I realize now that my views on mental health overdiagnosis were divisive. We all need better evidence | West Street

Earlier this year, I appeared on the BBC and Laura Kuenssberg asked me a question I hadn’t anticipated: did I think there was a problem with mental health overdiagnosis?

I gave a simple answer: yes, I thought there was overdiagnosis, that too many people were being pushed aside and too many people weren’t getting the support they needed.

I was subsequently inundated with messages and emails expressing both enthusiastic agreement and visceral disagreement – ​​including from mental health clinicians on both sides of the debate. One angry patient sent a message saying: “Far from overdiagnosis, I can’t even get an appointment to get a diagnosis. » The worst part was that I agreed with them, but I failed to grasp the complexity of this problem.

The truth is that there has been a massive growth in mental health and behavioral problems and there is no consensus within the clinical mental health community on the causes of this growth. Mental health problems among adults increased by almost 50% between 1993 and 2023. Mental health referrals for children and young people increased by around 50% in just two years during the pandemic. And 13 times more people are waiting for an autism assessment today compared to 2019.

Whether it’s because people are more open about their mental health, there’s a growing awareness of these conditions, it’s the consequences of the pandemic, or there have been other factors, we need to get to the bottom of what’s causing this.

Because the services are not keeping up.

As the Darzi survey revealed, around 109,000 young people and children had been waiting for more than a year for their first appointment with a mental health specialist. This is despite an increase in spending on mental health services of more than 50% since 2019.

I know, from the personal experience of some of my loved ones, the pain this causes. One attempted suicide after struggling to get mental health support. A family member suffered from lack of medication for attention deficit hyperactivity disorder, seriously affecting his mental health. At the same time, I have seen the transformational impact that an early diagnosis of autism can have on the support and education a child receives.

It was following my own episode of foot and mouth disease on live television that I decided that this problem was too important to leave unsolved and required a proper evidence base. This is why my department commissioned Professor Peter Fonagy, along with Sir Simon Wessely and Professor Gillian Baird, to carry out a study into the prevalence and support for mental health problems, autism and ADHD. The review brings together some of the country’s most respected researchers, clinicians and voluntary organizations, as well as people with lived experience.

I asked them to assess the data, consider the quality of the evidence, diagnose the problem and offer recommendations on how the NHS can meet the needs of all.

I am delighted that this study is supported by Mind, the Mental Health Foundation, the National Autistic Society, the Royal College of Psychiatrists and Anne Longfield, former Children’s Commissioner for England. Everyone can see that the current system is broken and are motivated by the need to fix it. As Dr Sarah Hughes, chief executive of Mind, said: “This is a huge opportunity to really understand what is driving rising levels of mental illness, particularly among our young people. »

I’m not waiting until the review is over to start fixing our mental health services. Since the election we have recruited over 7,000 additional mental health professionals, we have increased the number of NHS talking therapy sessions, we are building new emergency mental health services for those who reach crisis point, and we now have mental health support in almost half of the UK’s schools, because prevention is better than cure.

But there is still much to do. And to get the right prescription, we must first accurately diagnose the cause of the increase in mental health problems. This is how we will ensure that everyone receives the support they need, when they need it.

• Wes Streeting is Secretary of State for Health and Social Care and Labor MP for Ilford North.

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