’s mental health review suggest it is far from a neutral document. It reflects broader political and economic pressures, particularly in a context of constrained public spending.
What emerges is a clear message:
the conversation should not centre on whether “too many” people are being diagnosed, but on whether enough people are being recognised, understood, and supported.
Until that question is addressed, concerns about rising diagnoses risk obscuring a deeper and more urgent issue—one of unmet need, systemic inequity, and preventable harm.
For questions or comments please e-mail hello@ncamh.co.uk or call 07545 190915