Researchers from the NIHR Biomedical Research Centre (BRC): Maudsley and its partners have contributed to an independent review that is set to influence the future of mental health, ADHD and autism support across England.
Published today, the Independent Review into Mental Health Conditions, ADHD and Autism was chaired by Professor Peter Fonagy and supported by Vice-Chairs Professor Sir Simon Wessely and Professor Gillian Baird, both from King’s College London, a founding partner organisation of the NIHR BRC: Maudsley.
It was commissioned by the Department of Health and Social Care in December 2025 to establish what has changed in the nation’s mental health and neurodevelopmental needs, what is driving those changes, and what should be done in response.
A new approach to mental health, ADHD and autism support
The review concludes that rising levels of mental distress, particularly among children and young people, require a fundamental shift in how support is provided. It argues for a move from a system where diagnosis is often the main route to help towards a more flexible, needs-led approach that ensures support is available earlier and more effectively.
The findings show substantial increases in mental health difficulties such as anxiety, depression and eating disorders, particularly among younger people. The review found that while referrals and recorded diagnoses of ADHD and autism have risen, evidence suggests underlying population prevalence has remained broadly stable. Instead, growing demand reflects a complex interaction of mental health needs, neurodevelopmental differences and wider social pressures, including insecurity, loneliness, educational pressures and changes in digital environments.
Aligning with NIHR BRC: Maudsley research
The scale and complexity of need identified by the review underline the importance of the NIHR BRC: Maudsley’s research in this area. Its early translational focus seeks to generate the knowledge needed to identify and understand these challenges and provide a stronger basis for developing and testing new approaches to support.
Theme leads Professor Edmund Sonuga-Barke and Professor Johnny Downs bring complementary expertise to this agenda. Their research has advanced understanding of how mental health and neurodevelopmental needs overlap and how services can respond to children and young people regardless of whether they have received a formal diagnosis. Professor Sonuga-Barke leads the NIHR BRC: Maudsley’s Child Mental Health and Neurodevelopmental Disorders Theme, while Professor Downs serves as Deputy Theme Lead and leads pioneering work in child psychiatry, informatics and digital innovation.
Complementing the review's needs-led vision with research into mechanisms that operate upstream of and across diagnoses will be important for improving prevention, personalising support and transforming services.
Professor Gráinne McAlonanDirector, NIHR BRC: Maudsley
A key conclusion of the review is that many people seeking help do not fit neatly within a single diagnostic category. The report highlights that mental health difficulties, ADHD, autism and social adversity frequently overlap, and that long waits for assessments can delay access to support. It recommends a “needs-led plus diagnosis” model in which support is available before, during and after assessment, while maintaining access to diagnosis where clinically appropriate. The review argues that success should ultimately be measured through participation, wellbeing, education, employment and quality of life, rather than diagnosis alone.
For the NIHR BRC: Maudsley, the report strengthens the case for research that can identify needs earlier, clarify which forms of support work best for whom and translate these insights into more timely and personalised care.
As the government develops its forthcoming Mental Health Strategy, the review provides a framework for judging progress through participation, wellbeing, education, employment, relationships and community life. Its recommendations offer a practical basis for shaping services around the outcomes that matter most to children, young people and families.
Moving beyond diagnosis
Professor Gráinne McAlonan, Director of the NIHR BRC: Maudsley and former lead of the Child Mental Health and Neurodevelopmental Disorders Theme, welcomed the review’s emphasis on moving beyond diagnosis as the sole route to support:
“One of the review’s most important implications is that diagnosis, while useful for many people, should not be essential to receiving help. Support should be based on need and available before, during and after assessment. This offers a stronger basis for prevention and earlier intervention, before difficulties become established.
“The review rightly recognises that neurodevelopmental and mental health difficulties often overlap, and that physical health problems can also be associated with neurodevelopmental conditions. Some groups whose needs are only now being recognised remain largely outside its scope, particularly children with early-onset chronic physical conditions who may also experience substantial neurodevelopmental and mental health difficulties. A fuller account of how biological and environmental processes interact across life will remain important as this agenda develops.
“Within its remit, the review is exceptionally thoughtful and rigorous. It recognises the genetic and developmental foundations of neurodevelopmental conditions, but detailed consideration of biological mechanisms lies mostly beyond its brief. Complementing its needs-led vision with research into mechanisms that operate upstream of and across diagnoses will be important for improving prevention, personalising support and transforming services.”
