By Adam Crampsie, CEO, Everyturn Mental Health
The UK Government has published the long-awaited independent review into the prevalence of mental health conditions, autism and ADHD, led by Professor Peter Fonagy.
Its publication has reignited debate about mental health, ADHD and autism.
Much of that debate is focussed on diagnosis. Are more people being diagnosed? Are assessments consistent? Has greater awareness changed how people understand and describe their experiences?
These are important questions.
But as the debate unfolds, I’m thinking about the people hearing these discussions in the news, on social media and around kitchen tables across the country.
When you’ve spent years struggling to understand yourself or fighting for support for your child, a diagnosis can bring enormous relief. It can help explain experiences that never seemed to fit, provide access to support and offer a sense of understanding after a long period of uncertainty.
Hearing a national debate about whether too many people are being diagnosed could leave some people wondering whether they’ll have to explain themselves all over again.
We need to take care with that.
People deserve to feel believed. They deserve confidence in the help they receive. And they deserve a system that responds to their needs without forcing them to fight for recognition first.
The review raises important questions about misdiagnosis and overdiagnosis. But it does not conclude that overdiagnosis is happening at scale. Meanwhile, too many people continue to wait months or years for help while their difficulties affect their education, relationships, employment and wellbeing.
One of the review’s central recommendations is a move to a “needs-led plus diagnosis” system. That means support starts according to what someone needs, while assessment takes place. Diagnosis remains essential to understanding many people’s difficulties and getting treatment right. Practical support and timely assessment should happen alongside each other.
I strongly welcome that direction. The review is clear that the rise in common mental health problems is real, particularly among young people. The challenge now is to turn its recommendations into help that people can actually access.
That means making support available before, during and after assessment, while protecting access to specialist care for people with the most severe and complex needs.
People can find themselves stuck on waiting lists while their needs increase and their lives become harder. By the time help arrives, problems may have become more severe, more complex and more costly to address.
I strongly believe someone reaching out for support should receive a meaningful response that day: a conversation with someone who takes time to understand what is happening and helps them access appropriate support. Assessment and treatment should follow according to their needs.
The review also calls for consistent assessment standards. It says that anyone moved off an assessment waiting list should be connected to appropriate help, with support actively arranged with them. That is an important safeguard as services change.
What needs to change?
The review also reinforces something we’ve known for a long time: health services cannot solve mental health challenges alone.
Financial insecurity, housing pressures, loneliness and inequality all affect people’s mental health. If we want better outcomes, we need stronger partnerships between the NHS, local authorities, communities and the voluntary sector.
At Everyturn, we believe support should be available earlier, closer to where people live and shaped by the people who use it. That’s why the findings resonate so strongly with our new ten-year strategy, Hope for the Future.
Through that strategy, we’re focused on improving support and reducing inequalities, including through innovation and campaigning for a better mental health system.
We also need to be honest about the money. Demand and costs keep rising in an NHS already under huge financial pressure. We cannot keep pouring money into a system that leaves people waiting years for help. Investment needs to change how support is delivered and improve the value of every pound spent. That transformation will also need funding and time, with its impact measured.
The review explicitly recommends commissioning voluntary, community and social enterprise (VCSE) organisations as core partners, with stable and sustainable funding. Organisations like Everyturn bring community relationships and experience of delivering support alongside the NHS. We should be helping shape and deliver this change together.
People using services must have a real say in those decisions. Meaningful co-production means involving people from the start and being willing to rethink plans because of what they tell us. They should also help judge whether the changes make getting support easier and improve their lives.
There is hope in this report. We already see how timely support can change someone’s life. I want people hearing this debate to feel believed, and to see that getting help can become easier. That is what Everyturn wants to help make happen.