Mental Health Bill [Lords]

Debate between Josh MacAlister and Jen Craft

2nd reading
Monday 19th May 2025 Commons Chamber

[Josh MacAlister]

Absolutely. We need to support young carers and young people in care. One of the common challenges facing both of those populations is that services sometimes fail to look at what support can be provided to the whole family unit, so I take my hon. Friend’s point.

Finally, I will say a few words about a sensitive issue that is a growing trend. Most weeks, I visit a school in my constituency, and there is a growing theme: teachers, and now parents, are raising concerns about the potential over-diagnosis or misdiagnosis of ADHD and mild autism. I raise this point for two reasons: first, because the risk is that the scale of the increase in diagnosis is so great that it may take away much-needed mental health services from those with acute and genuine need; and secondly, because we have yet to grasp the potential negative impacts of treating what may be social challenges as medical disorders.

Some 400,000 children are currently awaiting an ADHD assessment, and rates of diagnosis have risen sharply in recent years. Diagnosis varies dramatically depending on where someone lives, who does the assessment and, worryingly, the socioeconomic background of the individual.

[Jen Craft]

Is my hon. Friend able to name an intervention for a diagnosis of mild autism that could be considered a medical intervention, not something to address one of the social issues he has identified, that could harm the individual?

[Josh MacAlister]

Yes, in a number of schools we have seen a growing number of ADHD and mild autism diagnoses that do not come with any form of treatment. That is in a system where there is an expectation that education, health and care plans will be filled and met by multiple agencies, and the families are often left battling the system, having to fight for a diagnosis to get that label and then finding that the help is not there. My argument is that those families—not all, but some of them—are battling a system that already has finite resources and now spends a huge proportion of its resources gatekeeping, when actually we should step back and look at what support the young person and their family need.

In the case of ADHD, the National Institute for Health and Care Excellence guidelines set out very clearly that, before an assessment is made, it should be established whether parenting support could be put in place to help. My guess is that, in many cases at the moment, that offer of parenting support is not in place before an ADHD diagnosis is made.

Diagnoses of autism have doubled in the last five years. I am not saying that that is incorrect, but I think the question needs to be asked, as part of the wider debate, whether that growing trend is a reflection of previously undiagnosed autism or, because of recent changes in the ICD-11 manual—the 11th edition of the “International Classification of Diseases”—people are being brought into that diagnosis who would previously have been supported in other ways.

I close by urging the Government to consider the implications of the reform of mental health services for those in rural and remote communities. They need to acknowledge the benefits that will come from these measures for those with a care experience, but also to think deeply about the need for residential care that can meet their need for a secure setting. They should also consider ways in which we as a country can have a full and rich conversation about the growing diagnosis of ADHD and mild autism, so that we can establish the best routes of support for the children crying out for support and the parents often battling against the system, who may be building up a future need for the crisis mental health services we have been speaking about this evening.