Listen again · In Conversation
Health explained: Rethinking ADHD and autism support October 10, 2026 · 6:17 · With Maya and Grace
Grace, our health and medicine columnist, is here to discuss a major review of mental health, ADHD, and autism services in England. Welcome, and thanks for listening wherever you are. Thanks, Maya.
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Maya This is Slow English FM, and this is Health Explained. I’m Maya. Grace, our health and medicine columnist, is here to discuss a major review of mental health, ADHD, and autism services in England. Welcome, and thanks for listening wherever you are. Grace Thanks, Maya. The review warns that rising demand could leave NHS services facing what it calls “system failures.” Its central recommendation is to offer support based on people’s needs, rather than making a formal diagnosis the main route to help. Maya Let’s start with that change. What does “support based on needs” mean here? And how would it differ from the current approach? Grace The review argues that people should be able to get help for their difficulties without diagnosis being the only doorway. That does not mean diagnosis has no value. It means access to some support should not depend entirely on first completing a formal assessment and receiving a diagnosis. The Guardian reports that the review also recommends bringing mental health and neurodevelopmental services together. Neurodevelopmental conditions are conditions linked to how the brain develops; ADHD and autism are examples. Maya So, in simple terms, the review wants services to respond to what someone needs, even if that person has not yet received a diagnosis. Is that right? Grace Yes. That is the basic idea. The review also recommends giving priority for specialist assessment to people with the highest needs. It is proposing a different way to organize support, not saying that every person should receive the same service. Maya The size of the waiting lists helps explain the pressure. What figures did the review report? Grace The Guardian reports that, at the end of 2025, more than 560,000 people in England were waiting for an ADHD assessment. Another 254,000 were waiting for an autism assessment. Those figures count people waiting for assessments. They do not, by themselves, tell us how many people received other kinds of help while they waited. Maya That distinction matters. The numbers show the scale of the assessment wait, but not the full picture of support. Does the review say that rising demand is only about more people being diagnosed? Grace No. The Guardian’s account of the review says it found that mental distress has increased substantially, and that greater awareness alone cannot explain the change. It also reports that, in England, the share of people aged 16 to 24 with a common mental disorder rose from about one in six in 1993 to about one in four in 2024. The review is looking at wider demand for mental health support, as well as demand for ADHD and autism services. Maya A rise in demand is not the same thing as proof that people are being diagnosed too often. But the BBC reports that the review found a risk of over-diagnosis. How can listeners understand those two points together? Grace They concern different questions. Rising demand describes more people seeking or needing help. The risk of over-diagnosis concerns whether some diagnoses may be given when they are not appropriate. The review’s call to focus on needs is relevant to both: it says services should support people according to their needs, while giving specialist assessment priority to those with the highest needs. That is the review’s approach; it does not mean the waiting-list figures alone tell us whether any individual diagnosis is correct. Maya There is also a staffing problem. The Guardian has reported that some NHS staff in ADHD and autism services have moved to private clinics. What does the reporting show about the effect on one service? Grace The Guardian reports that a trust in Herefordshire and Worcestershire temporarily limited access to its children’s neurodevelopmental service to the most urgent cases after staff left for independent-sector providers. The article said the trust planned to return to normal service on Monday. That is a report about one trust, not evidence that every NHS service has taken the same steps. Maya And what is happening with oversight of private assessment clinics? Grace The Care Quality Commission announced that it would begin inspecting private clinics that offer ADHD and autism diagnostic assessments, including clinics that had previously been outside its regulation. That is an announcement about inspection plans. It should not be confused with a finding that a particular clinic has failed an inspection. Maya Taken together, the review points to pressure on assessments, wider mental health needs, and questions about how support is organized. What is the main change it is asking for? Grace The main change is to make support less dependent on diagnosis as the first step. The review also calls for connected mental health and neurodevelopmental services, and for specialist assessment to focus first on people with the highest needs. In my reading, the challenge is turning those recommendations into support people can actually reach, while keeping assessment available for those who need it. Maya Grace, thank you. And thanks for listening to Health Explained on Slow English FM. Stay with us.
