Aidan, Eva and Osob from the Youth Steering Group respond to the Independent review into mental health conditions, ADHD and autism.
The Fonagy Review highlights systemic flaws across the SEND, mental health, and neurodevelopmental support systems, particularly regarding the response to surging numbers of young people seeking help.
Crucially, the review demonstrates that the co-occurrence of multiple challenges—such as overlapping mental health conditions or external societal pressures—is "the rule rather than the exception.”
The report highlights intense structural and societal pressures, such as economic insecurity, high-stakes academic strain, digital burnout, and depleted community spaces. Meanwhile, formal diagnosis has become the primary gateway to receiving any support. This creates significant risks of overdiagnosis and misdiagnosis while failing to address the underlying drivers of stress.
The Youth Steering Group (YSG) urges regional and national bodies with the power to reform the system to listen to young people, and to see these faults in the system as fixable, not inevitable.
What’s not working
The Fonagy Review is helpful when thinking about mental health in young people. It further emphasises that in recent years, one in four young people are meeting the criteria required for a “common mental disorder,” a drastic increase. The review then goes on to suggest that the rise in mental health problems “cannot be explained by greater awareness alone”. We agree with both of these findings.
Around the country, mental conditions mean that young people are struggling with everyday life and simply talking about the fact that they are on the rise is not enough. Action is required. There are issues with waiting times for diagnoses for conditions such as ADHD and autism, which sometimes take 2 years or more. The review also supports the belief that there isn’t a huge level of overdiagnosis currently in the UK, instead suggesting that we’re entering a time where there could be more misdiagnosis and overdiagnosis.
But the review also emphasises that underdiagnosis is a huge problem for certain groups. So many different people across the country are facing barrier after barrier when trying to get a diagnosis. Examples of this include, but are not limited to, OCD, eating disorders and bipolar disorder, where getting a diagnosis proves difficult all the way back to trying to get referrals.
Too often there is inconsistent support in local areas, especially when thinking about young people who are forced to refer themselves to try and get the support that they desperately need. The review supports this argument with the following recommendation: “Commission and deliver integrated digitally-enabled mental health and neurodevelopmental assessment and support that is age-appropriate and responds to the needs of local communities.”
Impact on young people
The real-world toll on young people is both severe and wide reaching, as protracted delays for assessment and support directly cause mental health conditions to deteriorate while waiting. Because co-occurring disorders are common, rigid service boundaries mean young people with overlapping needs regularly fall through administrative gaps. At the same time, formal diagnosis has become the primary gateway to receiving basic help, so broad psychological distress can lead people to search for clinical labels, heightening the risk of misdiagnosis or overdiagnosis.
This systemic failure spills directly into daily life, leading to falling school attendance, delays in securing Education, Health and Care Plans, and eventual disengagement from education altogether. The review found that while conditions remain undiagnosed, young people experience an erosion of self-confidence and emotional strain that damages friendships and fosters social isolation, which in turn only amplifies the already overwhelming symptoms. This, when paired with other mental health/SEND needs and wider societal and economic burden, creates an environment that hinders young people.
Families endure extreme household stress and uncertainty, while those unable to afford expensive private diagnoses remain trapped on long NHS waiting lists, widening wealth-based health inequalities. This creates family strain and an unsupportive environment for a young person with SEND or mental health needs.
Underpinning these daily struggles are heightened modern pressures, including economic and housing insecurity, constant academic evaluation, digital overload, cuts to youth spaces, and reduced opportunities for rest and community connection.
What young people want
As young people, we want a system that focuses on our needs and experiences rather than making us wait for a diagnosis before receiving support. While a diagnosis can help people understand their experiences, it should not be the only route to receiving help. Young people want to feel listened to and understood when they first ask for support, with services responding to the difficulties they are experiencing at that moment rather than waiting for problems to worsen.
Young people also want support to feel connected and consistent throughout their journey. We should not have to tell our story repeatedly to different services or worry about losing support as we move between stages of education or into adulthood. This is particularly important when young people turn eighteen, as many experience a sudden drop in support and are expected to navigate adult services on their own. Support should feel straightforward to access and designed around the individual, rather than expecting the individual to navigate a complicated system.
Services should work together more effectively, including schools, GPs, CAMHS, youth workers and other support organisations. A joined-up approach would help prevent young people from falling through gaps and ensure that support is consistent regardless of where they seek help. Young people also want support to be available close to home so that practical barriers, such as travelling long distances, do not prevent them from accessing the help they need.
Above all, young people want a system that gives them the same opportunity to succeed as their peers, regardless of their background, income, disability, or diagnosis status. Access to support should not depend on whether a family can afford private assessments or additional services. Support should empower young people to thrive, not simply help them manage a crisis once it has already developed.
A call for meaningful reform
Young people need the Government to treat our wellbeing as urgent. The current system is leaving many of us without support until things reach crisis, and this cannot carry on. Long waits for help are stopping young people from getting support. Excessive diagnosis requirements are creating barriers. Gaps between services mean young people fall through the cracks, especially at eighteen. The Government and health services must shift their mindset.
Young people with disabilities should not be seen as a burden, but as individuals who deserve the same chance to thrive as everyone else. Early intervention should begin as soon as someone starts struggling, not only after a formal label. Support must be joined up, easy to access, and available in every area, regardless of income.
We are calling for meaningful reform: a national commitment to measuring young people’s wellbeing as we have pushed for through the Our Wellbeing, Our Voice campaign, and a system that responds to real needs. Young people cannot keep waiting years for change. Action is needed now because wellbeing matters for all our futures.