England-focused mental health review returns stark warning and calls for shift to ‘needs-led’ system

• Explainer | What has the Fonagy review found and what does it recommend?

• Analysis | No ‘snowflakes’: mental health review says today’s youth have it harder and harms are real

The NHS in England is heading into a “world of system failures” as it struggles to cope with relentlessly rising demand for mental health, ADHD and autism care, leaving those affected desperate for support, a government-commissioned inquiry has found.

The stark warning was made in a review led by Prof Peter Fonagy into the sharp rise in demand over recent decades for help with mental health and neurodevelopmental conditions.

Assessment bottlenecks have knock-on effects, with delays in medical help and access to specialist support

• NHS bodies in England impose two-year minimum wait for ADHD and autism assessments

That NHS boards have imposed minimum two-year waiting times for attention deficit hyperactivity disorder and autism assessments shows a health service struggling to deal with the consequences of huge changes in understanding of and social attitudes to these conditions.

Sharp rises in referrals for clinical assessments over the past six years mean nearly 1 million people in England are on ADHD waiting lists, with the average wait already over a year (64 weeks). About 295,000 await an autism assessment.

Patient groups decry ‘scandalous’ delays as four integrated care boards take step due to soaring demand for diagnoses

• Two-year waiting times highlight NHS struggle with rise in ADHD and autism awareness

NHS bodies are forcing people with suspected attention deficit hyperactivity disorder and autism to wait at least two years before they can be assessed as they struggle to meet surging demand for diagnoses of neurodiversity.

Four NHS integrated care boards (ICBs) covering large regions of England have adopted the approach because they cannot afford the cost of the number of assessments that people are seeking.

You are not the only one, advice columnist Eleanor Gordon-Smith writes. It will help to ask whether you have a time problem or a bandwidth problem

• Read more Leading questions

I love my life in so many ways. I have a rewarding job, I’m making stellar progress towards a graduate degree, I have incredible friends and community, plus I’m even reconnecting with estranged family. My cup is very full but I still feel grief and shame for how much falls to the wayside.

I have missed countless doctors’ appointments. My vehicle’s license plates have been expired for almost a year. I often apologise to angry friends and acquaintances after they confront me for not seeing them in months. My significant other says she doesn’t see me enough. So do my parents. I clock out of work and shudder at the thought of facing my growing avalanche of text messages. I panic whenever I receive an email that demands I arrange yet another appointment or submit to a lengthy phone call. The stack of forms I’m overdue to submit makes me feel so irresponsible, as if I’m the only adult alive who can’t seem to take care of business.

County’s first such clinic, at Alder Hey in Liverpool, treating children suffering from chronic bladder problems with severe cases needing dialysis

Children as young as 13 in the UK have been referred to a specialist clinic for a “devastating” bladder condition linked to sustained use of ketamine.

Medics at Alder Hey children’s hospital in Liverpool opened the first ketamine clinic in the UK for young people amid a surge in urology problems linked to addiction of the drug.

Study finds overall differences between groups of newborns by sex that are likely to be determined by biology

The question dates back to the first man and woman: how does the world shape the behaviour of the sexes, and what differences, if any, are present at birth?

Untangling the contributions of nature versus nurture has proved challenging for scientists, and controversial at times, but a new study of babies sheds light on at least one aspect of the puzzle.

NHS ombudsman warns of years-long waits and patients paying thousands to go private as demand for services soars

Complaints about autism and attention deficit hyperactivity disorder services in England have more than tripled in five years, official figures show, with the NHS ombudsman warning of years-long waits and patients paying thousands of pounds for private care.

One woman was removed from an ADHD medication waiting list without warning after almost four years, leaving her without the support she needed for about six months. Another patient was given an autism assessment lasting just 50 minutes that failed to follow guidance from the National Institute for Health and Care Excellence, while a man referred to an ADHD service that was not yet operational ended up paying almost £4,000 for private treatment.

Neurodivergence can make an already challenging process far trickier — and in the UK support isn’t automatically available. A new book aims to help mothers prepare

It’s 7am in a postnatal ward. I’ve been brought here having given birth around four hours earlier. I’m hot and have not slept since arriving at the hospital at 9pm for an induction, only to go into labour spontaneously before it could begin. All around me is incandescent hospital light and the sound of crying newborns. This would be challenging enough for someone who isn’t neurodivergent, but coupled with my attention deficit hyperactivity disorder (ADHD) I could feel my ability to cope unravelling.

I remember looking around, crying, unable to shut off the noise in my brain. “What if I don’t ever sleep again,” the little voice asked. I shut my eyes and the noise grew. Then there was my newborn son, lying next to me in a cot, and the fact that I had absolutely no idea how to look after him. I pressed the emergency buzzer and told the midwife who arrived that I could not breathe and needed to be discharged immediately. She said they couldn’t do that because I was under the mental health team and needed to speak to them first. I cried more.

Channel 4’s programme wastes a chance to ask important questions about how ADHD is diagnosed and treated, instead indulging in unscientific methods and conspiracy theories

• Prof Gina Rippon is emeritus professor of cognitive neuroimaging at the Aston Brain Centre, Aston University

When Channel 4 announced that it would air a documentary titled The Great ADHD Myth?, an outpouring of fury followed. Despite this, I set out to approach it as a scientist – not just as a scientist whose own work has dealt with developmental disorders, but as someone who has enormous respect for the scientific process and for the importance of evidence-led debate.

Channel 4’s press release claimed the documentary sought to determine whether attention deficit hyperactivity disorder was a “genuine neurodevelopmental disorder, or a social construct”. At one level this is a brave enterprise. ADHD is recognised worldwide as a disorder, by the World Health Organization and our own NHS among others. Estimates suggest ADHD affects roughly 8% of children and adolescents and about 3% of adults worldwide. To overturn this consensus would require robust, reproducible findings capable of explaining away decades of genetic, developmental and clinical research. The press release described the documentary as “science-led”, which hinted at just such an enterprise. Was it really science-led?

Prof Gina Rippon is emeritus professor of cognitive neuroimaging at the Aston Brain Centre, Aston University, and the author of The Gendered Brain

Do you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters section, please click here.

Prof Katya Rubia withdraws support for The Great ADHD Myth? as other leading figures voice criticisms

A contributor to a controversial Channel 4 documentary on attention deficit hyperactivity disorder has withdrawn her support for the programme, saying it was biased and could lead to an increased suicide risk by encouraging parents to take their children off medication.

Katya Rubia, a professor of cognitive neuroscience at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, also said The Great ADHD Myth? misrepresented her views.

Psychiatrists in Channel 4 documentary argue it is more a ‘social construct’ than a medical condition

People are increasingly seeking to an obtain an ADHD diagnosis without pursuing treatment, according to experts who have called for more research to understand why.

Some people now regard ADHD as “an identity, rather than a disorder”, with the result that many obtain assessments from poor quality private providers, which lead them to “believe they have a condition needing treatment”, said the psychiatrist Dr Marios Adamou, the founder of the UK Adult ADHD Network.

Reform UK leader to quit as MP but stand again, saying the people of Clacton ‘should be the judges of my actions’

Q: Do you think the parliamentary commissioner for standards should investigate Nigel Farage’s gifts from George Cottrell?

Badenoch said that was a matter for the commissioner.

[Farage is] hinting at press regulation. For all of the criticism and the attacks, and I would even say abuse that I’ve got from the press, I’ve never once recommended curbing our free press. I think this is one of the amazing things about this country.

I would be very worried about a Reform government using government power to control the press. I don’t think that that would be right.

Up to 97% of autistic people over 60 are undiagnosed. Experts offer up advice for family members on how to support this ‘neglected generation’

There has been a huge shift in awareness around neurodiversity recently, with improved provision for children in schools and increased middle-age diagnosis and detection in women. Still, one group has remained underserved when it comes to support; adults over 60. A recent study estimated that 89-97% of autistic people over 60 are undiagnosed, leading experts in the field, such as Dr Louise Rutter (who last year co-authored a report on the subject for the British Psychological Society) to brand them a “neglected generation”.

It’s an issue facing adult children who might be caring for older parents and recognising traits of autism and ADHD. You may be wondering where to find support – or whether that’s the best course of action (the experts say it is). Here’s a guide.

Researchers say risk comes from ‘other factors, including genetic predisposition to mental health conditions’

Taking antidepressants during pregnancy does not increase the risk of children going on to develop autism or attention deficit hyperactivity disorder (ADHD), according to an analysis of more than half a million pregnancies.

The study, conducted by researchers at the University of Hong Kong and published in the Lancet Psychiatry, analysed data from 37 existing studies that included 600,000 pregnant women who had taken antidepressants, and 25 million women who had no antidepressant use during their pregnancies.

Phase Space pilot programme with NHS mental health trust used to calm anxiety around exams, ADHD and home troubles

Schools have begun deploying virtual reality to help pupils cope with stress caused by impending exams, attention deficit hyperactivity disorder or difficult home lives.

All 15 secondary schools in the London borough of Sutton are using VR headsets made by tech firm Phase Space in a pilot in conjunction with the local NHS mental health trust.

Can a sentence affect the course of your life? Five authors reveal the interactions that transformed the way they saw themselves – and the world

When I was 14, I had to start a new school. I wasn’t great at starting new schools, even though I had done so quite a few times – once for my dad’s work, once because I wasn’t fitting in at my primary school and once because my parents didn’t like the teachers. Of course, 14 is possibly the most awkward of all the ages to start a new anything. Anyway, it was halfway through the first term at the new school in Newark, Nottinghamshire, and I was taken aside by my history teacher, Mr Philips, at the end of a lesson. He didn’t like me very much. To be fair, I was probably hard to like, from a teacher’s perspective. I had trouble concentrating, I stared out of windows, I clowned around. However, it is difficult to explain the shock to my self-conscious teenage soul when he told me, “I think it would be a good idea for you to join a special needs class.” Now, for context, the year was 1989, and in my state comprehensive at that time the idea of being “special needs” was akin to being given a leprosy bell or being marked with a cross for the plague. It was a binary system. You were either “normal” or you were “special needs”. To make matters worse, I was told that another teacher – my art teacher – had come to a similar assessment.

These dodgy operators are very good at the shady work they do: they crank up the terror, drown out the logical part of your brain and then move fast

For the second time in the space of three years, I was sitting on my bed screaming, “They’ve stolen all my money.” I feel sick about it. Foolish and ashamed. Within minutes, thousands of dollars were stolen from my accounts, and I won’t be getting it back because I “willingly” gave out my private information.

In 2023 I wrote an article after I fell victim to a Facebook scam and had $1,000 stolen from my bank account. I thought that experience made me immune from it ever happening again. It didn’t and I think I know why.

A combination of autism and ADHD caused outbursts, confusion and stress that my son couldn’t understand – until he saw David Tennant behaving the same way

The film Elf is a no-go in our house. My son interprets it as the psychological horror story of a man who is telling the truth but is constantly disbelieved. He loves The Traitors and rewatches entire series of it – knowing who the traitors are gives him an autonomy and comfort watching the game. Any other kind of conflict on screen and he’ll leave the room or wind it forward. I tried to explain that there are no stories without conflict. It made no difference.

My son is autistic and has ADHD – what’s sometimes referred to as AuDHD. We’ve always called him “fizzy”. He’s often the noisiest person in a room but hates too much noise. He’s incredibly sociable and wants so desperately to be part of the fun but finds the fun stressful. I had never seen anyone like him represented on screen.

As a child, the singer loved to start fires. As an adult, he was barely less chaotic. He discusses Bez, charisma, ADHD, his new memoir – and why making music is great, even if the record industry will always screw you over

There are thousands of pictures of Shaun Ryder and Bez in Happy Mondays, from the mid- to late 80s, that run the gamut from mashed to wrecked. They don’t always look that cheerful, but when they do, they look insanely fun. In Ryder’s new memoir, 24 Hour Party Person, he quotes a critic: “The poorly educated might just call [Bez] a dancer, but he’s the proprietor of good times.” What Bez did for the band, the band did for the era: just went way too far, in an absolutely magnetic way.

Ryder, in a Novotel hotel to the west of Manchester, explains what drew the whole band together. “When you are neurodiverse, you attract other people who are,” he says. “I would have said at the time we were all fucked-up loonies. I mean Bez [he launches into a spirited impression]: ‘I’m-not-fucking-neurodiverse’… it’s like, mate. You are. ‘I’m fucking not.’ Mate, you are. The same with all of them. None of them have been tested and gone through the thing, but they are. All of them.