To ask His Majesty’s Government what assessment they have made of the change in number of diagnoses of mental health conditions in each of the last five years.
My Lords, I am extremely grateful to the House for allowing time for this debate and to all noble Lords who will be speaking.
Something has gone wrong when more than one in five adults in England now live with a common mental health condition such as anxiety and depression, with diagnoses of ADHD and autism also climbing steeply; among young people, it is one in four. The Adult Psychiatric Morbidity Survey shows it climbing from one in six a generation ago. Today, nearly half of young people who are NEET—not in education, employment or training—are classed as disabled. The single largest reason is a mental health condition such as anxiety, and four in five of those on health-related universal credit are there for a mental health or neurodevelopmental condition.
But here is the bit that should make us ask questions: while these conditions have surged, the most serious illnesses—schizophrenia, bipolar disorder and the psychoses, together with the most severe learning disabilities—have stayed almost flat. Were we truly in the grip of a new epidemic of disease, we would expect it at the most serious end as well. This strongly suggests that what has changed is not our human biology but our understanding and where we draw the line between health and sickness.
Of course it is right to look at many factors for this and I do not dismiss them—although time does not allow me to explore, for instance, the impact of the pandemic or social media—but I do not hear us in our debates talk about something that I believe is very important, so I want to mention it this evening. It is the importance of what we used to call grit, self-sacrifice and discipline. It was integral to our culture and to what it meant to be British. It meant that work was not a curse, nor only a wage, but a calling and a source of deep pride. Our Protestant work ethic laid the foundations for so many things that we revere today. It built the mills and dug the mines; it underwrote the Victorian gospel of self-improvement; it built the chapels and friendly societies; and it was the spirit that rebuilt our bombed cities after the war.
My Lords, I thank the noble Baroness, Lady Maclean, for securing this very important debate. While mental ill-health is rising across our society, the deterioration has been particularly marked among girls and women. I do not for one moment minimise the crisis in male mental health. The persistently high suicide rate among men demands urgent action and sustained attention. Today, however, I wish to focus on the mental health of girls and women.
Around one in four women now experience a common mental health condition, compared with around one in seven men. Nearly one in four girls aged 17 to 19 has a probable mental health condition—more than double the rate among boys of the same age. Eating disorders affect more than one in five young women—four times the rate among young men. More than 30% of women aged 16 to 24 report having self-harmed.
These are not isolated statistics. Together, they point to a profound and worsening trend. Many young women are growing up in an environment, where social media can amplify pressure around appearance, achievement and self-worth. Although technology brings many benefits, we cannot ignore the growing evidence linking excessive social media use to anxiety, depression and eating disorders, particularly among adolescent girls. I welcome the proposed social media ban for under-16s.
My Lords, I welcome this timely and important debate. I want to start by addressing head-on the issue of the so-called overdiagnosis of mental health conditions. In these increasingly contested and often divisive debates, I find it hugely helpful to look at the facts. That is why I very much welcome the Government’s independent review into the prevalence of mental health conditions, ADHD and autism, alongside existing national survey data and academic research on the issue.
Simply put, the strongest available evidence does not support claims that rising mental health diagnosis, which undoubtedly exists, is driven simply by widespread overdiagnosis. Population surveys, clinical evidence and service use data all point to a genuine increase in mental health need over time and a worsening of the social determinants of mental health, alongside improved recognition, reduced stigma and a greater willingness to help.
As we have already heard in this debate, one in five adults now live with a common mental health condition, up from one in six 10 years ago, and, according to the King’s Fund, one in five children in England now have a probable mental health condition, up from one in eight 10 years ago. Yes, the increase in serious mental health illness is less sharp, but it is still going up. In short, the best available evidence suggests that mental health need has increased over time, particularly for common mental health conditions such as anxiety and depression. So, to my mind, the key policy challenge is not whether diagnosis rates are too high or too low but whether people can access timely, appropriate and effective support, and that is where I will focus the rest of my remarks.
My Lords, I am a fellow of the Royal College of Psychiatrists, but what I am going to say this evening will, I fear, be unpopular in some quarters, including with my own royal college, which broadly says that these rising figures merely expose unmet need. I disagree. Rather, I agree almost entirely with the noble Baroness, Lady Maclean. I shall talk today particularly about children, because of the horrendous impact that this diagnosis problem has on children and their futures.
We have engineered a situation where far too many children are labelled as mentally disordered. They are indeed troubled and they need support but not a medical diagnosis. Since the early 19th century, every generation has believed that mental ill health was on the rise. As has been pointed out in epidemiological studies, prevalence has remained remarkably stable throughout the generations. What we see now has been referred to as the cultural inflation of morbidity, including the rise in so-called autistic spectrum disorder in children with average or superior intellectual gifts, attention deficit hyperactivity disorder—if noble Lords would like to test themselves on the myriad of online websites, they will find we have all got it—and a range of other disruptive and distressing behavioural abnormalities, plus depression and anxiety. All have been accepted as a suitable case for treatment.
My Lords, I welcome the debate and the opportunity to speak in support of the Government’s approach to one of the most pressing public health challenges of our time. I do so not as a politician but as someone who has the personal experience of what it means to love somebody with a serious mental health condition.
My late husband was diagnosed with bipolar disorder at the age of 29, following a long process of trying to find answers to how he felt and because he knew he had to learn how to manage things, particularly for our daughter. Looking back, we came to recognise that many of the symptoms, such as anxiety and depression, had been present since his early teens. He was fortunate: he had a good support network around him, and I learned how to be there for him through his manic episodes, his depressive states and the darkest moments when he was living through suicidal thoughts. Not every family has that, and that is why this debate matters so much.
I am glad that more people are looking for help with their mental health. It shows that the stigma around mental well-being is dissipating and, I hope, not manifesting in other ways. The crucial thing will now be how they are helped, whether it is in the home, in school, in the community or through a medical specialist.
Among many things, the Mental Health Act 2025 crucially enhances the rights of children and young people, ensuring that their wishes and those of people close to them are central to decision-making. That matters deeply to me, not only because of my husband's experience but because I am the mother of a 17 year-old daughter who struggles with anxiety—and, I can assure this House, has plenty of grit. My husband’s journey has given me tools that many parents simply do not have. I understand the signs and I know how to have the conversations, but what I cannot protect her from is the environment in which she is growing up. That environment is far more exposing than anything her father or I faced at her age. NHS England’s Mental Health of Children and Young People in England report found that 20.3% of eight to 16 year-olds had a probable mental health disorder in 2023. The pandemic accelerated a crisis that was already building. Into that fragile landscape, came the relentless—I would argue deliberately engineered—pressure of social media.
My Lords, I am grateful to the noble Baroness, Lady Maclean, for securing this debate. I am also grateful to my noble friends for their contributions so far, particularly their citation of the data, which will save me from repeating it. I am grateful to the noble Baroness, Lady Shah, for sharing her own personal story, which brings to life some of the challenges faced by families in extreme circumstances.
Given the extraordinary rise in diagnoses of mental illness among young people, I want to address young adults in particular. We need to ask, as the noble Baroness, Lady Murphy, said, whether we have fundamentally altered how a generation defines mental ill-health and how they handle it.
It is absolutely not the case that there are not serious conditions and children and young adults in desperate need of help, but there is also a vast increase in the number of young adults who are meeting the threshold for a common mental health condition, most commonly anxiety and depression. At the same time, among the category of disabled young people who are not in education, employment or training, the proportion citing mental ill-health as their primary condition has rocketed from 24.3% in 2011 to 42.6% in 2025. That is an extraordinary rise. As the Milburn review has reported, we are seeing a generation of young adults, at what should be the beginning of their working lives, increasingly defined by a psychiatric diagnosis and absent from education and work. They are absent from their own lives.
There is real concern that some mental health conditions are being diagnosed too broadly, and it is worth giving the matter a serious discussion, so we owe our thanks to the noble Baroness, Lady Maclean, for raising the issue this evening. But that concern should never become a barrier for someone who is struggling and prevent them seeking the help that they require. As my noble friend Lady Nargund explained, there are pressures on young people today and, from my perspective, it is tougher.
Overdiagnosis is a systemic issue. It is something that clinicians, researchers and policymakers need to work through, and they are—they are not unaware that these are real issues—but it is not something that a person in pain should factor into their decision before reaching out to a professional. Those are completely separate conversations and, I have to say, grit and the Protestant work ethic are not really part of either conversation. If you are finding it hard to function, sleep or feel okay on most days, that matters. Whatever label ends up being or not being attached to it, the experience is real. A good clinician will not just hand out a diagnosis; they will listen, ask questions and work with you over time. Attention has been drawn to the remarks of Professor Sir Simon Wessely, who drew attention to the overmedicalisation of everyday problems. I support that characterisation, but here we are talking about diagnosis by trained medical professionals, not self-diagnosis.
My Lords, I thank the noble Baroness, Lady Maclean, for securing this important debate. There were around 1.8 million people waiting for mental health services in quarter 1 of this year, and long waits for access to mental health services seem to have become normalised. But rather than looking at the numbers negatively—as I think the noble Baronesses, Lady Murphy and Lady Cash, seem to—I see this as people starting to seek help as they would for their physical health. Removing that stigma in my lifetime, as people understand more and are willing to come forward when they are in need of help with their mental health, has been a positive move. I thank the noble Baroness, Lady Shah, for her very personal and powerful contribution to this debate.
As Mind, the mental health charity, has advised,
“the strongest available evidence does not support claims that rising mental health diagnosis is being driven by widespread overdiagnosis. Population surveys, clinical evidence and service data, point to a genuine increase in mental health need over time, alongside improved recognition, reduced stigma and greater willingness to seek help”.
As my noble friend Lady Tyler of Enfield rightly stressed, the key issue we should be debating is not whether diagnosis rates are too high or too low, but how we can ensure that people can access timely and appropriate support. I do not agree with the noble Baroness, Lady Maclean, and her talk about something having somehow gone wrong, and the need for grit. There is a danger that dismissive language will begin to undo the progress we have made, by reintroducing stigma and shame into conversations about mental health. As the noble Lord, Lord Davies, said, the experience is real and we do not need an extra layer of burden in this space. Rising diagnosis is occurring alongside rising symptoms, distress and impairment. That points to a genuine increase in need, rather than simply a change in labelling or lower thresholds for diagnosis.
My Lords, I begin by thanking my noble friend Lady Maclean for securing this important debate. The question before us is not whether mental health conditions are serious or deserving of support, because we all agree that they are. Nor should we overlook the very real impact that anxiety, depression and other conditions can have on people’s lives: on their education, on their employment and on their relationships. The noble Baroness, Lady Nargund, spoke movingly about women’s and maternal mental health. The noble Baroness, Lady Shah, spoke incredibly movingly about living with her husband’s and daughter’s mental health challenges. It took a lot of courage to share that with noble Lords.
However, as parliamentarians, while we should show compassion and understand that every case is different, and that, as the noble Baroness, Lady Pidgeon, said, it is important to remove the stigma, we would be failing our duty if we did not seek to understand why the number of diagnoses has risen so dramatically in recent years. We should do that not only for the well-being of those with mental health conditions, but because of the demographic challenge facing the UK and many other countries with ageing populations. While the dependency ratio—that is, the proportion of young and old dependants relative to the working age population—is climbing, Governments of all colours are asking what that rise means for individuals, for state-provided services, for the economy and for the taxpayer.
20 of 22 shown
I am sure that some will accuse me of turning back the clock or trying to, and they will point to government schemes in schools and interventions in businesses, mental health counselling and awareness days. But if all those schemes actually worked, they would be reducing mental health problems and sickness benefits, not driving them up, and today we would not be spending twice as much on working-age welfare as we do on defence. The OBR expects spending on sickness and disability benefits alone to climb past £100 billion by the end of this decade, and just last week, the Defence Secretary and the junior Minister resigned from their posts because neither of them could in all conscience defend this position.
I believe the reason that we have been so willing to sign people off work for mild conditions is that we have forgotten that work is the best way to heal from many troubles. As Barry Ingleton, who runs the Synolos mental health charity in Oxfordshire, puts it:
“Not every emotion is an illness, but every emotion deserves to be heard”.
He works with clients with serious mental health conditions, but they go on to find purpose and joy in meaningful roles.
We do not talk enough about the culture behind our Protestant work ethic and how any kind of work, including all kinds of manual labour, done well can give dignity and purpose to a life. Of course, we should experience emotions; that is what being human means. But an emotion is an emotion, not a life-limiting condition meaning you are permanently ill or disabled.
In the policy space, I am honest that the last Government did not get everything right. But this Government know they have the support of our Benches to do the right thing on welfare, and they must start by telling the truth about these common mental health conditions, including neurodiversity and the benefits system.
I hold two psychology degrees, for my sins, and before politics I spent 30 years running a small business in Birmingham. I understand what people get from work and how a good employer accommodates someone going through a hard time—and it is not by mandating more mental health awareness days, or taxing businesses more.
Many professionals are raising this alarm. Sir Simon Wessely, a former president of the Royal College of Psychiatrists, warns against the “overmedicalisation” of normal emotion. The neurologist Dr Suzanne O’Sullivan argues that “our obsession with medical labels is making us sicker”, not better. Alan Milburn’s review, commissioned by the Government, describes a system in which a life on benefits for mental health conditions is more lucrative and far less hassle than work.
We seem to have come to confuse workplaces, schools and universities with therapeutic services. Yes, I agree that we originally needed to remove stigma from mental health, but we have overcorrected. We started with being kind and well-intentioned, but it is cruel to tell people that they are so fragile, ill or even neurodivergent—a label that simply means the brain is different but is now stretched so wide that it can accommodate almost everybody—that they cannot ever work. I do not blame people for doing what the system incentivises them to do. But our system now means that those with the most serious conditions are at the back of the queue for the help that the state should rightly provide. I think this is morally wrong.
I ask the Minister, who has a huge amount of experience: do the Government accept that reform is desperately needed to reduce the ballooning rise in less serious mental health and neurodiversity conditions that underpin our out-of-control welfare bill? Does she agree that it is time for a truthful conversation about the best form of help for these conditions, so that our budget can be targeted at the most vulnerable, seriously ill and disabled?
Professor Fonagy’s interim report shows that young people now report higher levels of psychological distress than older adults, reversing historical patterns. We must also acknowledge the profound impact of violence against women and girls. Women who experience domestic abuse, sexual violence and harassment are at substantially increased risk of depression, anxiety and self-harm. For women, mental health is also shaped by factors that are unique to women’s health. Across the reproductive life course, from premenstrual dysmorphic disorder to the mental health impacts of menopause, mental health and physical health are inseparable. Pregnancy-related mental health problems affect around one in four women. Maternal suicide remains one of the leading causes of death between six weeks and one year after childbirth. Although awareness has improved, too many women still struggle to obtain a timely diagnosis and the support they need. The consequences extend far beyond the individual woman. Poor maternal mental health can affect infant development, family relationships and the long-term life chances of children.
If we are to reverse the deterioration in the mental health of girls and women, services alone will not be enough. The true measure of our commitment to mental health is not how we respond when people reach crisis but how we prevent them getting there in the first place. People living in the most deprived communities are almost twice as likely to experience a common mental health condition as those living in the least deprived. We must address the social determinants of health: poverty, financial insecurity, loneliness and the erosion of community support. That requires more than increasing capacity; it requires a healthcare system that understands the causes of mental health problems, understands gender-specific presentations of mental illness and ensures that women are listened to when they describe their symptoms and experiences.
I therefore welcome the Government’s commitment to community mental health centres, school mental health support teams and a neighbourhood health service. These are important steps forward. I ask my noble friend the Minister to ensure that the rollout of these services will be designed explicitly to address inequalities and that women’s physical health and mental health services are connected.
First, on children and young people, charities such as Barnardo’s with many years of first-hand experience in this field are clear that the number of children and young people diagnosed with mental health conditions reflects primarily a rapidly-changing world—particularly the digital world—greater need and improved awareness. Also, as the Prime Minister acknowledged this morning, a rise in online and social media use can be a driver of poor mental health in some children. That is why in principle I welcome today’s announcement of a social media ban for under-16—indeed, action was long overdue—but, and it is a big but, we need to see far more details on how it is going to be implemented and enforced; we need to make sure that we learn the lessons from Australia, and we must never shy away from holding big tech companies’ feet to the fire for peddling harmful content and addictive algorithms.
According to a recently commissioned report by the Children and Young People’s Mental Health Coalition with Mumsnet, 87% of parents say that today’s children face more mental health pressures than they did. What parents say they really want is more school-based mental health staff and shorter NHS waiting times, particularly for specialist services. I have always supported the Government’s commitment to expanding enhanced mental health support teams for all schools and colleges in London and the enhanced pilot, but the model is not effective for all children and young people. There are those for whom mental health support teams do not provide sufficient support but whose needs are not acute enough to meet the threshold for child and adolescent mental health services. In my various Private Member’s Bills on this issue and my recent amendment to the Children’s Wellbeing and Schools Act—unsuccessful, I have to say—I have called these children “the missing middle” because they are falling through the gap in support and would greatly benefit from access to a schools-based counsellor as part of the funded rollout of mental health support teams. Sadly, I have not been able to persuade Ministers of this yet, but I will continue my campaign.
Mental health currently gets only 10% of total NHS funding but provides 20% of the disease burden, and it has costly knock-on effects on physical health. That is why I want to see the mental health investment standard reinstated—the Government dropped it quietly last year. We also need to see waiting time targets reintroduced, access standards introduced for community mental health services for adults with severe mental illness, and urgent crisis care for all ages. I am sure the Minister will also be delighted to hear that I have not given up my campaign for an independent mental health commissioner to represent patients and families and carers.
I conclude by emphasising that we urgently need a new mental health strategy with a strong focus on community services, early intervention and prevention. The Government recently issued a call for evidence, which of course I welcome, but it must be followed up with action. Indeed, the Government are more than welcome to borrow from the wealth of ideas and evidence in the Liberal Democrats’ recent policy paper entitled Whole-Person Mental Health. That includes a new offer for young people, mental health walk-in hubs in all communities and the introduction of mental health check-ups for adults going through major life events, and there is lots more too.
Prescriptions of stimulants for ADHD have gone up by 50% since 2019. There is no such thing as bad behaviour anymore, but rather it is oppositional defiant disorder—and yes, there is a DSM-5 and an ICD diagnostic category for it. Society, of course, has made it a lot worse by providing huge financial incentives for parents and children to insist on being labelled in this way.
It is much worse in the United States, where there was recently a series of articles in the New Scientist pointing out how disastrous the mental therapy mania is for young people and its unfortunate impact on other children. In the UK, as of spring this year over 700 mental health support teams are now operational, and accessible to well over half the students in schools and FE colleges. Utterly predictably, they keep finding more customers to label and put on waiting lists, with the so-called undiagnosable middle who are not yet being tackled. The cost is nearly £500 million annually across the country. Is it cost-effective? The evidence is very poor. Not surprisingly, those engaged in the services—teachers and parents—love it, but I am sceptical and astonished that the Government would expand these teams on such flimsy evidence.
I emphasise that I do not underestimate the problems that many children face, especially inadequate parenting but also profound poverty, housing and health challenges, bereavement, being at risk of criminal or sexual exploitation, and having caring responsibilities. These are real problems and I do not doubt that early years and older children’s support is sometimes very worthwhile for these children. These are normal responses to often appalling circumstances and are the kind of things that effective social workers used to tackle but now do not.
There are two major adverse consequences to this problem. The less important, perhaps, is the extra time that children with problems are given to complete exams and tasks, with the consequence that they are believed to be capable of a lot more than they can achieve, leading to the truth of inadequacy emerging only on employment or in higher education. Much more importantly, children and young people with serious mental illnesses, such as incipient psychosis or a learning disability with associated serious mental disorder, have huge difficulties accessing care. It is they who need mental health support, but they get lost in the morass of others with less profound problems. These children are buried in a tide, waiting to see a CAMHS specialist. It is these young people we should prioritise. I would close these mental health teams and concentrate on the seriously unwell.
The Mental Health Foundation has warned that social media has contributed to a 47% increase in young people experiencing mental health harm in England since 2007. Most young people aged 16 to 21 have been exposed to harmful or disturbing content online, with over a third having encountered suicide or self-harm content and more than a quarter exposed to pro eating disorder material. The algorithms make it worse. These platforms are not neutral; they are designed to maximise engagement, and parents cannot just simply switch them off. The exposure is constant. Ofcom research showed that a third of eight to 17 year-olds said they had seen something online that they have found worrying or nasty in the past 12 months. That is not an accident; that is a design, by choice, by technology companies that have for far too long faced far too few consequences. I welcome the approach that the Government are taking on this. Social media can be a benefit, but we all must be alive to the very real harms.
The consequences for young people are stark. YoungMinds reports that the number of children and young people referred to emergency mental health care rose by 10% between 2023 and 2024, with many stuck on waiting lists for months and years. The human cost of delays is not abstract; it is measured in school days lost, futures diminished and families left to cope alone. I welcome the Government’s response, with extra mental health care workers and, crucially, by 2029, national coverage for pupils covered by a mental health support team—something my daughter had the benefit of to manage her grief when her father passed away.
Even if one young person gets the support they need earlier through this support from the Government, before a crisis deepens, the reforms will have made a difference. I know from my own family what early identification and proper support can mean. This Government are moving in the right direction on health and online. Our duty now is to ensure that they see these commitments through, fully resourced and understood, reaching every community in this country.
The rocketing numbers are a warning for us as a society. As the noble Baroness said, we need to examine very carefully whether the definitions of mental illness have expanded too far in some cases. A diagnosis is not a neutral thing; it has the power to shape how a young person defines themselves, and how others then treat them.
Some noble Lords know that I co-founded a behavioural science business and spent 10 years immersed in the research. The body of science now shows us that how we treat people, and how they define themselves, has a massive impact on their life and health outcomes. Professor Langer’s work has showed the profound influence of context and expectation on human functioning. Albert Bandura demonstrated self-efficacy: the belief that “I can do this” is a powerful predictor of whether people persist through difficulty. We are not giving this whole generation of troubled young people those messages any more. Martin Seligman’s famous work on learned helplessness showed the very opposite: when people come to believe they have little control over their circumstances—and this is what we are telling them—they stop trying, even when improvement is possible.
There is such a profound difference between telling a young person that they are experiencing anxiety but, with support, can learn strategies to manage it or face the situations that frighten them; and telling them that they have an anxiety disorder, which explains why these situations are too difficult for them to take on. One message reinforces agency and the other victimhood. Sometimes children get told one thing, but too many young adults are being told the opposite.
The Government deserve enormous credit for commissioning Professor Fonagy, Sir Simon Wessely and colleagues to ask the difficult questions about excessive diagnosis, medicalisation and whether our systems have become far too dependent on labels. Can the Minister confirm to the House that she will pursue the outcome of that review and its findings in full? Can she ensure that those findings are communicated to the other relevant departments, and that there is collaboration between those departments?
There is already enough shame attached to mental health struggles—I know the situation is improving, but it is still a big barrier—without adding an extra layer: the worry that your problem is not real enough, or that you are somehow contributing to a broader diagnostic trend. That is not a burden anyone should be carrying. I ask my noble friend the Minister to show that she understands the issues in her reply and to commit the resources to provide a mental health service across the range of mental problems. Clearly, serious problems should be a priority, but that does not preclude the need to provide a range of services.
The noble Baroness, Lady Murphy, is right: the goal of mental health care is not to provide a diagnosis; it is to help people to feel better and function well—and, ultimately, you do not need a label for that. But the problems are real, and we should not do anything that would suggest to people that their problems are not real.
The noble Baroness, Lady Nargund, rightly highlighted the increase in women—now up to one in four—and some of the reasons for this, including technology. That was really powerful. As we have heard in much of the debate today, nowhere is this more acute than among children and young people. Barnardo’s practitioners report growing complexity in presentations, including acute anxiety, depression and trauma-related distress. Yet less than 10% of the NHS budget is spent on children and young people’s mental health.
The Government’s commitment to expanding mental health support teams to all schools and colleges is welcome. But these support teams are not designed to meet every need. Younger children and those with special educational needs or facing more complex mental health challenges may simply not be able to engage with low-intensity cognitive behavioural therapy, or may need something that the model cannot offer. My noble friend Lady Tyler, and Barnardo’s, rightly describe this as the “missing middle”—children who do not quite reach a threshold for CAMHS referrals, yet whose needs exceed what the support teams can provide. Children experiencing moderate depression, self-harm, trauma or bereavement are left without appropriate help. Barnardo’s has called for mental health support teams to be expanded to include school-based counsellors: what it calls MHST plus.
The economic case is compelling, because every £1 spent on school counselling services can return £8 to the state. However, we on these Benches believe that resources in our mental health services too often kick in only at the point of crisis, and that families and communities also need to play a role in the lives of people with mental ill health. We have not been silent on some of the structural questions either. During the passage of what became the Mental Health Act last year, as we have already heard, we made the case for the creation of a dedicated mental health commissioner to provide independent oversight and accountability across the system. We have also continued at the other end, calling for mental health investment standards to be protected.
Both these measures go to the same point: without proper oversight and protected resources, warm words about parity of esteem just will not be enough. I therefore ask the Minister: as part of the Government’s new mental health strategy and the work they are doing there, will they look to offer regular mental health check-ups of people and those supporting them when they are most vulnerable to mental ill health? Will they ensure that all mental health services are integrated with money advice, and substance abuse, housing and employment advice services? Will they provide a dedicated mental health professional in every primary and secondary school? And will the Government look to make mental health referral and support services available following every miscarriage, not just after three? There is much to do to support people with their mental health. Claims that this is being overdiagnosed offer a simplistic headline to a far deeper and more complex area. I await the Minister’s response with interest.
The latest data, from 2023-24, suggests that 20% of adults meet the criteria for a common mental health condition, and that, among younger adults, prevalence has risen significantly over the last two decades. At the same time, the number of people who receive health-related benefits has increased sharply. The Office for Budget Responsibility reported that spending on incapacity benefits as a share of GDP increased between 2019-20 and 2023-24. Department for Work and Pensions data shows that 68% of work capability assessment decisions between January 2022 and November 2024 involved claimants whose primary condition was a mental or behavioural disorder.
These trends raise a number of questions. Are we witnessing a substantial deterioration in our nation’s mental health? Has greater awareness led more people who might previously have gone unsupported to seek help, or have aspects of our health, education and welfare systems become too reliant on diagnosis as the gateway for support? Are parents and children incentivised to claim mental health conditions, as the noble Baroness, Lady Murphy, suggested?
These are the issues that the Government’s Independent Review into Mental Health Conditions, ADHD and Autism was established to examine—something that these Benches welcome; I have noticed noble Lords across the House welcome it. The interim report recognises the growing demand for diagnosis and increasing pressure on services, and it raises important questions about whether support can sometimes become too narrowly tied to obtaining a formal diagnosis rather than being based on need.
As the noble Baroness, Lady Tyler, said—and the noble Lord, Lord Davies, agreed—those with serious conditions struggle to access timely support, while families often feel compelled to pursue a diagnosis simply to obtain assistance that should perhaps be available more broadly. As my noble friend Lady Cash said, the recent Milburn review highlighted that the proportion of disabled young people not in education, employment or training who cite mental health as their primary condition has almost doubled over the last decade. That should concern us all, and a truly compassionate society helps those who can work to do so.
Good work can provide purpose, independence, routine, social connection and societal contribution, all of which can contribute positively to mental well-being. But we should be very careful about saying that it is some sort of panacea—although it is still very important. The previous Government took steps through WorkWell and the wider employment support programmes, and we welcome efforts by this Government to continue helping people into sustainable employment. But the scale of that challenge, I believe, demands greater urgency.
I end by asking the Minister four questions, to be answered now or perhaps later in writing. When will the Government publish the final report of the independent review, and how much longer will we have to wait to know which of the recommendations the Government will implement? Do the Government have any existing assessments of the relationship between the rise in diagnosis and the increase in economic inactivity, or do we have to wait for a report? What thinking is there in government about ensuring access to support for those who need it without creating a system that makes diagnosis the only route to getting support and assistance?
Those with genuine mental health conditions deserve effective treatment and support, but taxpayers deserve confidence that our welfare and healthcare systems are sustainable and focused on the outcomes and those who need help. The challenge for this Government—any Government—is to achieve both. I look forward to the Minister’s response.