The Guardian Monday 12 October 2026 - A moment of hope and peril for our mental health crises - John Harris

Oct 12, 2026

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Analysis of England’s independent review into mental health diagnoses, including ADHD and autism, and the broader political and welfare-spending pressures surrounding its recommendations. The piece weighs media reactions that frame the debate as overdiagnosis versus harm, highlights the report’s caution that evidence is not yet definitive, and discusses a troubling proposal to rely on observed needs rather than formal diagnosis while underscoring the risk posed by systems of power and limited support.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Journal

Independent review into mental health diagnoses

Media reactions and the overdiagnosis debate

Risks of substituting support for formal diagnosis

Evidence, testimony, and system constraints

Abloody attackin Riyadh has shattered Gulfillusions Nesrine Malik,page3DailypulloutIt was atough week-but the Greens are here to stay Zack Polanski,page4life&artssectionAda Yonath,biochemist awarded a Nobelprizein2009 Obituaries,page6Inside The Guardian Monday 12October2026 Amomentofhopeand perilforourmentalhealth crisesJohnHarris Journal ack in2025,the then health secretary,Wes Streeting,commissioned what thegovernment called its "Independentrevewintoprevalence and supportfor mental health conditions,ADHDandautism”.Here,it seemed,wasnot just an inquiry into England'sever-extending waiting lists for the diagnosis of mentalillness and neurodevelopmentalconditions,and the dire lack of supportfor peoplewhoexperienceone or both ofthem.The review would alsodovetail with twoother huge issues:mounting claimsof “overdiagnosis",and the government's drive for therefom of so-called welfare.An apparently well-briefedpiece in the Timessaid the review,led by the renownedpsychologist Peter Fonagy,was commencingjust"asLabour seeksa fresh crackdownon welfare spending”amid diagnoses“which have become the mostcommon reason for asickness benefit claim". Last Friday saw the publication of the 600-page finalreport.And its interpretation suggested the media'sequivalent ofa Rorschach blot.One of the Guardian'sheadlines was"No'snowflakes':mental health reviewsays today's youth have it harder and harms are real".The Mail,by contrast,yelled:“Rush to diagnose ADHD and autism can damage children”,while"ADHD surgefuelled by benefits,report warns"said the Telegraph. Such are the perils of producing a very nuancedmixture of analysis and recommendations.Whenhe appeared on Radio 4's Today programme,Fonagysaid that Streeting had been “completely wrong”toagree with suggestions ofthe common overdiagnosisof mental health disorders.When it comes to autismand ADHD,he and his colleagues'report says that"if present trends continue we are clearly entering aphase in which the balance ofrisks is changing,fromprevious merited concerns with under-recognitionandunderdiagnosis towards anincreased risk ofmisdiagnosis and overdiagnosis”.But it also insiststhatright now,“we cannot conclude that overdiagnosisis occurring at scale”,and points outthat any datathatmight settle this festering argument "largely do notexist".This is not the kindof stuff thatsuitsaworldthat craves simplebinaries and polarised shouting. For the most part,in fact,it is hard to disagreewith what the review points out.But among itsconclusions liesone troubling proposal-that provision for both mental illness and so-calledneurodivergence can and should oftenbeled by observations ofneed rather ILLUSTRATION: MATT KENYON TheGuardian Monday 120ctober2026 | Amoment of hopeand peril
for our mental health crises
John Harris
←Continuedfromfront | The
Guardian
Founded1821Independentlyownedbythe Scott Trust N⁹56,035
Comment isfree...utfactsaresacred'CPScott | | --- | --- | | than formal diagnosis.In making that
suggestion,Ihave no doubt tha Fonagy
andhis colleagues'intentions are benign.
But our systems of power and politics and the
government's increasingly anxious view of public
spending could yet make itvery dangerous indeed.
First,though,the undeniable positives.Fonagy-
whois74-completelyrejects the popular idea ofa
new generation of wilting wimps falselyclaiming to
be suffering from mentalill-health."The cacophony
of voices now available to a young person-most of
them digital,many of them confident,few of them
accountable-has made the ordinary developmental
process ofunderstanding oneself far harder than it
was forme,"he says.He goes on:“Young people today
are contending with more powerfulforces thanIever
faced.They are notfragile.They are outnumbered."
These aremental health issues.When it comes to
autismandADHD,Fonagyand his two colleagues'
insistence that

FAQs

What independent review is discussed, and why was it commissioned?

The text describes a 600-page final report commissioned in 2025 by the then health secretary Wes Streeting into prevalence and support for mental health conditions including ADHD and autism.

How does the report address the question of overdiagnosis and misdiagnosis?

It says present trends may shift the balance of risks toward misdiagnosis and overdiagnosis, while also stressing it cannot conclude overdiagnosis is occurring at scale and that decisive data largely does not exist.

What is the main concern about relying on need rather than formal diagnosis?

The article warns that while the proposal may have benign intentions, government spending priorities and political pressures could make it dangerous, especially for people with genuinely diagnosable and debilitating conditions.

Oct 12, 2026

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