Review warns of youth mental health crisis and long waits for care

A government-commissioned review has warned that young people in England are facing unprecedented levels of common mental health problems and long waits for treatment. The review, led by Professor Peter Fonagy, found a dramatic rise over the past 25 years, especially among 16 to 24 year olds and especially young women. More than one in four people in that age group are affected by conditions such as anxiety and depression, and the report says the situation is set to get worse.

The review estimates that the two million young people who have self-harmed could rise to nearly 2.5 million by 2030. The number in psychological distress could reach nearly 4.5 million. Professor Fonagy said the causes include insecure work prospects, social media and a general lack of hope. He rejected the idea that the problem is simply a lack of resilience in a so-called snowflake generation. He said the current generation does not believe it will have a better life than its parents, and that this is not something young people have done but something that has been done to them.

The report also looked at autism and ADHD. Diagnoses have risen sharply, pushing waiting lists to around 650,000 for ADHD and 250,000 for autism. But the share of the population with those conditions has stayed broadly steady since the turn of the millennium. Henry Shelford, chief executive of ADHD UK, said waits are the most pressing concern. In one part of England, he said, the wait for an adult diagnosis is 52 years. Someone referred at 18 would not be seen until they were 70. He said every adult diagnosed is a child who was missed.

Laura Collins, 25, described how her mental health problems began in primary school. Her parents sought help after an undiagnosed eating disorder emerged, but she spent a very long time on a waiting list. By the time she was seen for anxiety and OCD, she was terrified she would be sectioned. She said earlier support would have stopped her conditions getting worse.

The government said it is looking at the review's recommendations and that they will feed into a mental health strategy due in a few months. Professor Fonagy said the current system is not fit for purpose and needs to be sorted urgently. Dr Zubir Ahmed, Labour MP for Glasgow South West, who was a junior health minister when the review was commissioned, said the report's picture is bleak. He said there was no widespread evidence of overdiagnosis of ADHD and autism, though there are worrying trajectories among younger people. He called for more consistent diagnosis and regulation of private providers. He said mental wellbeing does not occur in a vacuum and is affected by insecurity and high expectations on young people. Asked about the pace of government action, he said the business-as-usual model is not tenable and that support must be needs-based and risk-based. He said departments must work together, including local government and the Department for Work and Pensions through Alan Milburn's review. He added that the cost of inaction is high for young people and the economy.