Autism, ADHD and Mental Health

WHY THE CONVERSATION ABOUT NEEDS-LED SUPPORT IS CHANGING

One of the biggest conversations currently emerging across the SEND, autism and neurodiversity communities concerns the relationship between diagnosis, early intervention and access to support.

For many years, families have described the difficulties of obtaining an autism or ADHD assessment, with waiting lists, limited specialist capacity and considerable pressure on NHS services. At the same time, parents and professionals have highlighted how difficult it can be to secure meaningful support while waiting for a formal diagnosis.

A significant development came in October 2026 with the publication of the independent review into mental health conditions, ADHD and autism, chaired by Professor Peter Fonagy.

The review has prompted important discussion about whether people should have to wait for a formal diagnosis before receiving help.

The Government has responded by committing to a stronger focus on early intervention and needs-led support. Its intention is to make broader advice and support available to children, young people and adults experiencing mental distress without requiring them to wait for a clinical diagnosis.

At first glance, this sounds like a positive step, particularly for families who have spent months or even years waiting for an assessment while watching their child struggle.

Consider a child who is experiencing difficulties with communication, emotional regulation, sensory processing or social interaction. Their family may recognise that something is affecting their ability to access education and everyday activities, but they may still be waiting for an autism or ADHD assessment.

Should that child have to wait before receiving adjustments in school? Should their emotional wellbeing be allowed to deteriorate while a referral works its way through the system?

Of course not.

Children should receive appropriate support based on their individual needs, not simply on whether a particular diagnosis has been added to their records.

However, there is an important distinction between removing diagnosis as a barrier to basic support and suggesting that diagnosis is no longer necessary.

For many autistic people and people with ADHD, receiving a diagnosis can be life-changing. It can provide an explanation for experiences they have struggled to understand, help families make sense of their child's needs and open doors to appropriate specialist support. Diagnosis can also be essential when considering treatment, medication and certain forms of intervention.

The review does not suggest that diagnosis should disappear. Instead, it raises questions about a system in which diagnosis has increasingly become the gateway to receiving help.

The Government has also indicated that it wants stronger regulation and oversight of autism and ADHD assessments, including bringing diagnostic assessments under Care Quality Commission regulation. This is intended to improve consistency and confidence in the quality of assessments.

Another important part of the discussion concerns mental health. The review identified increased distress among children and young people and highlighted factors including social media, financial insecurity, uncertainty about the future, poorer sleep and reduced feelings of connection and belonging.

This matters enormously within the SEND community because mental health and neurodevelopmental needs do not exist separately from one another. A young person who is struggling with anxiety may also be experiencing sensory overload, difficulties with communication or challenges navigating an educational environment that does not meet their needs.

It is therefore important that professionals look at the whole picture rather than treating each difficulty in isolation.

Schools, families, health professionals and community organisations all have a role to play in recognising when a child needs help. Earlier support can make a considerable difference, particularly when it is consistent and built around the individual.

But there are questions that still need answering. Who will provide this earlier support? How will schools access specialist advice? What happens when a child's needs are complex? And how will the Government ensure that needs-led provision does not become another phrase that sounds promising but is difficult to access in practice?

These are the issues that families will rightly want to see addressed.

The conversation around autism and ADHD is evolving, and that is not necessarily a bad thing. We should be moving towards a system that recognises individuals rather than waiting for paperwork to validate their experiences.

But we must never lose sight of the fact that diagnosis and support are not competing ideas. They can and should work together.

A child should not have to prove how much they are struggling before someone offers help. Equally, people who need formal assessment and specialist clinical expertise must continue to have access to it.

The real ambition should be a system where understanding comes earlier, support is easier to access and nobody is left struggling simply because they are still waiting for a diagnosis.