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Getting mental health diagnoses right without undermining access to care and disability rights

The UK government’s forthcoming review of mental health and neurodevelopmental diagnoses presents an opportunity to improve the healthcare and benefits system if the potential risks are averted. Rising rates of conditions such as ADHD, autism, and anxiety disorders have raised questions about whether we are seeing a genuine increase in need or greater awareness and possible over-diagnosis. A thoughtful, evidence-based review could help bring much-needed clarity. But if mishandled, it could deepen inequalities and undermine support for those who need it most.

Done well, the review could improve diagnostic quality and reduce the postcode lottery that too often defines access to assessment and treatment. Clearer clinical standards and properly funded services would allow professionals to make more accurate diagnoses, shorten long waiting lists, and better match interventions to individuals’ needs. This is an outcome everyone should welcome.

But the review must not become a vehicle for restricting access to treatment, reasonable adjustments, or disability benefits. The increase in diagnosed mental-health and neurodevelopmental conditions reflects, in large part, years of unmet need and increasing public willingness to seek help. Tightening diagnostic thresholds or narrowing eligibility criteria risks penalising individuals who already face significant barriers to care, particularly those from disadvantaged communities. It also risks pushing desperate families towards unregulated private providers.

Framing this issue as one of “too many diagnoses” is unhelpful. It risks stigmatising people who are already struggling and undermines recent progress in public understanding of neurodiversity and mental health. The question we should be asking is not “How do we reduce the numbers?” but “How do we ensure people receive timely, appropriate and equitable support?”

If the government wants to improve outcomes, the path forward is clear: strengthen diagnostic pathways, expand clinical capacity, invest in multidisciplinary teams, and safeguard the rights and protections that enable people to live well. Any attempt to use the review as justification for cuts, gatekeeping, or narrowing access would be a profound step backwards.

A better mental health system is one that supports people — not one that seeks to reduce the number who qualify for support. The review should be a catalyst for improvement, not an excuse for limiting care.

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