Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 26 January (HL13928), what consideration have they given to the risks of self-diagnosis of mental health conditions from online quizzes and other resources.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government recognises that information about mental health is increasingly accessed online, including through quizzes and other digital resources. While such tools can play a role in helping people reflect on their wellbeing and can encourage them to seek support, they should not be used as a substitute for professional advice or diagnosis from appropriately trained clinicians.

We continue to signpost the public to trusted sources of information and support. For example, the National Health Service’s Every Mind Matters platform provides evidence-based advice, including a short quiz which offers tailored tips to support mental health and wellbeing.

The Government also recognises the broader risks that can arise from online environments. We have launched a national consultation on children’s online wellbeing to gather views on the next steps to build on the provisions in the Online Safety Act 2023. The three-month consultation will be evidence-led, with input from independent experts, and will explore options including strengthening age assurance, addressing harmful design features, and determining the appropriate minimum age for children to access social media. It will report in the summer.

We are also aware that more children and young people are using generative artificial intelligence (AI) chatbots for mental health advice and support. The Government is clear that AI chatbots must not replace advice and support from trained medical professionals. Publicly available AI applications that are not deployed by the NHS are not regulated as medical technologies, and users should exercise caution when using unregulated applications. The Government’s consultation will also explore the impact that chatbots may have on children’s wellbeing and whether further safeguards are required.

More broadly, we recognise that mental health is complex and that a range of factors may be contributing to rising demand for support. In December 2025, my Rt Hon. Friend, the Secretary of State for Health and Social Care, commissioned an independent review into the prevalence and support for mental health conditions, attention deficit hyperactivity disorder, and autism. The review will examine the evidence on what is driving increased demand for support and diagnosis so that we can ensure people receive the right support, at the right time, and in the right place.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 26 January (HL13928), what assessment they have made of the use of labels for mental health conditions, and whether the independent review into the prevalence and support for mental health conditions will consider this.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

While no such specific assessment has been made, the terms of reference for the independent review into the prevalence and support for mental health conditions, attention deficit hyperactivity disorder, and autism state that the review will look at evidence on the role of diagnosis for children, young people, and adults, including the value of diagnosis to individuals, and barriers to receiving a diagnosis, and its impact on receiving support. The terms of reference are available on the GOV.UK website.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 30 January (HL14009), what steps they are taking to understand the factors driving the increasing demand for mental health services, and whether increased spending will have any impact on reducing these factors.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government has launched an independent review into mental health conditions, attention deficit hyperactivity disorder, and autism to understand the rises in the prevalence and demand on services. The review will examine the evidence around what is driving this rising demand, including determining which trends reflect real increases in disorder, which reflect changes in awareness or access, and which are artefacts of measurement or definition. It will also consider wider factors beyond the National Health Service, such as education, employment, housing, and digital culture, to understand how these interact with people’s needs and where intervention may make the greatest difference.

We need a new approach to mental health that goes further than simply more funding, one that reduces waiting times, improves the quality of care, and promotes prevention and early intervention. Patients should have access to alternative models of support within and beyond the NHS, supplemented by clinical care. This will mean people get support earlier, avoid reaching crisis, and experience better mental health outcomes.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 29 January (HL13929), whether the independent review into the prevalence and support for mental health conditions will include any of the harms which follow from unnecessary diagnosis or treatment.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

As this is an independent review, it is for the chair, Professor Peter Fonagy, alongside the co-chairs, to determine the scope of their work, what conditions are covered, and the outputs and recommendations they choose to make, in line with the terms of reference set by the Government.

The review will examine the impact of clinical practice and explore the role that medicalisation of mental health conditions, attention deficit hyperactivity disorder, and autism plays, including the associated risks and benefits. The terms of reference are available at the GOV.UK website.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether they plan to increase the minimum age for access to adult gender clinics.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

On 18 December, NHS England published the Review into the operation and delivery of NHS Adult Gender Dysphoria Clinics, which was chaired by Dr David Levy. The review provides a strong basis for action to improve adult gender services.

As set out in the Written Ministerial Statement published alongside the Review, NHS England and the Department are taking forward a set of immediate priorities. This includes raising the referral threshold to 18 years old, aligning it with the age of discharge from the NHS Children and Young People’s Service.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the reasons why annual referrals to adult gender clinics have doubled since 2022–23; and whether they have made an assessment of the impact of social media and educational settings on referral patterns of young people.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The review into the operation and delivery of NHS Adult Gender Dysphoria Clinics (GDCs), led by Dr Levy, was published on 18 December 2025 and undertook a comprehensive examination of all nine National Health Service-commissioned adult GDCs in England. The review specifically considered issues of access to clinics, reviewing both the volume of referrals and the length of waiting times for initial assessment and treatment. Dr Levy identified that waiting times for first appointments remain lengthy, with a significant increase in the number of people awaiting assessment, as annual referrals have doubled since 2022/23. The review attributed these extended waits to several factors, including improved reporting as more clinics have joined the national system, as well as a backlog from referrals deferred during the COVID-19 pandemic.

The review also set out that surgery waiting times also contribute to the problem, as some masculinising procedures have waits of approximately eight to nine years. As a result, many patients require extra GDC appointments because the current service specification mandates follow-up reviews every six months for those waiting for surgery.

NHS England has established a National Portfolio Board, in line with Dr Levy’s recommendation, to build and develop a full implementation plan. This will address each of the review’s recommendations in turn and be aligned with the ambitions of the Government’s 10-Year Health Plan for England.

Baroness Cass’s Independent Cass Review of Gender Identity Services for children and young people published in 2024 and observed social factors, including social media and links with children and young people experiencing gender dysphoria.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what research they have commissioned, if any, to assess whether peer-group clustering occurs in gender clinics, in particular among adolescent girls; and what clinical protocols are in place to assess the influence of social factors in referrals to gender services.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The new, regional children and young people (CYP) services provide holistic care, centred on psychosocial support. This will include thorough mental health support that takes account of the child and young person's individual circumstances, including social factors.

More widely, the Independent Cass Review published in 2024, of which the new National Health Service CYP Gender Services are based, sets out the role social factors, including the role of social media and family mental health problems have in CYP experiencing gender dysphoria.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure that NHS adult gender clinics maintain comprehensive patient data and outcomes records.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

On 18 December 2025, NHS England published the Review into the operation and delivery of NHS Adult Gender Dysphoria Clinics, which was chaired by Dr David Levy. This review provides a strong basis for action to improve adult gender services.

Recommendation 13 of the review states that NHS England should work with adult gender dysphoria clinics (GDCs) to establish a national minimum dataset so medium and long-term patient outcomes can be understood following treatment by the adult GDCs, and to develop a national research strategy for adult gender dysphoria services.

NHS England, in full partnership with the Department, will now take forward the implementation of the review’s recommendations.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what guidance they have issued to NHS adult gender clinics about the assessment and management of patients with mental health comorbidities; and what proportion of patients prescribed cross-sex hormones have comorbidities.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The approach for assessment, diagnosis, and care planning, including patients with other presentations, are described in NHS England's published service specification for National Health Service adult gender clinics, which was adopted in April 2020 following a comprehensive public consultation, respondents to which included medical bodies, professional associations, and regulatory bodies. There is currently no specific data field that records the number of patients who are prescribed cross-sex hormones and who have comorbidities.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what progress they have made towards implementing the recommendations of the Levy Review into adult gender services; and when they plan to publish a full implementation report.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The review into the operation and delivery of NHS Adult Gender Dysphoria Clinics (GDCs), led by Dr Levy, was published on 18 December 2025 and forms the basis for improving adult gender services.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, laid a Written Ministerial Statement following the review’s publication. This set out that in response to the findings of this review, the Department and NHS England are taking forward a set of immediate priorities that includes:

- creating a new single, national waiting list for adult gender services to be implemented in April 2026;

- raising the referral threshold to 18 years old to align with the age of discharge from the NHS Children and Young People’s Service;

- bringing an end to self-referrals into the service and, in parallel, providing advice and guidance for those finding it difficult to secure a referral; and

- establishing challenging but achievable productivity goals for every service which can then guide and inform the commissioning of additional services, underpinned by a clear understanding of the regional demand through the national waiting list.

In addition to this, NHS England has established a National Portfolio Board, in line with Dr Levy’s recommendation, to build and develop a full implementation plan for the Adult Gender Services review.

We are making progress beyond this review, as NHS England has increased the number of adult GDCs in England from seven to 12 since 2020, and has established a national Quality Improvement Network for Adult Gender Services. In order to support the well-being of patients awaiting their first appointment with a GDC, we are rolling out a ‘waiting well’ pilot for patients on the waiting list for the GDC in the South West.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what spending is allocated across all departments to supporting individuals who are defined by themselves or others as neurodiverse.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

This specific data is not held centrally. The 2025 Spending Review prioritised health, with record investment in the health and social care system. The Spending Review announced that annual National Health Service day-to-day spending will increase by £29 billion in real terms, a £53 billion cash increase, by 2028/29 compared to 2023/24. This will take the NHS resource budget to £226 billion by 2028/29, the equivalent to a 3% average annual real terms growth rate over the Spending Review period.

However, the Government has been clear that this investment must come with reform. We will completely reorient the NHS’s operating model, so it is focussed on the most important things, better outcomes for patients.

NHS England is responsible for determining allocations of financial resources to integrated care boards (ICBs). Funding for attention deficit hyperactivity disorder (ADHD) and autism assessments are included within NHS England’s financial allocations to ICBs. The process of setting allocations is informed by the Advisory Committee on Resource Allocation, an independent committee that provides advice to NHS England on setting the target formula which impacts how allocations are distributed over time. ICB allocations for 2026/27 to 2028/29 were published on 17 November 2025 and are available on the NHS England website.

Through the Medium-term planning framework, published 24 October, NHS England has set clear expectations for local ICBs and trusts to improve access, experience, and outcomes for autism and ADHD services over the next three years, focusing on improving quality and productivity.

On Monday 23 February, the Government published the Schools White Paper, Every child achieving and thriving, and a consultation document on Special Educational Needs and Disabilities (SEND) reforms, with both documents being available on the GOV.UK website. SEND reforms begin with significant upfront investment, joint planning, and a lead in period to build system capacity ahead of legislation. As part of these reforms, £4 billion is being invested over the next three years to make schools more inclusive, including £1.8 billion over three years for the new Experts at Hand offer which will bring health and education professionals into schools to upskill education staff and enable earlier intervention.

The Experts at Hand offer builds on the emerging evidence from programmes such as Partnerships for Inclusion of Neurodiversity in Schools, which show the benefits of embedding health and other specialist professionals in mainstream settings to support settings to be more inclusive and to de-escalate need.