Health and Social Care Secretary Wes Streeting has ignited a contentious debate by announcing an independent review into mental health conditions, ADHD, and autism as 2025 draws to a close. While framed as an investigation into support and NHS provision, the move has been widely interpreted as an official probe into the potential overdiagnosis of these conditions.
The Political Bandwagon of Overdiagnosis
The term 'overdiagnosis' has become a buzzword in certain political and media circles over the past year. It has been championed by figures like Reform UK deputy leader Richard Tice and discussed in works such as neurologist Dr Suzanne O'Sullivan's book, The Age of Diagnosis. The review's launch, first reported in October, carries a political whiff, with its terms of reference mixing questions about mental illnesses like anxiety and depression with neurodevelopmental conditions like autism and ADHD.
Critics argue this conflation is misleading. The language used in official documents, including mentions of economic inactivity and medicalisation, suggests a potential softening of the ground for future welfare reforms. The government appears to be speaking in contrasting tones, telling the Times of concerns about rising diagnosis rates and the 'overpathologising' of ordinary stress, while publicly emphasising support.
Understanding the Rise in Diagnoses
The answers to why diagnosis rates are increasing may be more straightforward than the review implies. Rising cases of anxiety and depression are linked to a harshly competitive education system, precarious work models, and the lingering effects of the pandemic. For ADHD and autism, increased diagnoses reflect better understanding, not a societal malady.
Official reports suggest 2.5 million children and adults in England are affected by ADHD, yet only 800,000 have a formal diagnosis. Autism diagnoses have risen due to a widened definition introduced in the late 20th century, recognising the autism spectrum, and more recent awareness of how it presents in women and girls. The internet has empowered individuals to seek explanations for lifelong struggles, leading to more people identifying their needs.
The Real Danger: Turning Back the Clock
The core fear is that the 'overdiagnosis' narrative will be used to dismiss genuine need, particularly for those labelled 'mild' or 'moderate'. Proponents like O'Sullivan argue diagnoses can be a 'self-fulfilling prophecy', but this overlooks a critical point: without a clear understanding of how someone's mind works, providing effective support is impossible.
Autism, often reflecting familial traits, allows people to reinterpret past struggles of relatives who lived without support. The push for resilience over recognition risks recreating those frustrating and broken lives. The real question for the Health Secretary should not be about the number of diagnoses, but why our systems of work, education, and care remain so ill-equipped to support neurodivergent people and those with mental health conditions.
In a flatlining economy with squeezed public spending and long NHS waiting lists, the easy political answer is to question the validity of need. The complex, humane answer is to build institutions that finally understand the sheer diversity of human minds.
