Parity of esteem with physical healthcare remains a distant prospect. Ministers must do more to tackle rising distress

Perhaps the single most important finding of the independent review into mental health, ADHD and autism in England, published last Friday, is that mental distress across the population, and particularly young people, has substantially worsened. Its chair, Prof Peter Fonagy, told the BBC that the former health secretary Wes Streeting had been “completely wrong” to suggest that conditions and disorders were being overdiagnosed.

Mr Streeting acknowledged his mistake. But some rightwing politicians and commentators have leapt on the notion that medicalisation of ordinary states of mind is behind the huge rise in young people seeking help. This review should bury that idea. Instead, this should be a moment to face facts. First, that the rises in psychological distress, and the need for support with neurodevelopmental differences, are real and tied to social changes. Second, that current services are not up to what is being asked of them.

Do you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters section, please click here.

There is much to agree with in the Fonagy review into mental health support. Without serious public funding, however, its approach won’t work

Back in late 2025, when Keir Starmer’s grip on the Labour party was loosening and Reform UK was still in its pomp, the then health secretary, Wes Streeting, commissioned what the government called its “Independent review into prevalence and support for mental health conditions, ADHD and autism”.

Here, it seemed, was not just an inquiry into England’s ever-extending waiting lists for the diagnosis of mental illness and neurodevelopmental conditions, and the dire lack of support for people who experience one or both of them. The review would also dovetail with two other huge issues: mounting claims of “overdiagnosis”, which Streeting had appeared to partly endorse, and the government’s drive for the reform of so-called welfare. An apparently well-briefed piece in the Times seemed to speak volumes: work led by the renowned psychologist Peter Fonagy, it said, was commencing just “as Labour seeks a fresh crackdown on welfare spending” amid diagnoses “which have become the most common reason for a sickness benefit claim”.

John Harris is a Guardian columnist

When the Southport killer Axel Rudakubana was transferred from a category A prison to Broadmoor hospital, many observers complained that he was getting off lightly. But these places are anything but ‘cushy’, says the mother of one patient

Rampton high-security hospital in Nottinghamshire was built in 1912. Everything about the bleak, remote facility for mentally ill people is forbidding, says Jan Neate. “I get really upset going there,” she says. “Even though I really want to see Jake, visiting is an ordeal.”

Jake, 45, is Neate’s son. He has been held at Rampton for eight years. In 2017, many years after being diagnosed with paranoid schizophrenia, he killed his partner, Suzanne Brown, and was deemed mentally unfit to stand trial.