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A review of rising diagnoses of mental health conditions has been ordered by the UK government as it seeks to stem pressure on the NHS and a surge in benefits claims.
Wes Streeting, health secretary, said he needed to understand the “sharply rising” number of conditions such as depression, autism and ADHD being diagnosed.
This has led to long waits for treatment and has also been a driver of rapidly rising spending on sickness benefits, which is projected to exceed £100bn by the end of the decade.
Ministers insisted the review was not about cost-cutting, but Streeting has previously warned of an “over-diagnosis” of mental health conditions. The review will look at whether normal problems are being unnecessarily medicalised, as well as issues such as whether smartphones are leading to rising mental distress.
NHS surveys show 23 per cent of those aged 16 to 64 have a common mental health condition, up from 16 per cent in 1993. NHS waits are lengthening as demand rises, with almost half a million referrals a month for specialist mental healthcare in 2024-25, up 15 per cent on the year before.
“I know from personal experience how devastating it can be for people who face poor mental health, have ADHD or autism and can’t get a diagnosis or the right support,” Streeting said.
“I also know, from speaking to clinicians, how the diagnosis of these conditions is sharply rising. We must look at this through a strictly clinical lens to get an evidence-based understanding of what we know, what we don’t know, and what these patterns tell us.”
Experts say there is clear evidence that conditions such as depression and anxiety have become more common, but the causes are poorly understood. There are also growing questions about whether the NHS and the welfare system respond in the best way to signs of distress, which could have causes ranging from housing and work problems to relationship breakdown.
“In the absence of wider social, economic and community support, which is so desperately needed, the NHS is bearing the brunt,” said Tom Pollard, head of policy at the mental health charity Mind.
He added the review should “shut the door on arguments from those who want to wish away the scale of mental ill health in order to justify cuts”.
By contrast, autism and ADHD are neurodevelopmental conditions that experts agree are not becoming more common. “I would hope each condition would be considered on its own as well as asking, could there be factors operating across multiple conditions?” said Traolach Brugha, professor of psychiatry at the University of Leicester. “Any review should consider over- and under-diagnosis.”
An estimated 3 per cent to 5 per cent of the population has ADHD, an NHS task force reported this year, but diagnosis has soared as awareness of the condition has increased.
Some experts also believe that, at the same time, some people are unnecessarily being diagnosed and then treated. The review will look at whether a growing private-diagnosis industry is contributing to this.
The review will also look at employment and welfare, with a focus on the 1mn young people not in education or work.
The findings will contribute to a separate review of disability benefits, as ministers prepare to make another attempt at welfare reform. Prime Minister Sir Keir Starmer and chancellor Rachel Reeves have both argued it would be better to spend money on treatment for mental health rather than benefits. They have said they want to see further welfare reform after being forced to abandon £5bn in disability benefits cuts in the summer following a revolt by backbench MPs.
One in 10 working-age adults is now claiming some kind of sickness benefit, with mental health problems an increasingly common reason. Two-thirds of those claiming incapacity benefits because they are too ill to work cite a mental health condition.
At the same time, depression and anxiety are now the biggest category of claims for separate disability benefits. Spending on personal independence payments for these conditions has doubled since the Covid-19 pandemic to £3.4bn a year.
However, the reason for such trends is poorly understood. Professor Peter Fonagy, a psychologist and researcher at University College London, will lead the review and promised to “examine the evidence with care”.
Data visualisation by Amy Borrett
