In March last year Wes Streeting, then the health secretary, suggested that mental health and neurodevelopmental conditions were being “over-diagnosed”. In doing so, he rode “headlong into another culture war”, said Patrick Butler in The Guardian.
Stretched services
Although he later changed his mind on the subject, Streeting seemed to be endorsing the popular view that everyday stresses and disappointments are being too often medicalised, “resulting in a surge of bogus clinical diagnoses” – and creating a “snowflake generation” of fragile, work-avoidant young people.
Last week, a “mammoth review” of mental health, autism and ADHD in England, commissioned by Streeting and chaired by Prof Peter Fonagy, published its findings. It “has no truck with the snowflake generation caricature”: there has been a steep rise in mental health problems, it concludes, particularly among the young, and this is causing genuine distress.
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The report cites insecure work, unaffordable housing and the growing influence of social media as major contributing factors to mental distress, said The Guardian. There is a “lack of hope among young people that their lives will be better than their parents’”. And stretched mental health services are clearly failing them.
Surge in demand
The rise in mental distress is real, said The Times, but when it comes to diagnoses for ADHD and autism, the report suggests that the process is certainly in danger of “going awry”, and that there is an increasing risk of overdiagnosis. The report cites research estimating that about 1.2% of children in England are autistic. Yet by last year around 6% of boys aged six to 11 had been diagnosed with autism.
The overall surge is due, in part, to an explosion in the number of private clinics offering sometimes unreliable services. They should be prevented from direct advertising, as the report suggests. While sometimes necessary, diagnoses can also cause harm if they hold people back; children diagnosed with ADHD are four times more likely to end up as Neets – not in education, employment or training. Young people need “prompter psychological help”, not “a label for life”.
So what should be done, asked Sean O’Grady in The Independent. “It’s not that obvious.” The review backs government plans to help more people into work as a way of addressing underlying problems. It also recognises the dangers of over-medicalisation: many young people would benefit more from rebuilding social connections than from antidepressants. But Fonagy doesn’t offer any clear advice about the policy choices on, for instance, welfare. That will have to wait for Alan Milburn’s review into youth unemployment later in the year.
