A national review was meant to settle the “overdiagnosis” question. It did. The headlines just reported the opposite. Here is what it actually found, where I think it gets things right and wrong, and what we are doing about it in Kent and Medway.
By Dr Chloe Farahar, Director, Aucademy CIC
Every section has a Clear Read box (the full version) and an Easy Read box (short sentences and pictures). Read whichever suits you, or both.
What the headlines said
On 9 October 2026 the Department of Health and Social Care published the final report of the Independent Review into Mental Health Conditions, ADHD and Autism, chaired by Professor Peter Fonagy. Within hours, the word leading the coverage was “overdiagnosis”. The BBC’s headline read: “ADHD and autism at risk of over-diagnosis, says government review”. Its first sentence told readers that “there is a risk of people being over-diagnosed with ADHD and autism, an official review in England has found”.
To be fair to the BBC, the article does say the review could not “conclude over-diagnosis was currently occurring at scale”. But that line sits near the bottom, long after most readers have scrolled on. A warning about a possible future risk was presented as the finding. And the story was illustrated with a stock photo of a child holding a colourful puzzle. I will let that speak for itself.
Why does this matter? Because most people will never read a 599-page report. They will read a headline, maybe on their phone, maybe while sitting on a waiting list that has already lasted years. For many Autistic people and people with ADHD (which some of us prefer to call Polyennic, a term coined by Raven Cochrane), the message they received was, quite simply, “you are probably not who you think you are, and you are part of the problem”.
That message is not what the review says. And it causes harm.
- A big report came out in October 2026.
- Some news said too many people are told they are Autistic or have ADHD.
- The BBC news said there is a risk of this.
- This news upset a lot of people.
What the review actually found
I have read the report so you do not have to. Here are its own words.
| The headline impression | What the review says |
|---|---|
| Too many people are being diagnosed | “On the basis of evidence available to us we cannot conclude that overdiagnosis is occurring at scale.” |
| People’s struggles are being exaggerated | “None of this should be taken to suggest that people’s distress or difficulties are not real.” Those now presenting “are no less affected than those identified before.” |
| There are suddenly more Autistic people | Underlying prevalence shows “little evidence of a substantial change”. What has risen is recognition, and demand for help. |
| It is too easy to get a diagnosis | More than 254,000 people had an open autism referral by December 2025, with over 90% waiting longer than 13 weeks. The review’s own Lived Experience Partners described their “anger and upset” at debates that “minimise, trivialise or deny lived distress”. |
The review’s central line is one I wish had been the headline: “People are seeking answers and support for very real problems, and they are not the problem.” The problem, it says, is a system that “leans too heavily on diagnosis as the route to help and cannot keep pace”.
It does warn that the risk of misdiagnosis is growing, especially where assessments are rushed, done remotely, or carried out by poorly regulated providers. That is a call for better assessment, not fewer diagnoses.
- The report found people’s needs are real.
- It did not find that too many people are being told they are Autistic or have ADHD.
- Many people wait a very long time for help.
- People asking for help are not the problem.
What the review gets right
I argue the most important thing in this report is not a number. It is a door. The review says support has been “locked behind” a diagnosis, and that this is wrong. It proposes a move from a “diagnosis-dependent” system to a “needs-led plus diagnosis” system. Help should come before, during and after assessment, and diagnosis should stay available to those who need it.
- Mental health care should not wait. For Autistic people with anxiety, depression, eating distress, self-harm or trauma, care “should not be withheld while diagnostic clarification is pending”.
- Adapted care works better. Autistic adults are less likely to benefit from standard NHS Talking Therapies, and more likely to deteriorate. Adapted therapies do better.
- Environments matter. “The difference lies as much in the environment as in the individual.” This is close to what Autistic scholars have argued for years, through ideas like the double empathy problem.
- Hospital is not automatically safe. “Admission is not, in itself, safety.” Autistic people and people with a learning disability are over-represented in inpatient care, and the review wants that to change.
- Nobody should be dropped. The BBC reported that some people “could be removed” from waiting lists and offered other support. What the review actually says is: “No one should be taken off a waiting list without being connected to appropriate help, and alternative support should be actively arranged with the person, not simply signposted.”
“I don’t think you are fragile. I think you are outnumbered.”Professor Peter Fonagy, in a letter to young people written as chair of the review
- You should get help for what you need.
- You should not have to wait for a diagnosis to get help.
- Help should be close to home.
- Places should change to suit Autistic people.
Where I would push back
Welcoming a report does not mean agreeing with all of it. A few things concern me.
- “Needs-led” must not become “diagnosis-denied”. In a stretched system, there is a real risk that “you do not need a diagnosis to get support” quietly becomes “you will not get a diagnosis”. Diagnosis is, for many of us, about identity, community and self-understanding, not only access to services. The review says diagnosis “matters”; we need to hold commissioners to that. Although, I have written on the hope and need that as a society, we should move from diagnosis to recognition, affording more holistic and kinder ways of working out your identity and needs, while still demanding protections as people disabled by current systems.
- Self-identification is treated with suspicion. The report raises concerns about “neurodiversity assessments” and the “blurring” of the social and the medical. Yet neurodiversity is a social and political idea that emerged from Autistic communities themselves. Community self-identification is often where people first find safety and belonging, and belonging is protective.
- The language is still largely deficit-based. “Disorder”, “traits”, “impairment”. The review does say “neurodevelopmental difference is not a problem to be eliminated”, which I welcome. I would like the rest of the language to catch up.
- AI is not a substitute for being understood. The proposed “digitally and AI-enabled” needs assessment framework could help with triage. It could also risk becoming a cheaper replacement for skilled, in-person, adapted assessment. The review says in-person care should be preserved. That needs to be a hard line.
- Lived experience must mean power, not presence. The review calls for “meaningful partnership with people with lived experience”. Meaningful means paid, and it means a share in decisions, not a place on a consultation list.
- I like a lot of the report. But I worry about some things.
- People should still be able to get a diagnosis if they want one.
- Real people should help with assessments, not just computers.
- Autistic people who help make decisions should be paid.
What we are doing in Kent and Medway
I am not writing this from the sidelines. Alongside Aucademy, I am Programme Project Manager for the Learning Disability and Autism (LD&A) Programme at Kent and Medway Mental Health NHS Trust. Much of what the review asks for is work we have already started, led by and developed with Autistic people and people with a learning disability as paid partners and decision-makers.
- Support based on need. The CHECK reasonable adjustments project, a Communication Needs Tool, and the Neurodivergent Profile Guidebook help people say what they need, with or without a diagnosis.
- Records that remember. Our digital flagging work makes sure people’s needs and adjustments are visible in their records, so they do not have to explain themselves again and again.
- Skilled staff everywhere. The Oliver McGowan Mandatory Training, simulation-based training, Autistic healthcare webinars, learning disability webinars, and a university course in development with Canterbury Christ Church University.
- Better diagnosis. A lived expert-led Autism Diagnostic Training and Evaluation Project, so assessment is done well.
- Fewer people in hospital. Work on resettlement and repatriation for Autistic people, and a review of how inpatient care is designed.
- Belonging as prevention. The Kent and Medway Learning Disability and Autism Community of Practice, and our lived expert group, which shapes the programme. Autistic community and safe spaces are protective against crisis; the review’s own focus on “belonging, purpose, routine” points the same way.
Simply put: the review has described where we are trying to go. The challenge now is funding it, and keeping Autistic people and people with a learning disability at the centre while we do.
- We write your needs in your health records. This is called a flag.
- We train NHS staff about autism and learning disability.
- We want fewer people to stay in hospital.
- Autistic people and people with a learning disability help lead this work. They are paid.
If the headlines hurt
If you are Autistic, or Polyennic, or waiting to find out, and the coverage left you doubting yourself: the evidence is on your side. The review’s own lived experience partners were angry about exactly the framing that followed it.
- Your experiences are real, with or without a diagnosis.
- You can ask any NHS service for reasonable adjustments based on what you need.
- If you want to read the review for yourself, there is an official Easy Read version on GOV.UK – https://www.gov.uk/government/publications/independent-review-into-mental-health-conditions-adhd-and-autism-final-report.
- Find your people. Autistic-led spaces, online and in person, are where many of us first feel understood.
- Your feelings and needs are real.
- You can ask for changes that help you. These are called reasonable adjustments.
- Spending time with other Autistic people can help.
Sources
- Department of Health and Social Care. (2026, 9 October). Independent review into mental health conditions, ADHD and autism: final report, executive summary, and Easy Read version (Looking into mental health conditions, ADHD and autism). GOV.UK. gov.uk
- ITV News. (2026, 8 October). ADHD and autism could be at risk of overdiagnosis: so what needs to change?
- Triggle, N. (2026, 9 October). ADHD and autism at risk of over-diagnosis, says government review. BBC News.
- Milton, D. E. M. (2012). On the ontological status of autism: The “double empathy problem”. Disability & Society, 27(6), 883–887.
- Botha, M., & Frost, D. M. (2020). Extending the minority stress model to understand mental health problems experienced by the autistic population. Society and Mental Health, 10(1), 20–34.