Commissioned in 2025, the Fonagy Review aimed to understand the cause and nature of rising demand for mental health and neurodevelopmental services, assessing how common different conditions are and how prevalence has changed over time. It also set out to see how people could be offered the right support at the right time and in the right place.
Fonagy’s report was published last week, and its 600+ pages include a wealth of evidence, analysis and recommendations. But perhaps one of the review’s most important findings is that mental health needs are real and rising, and that the system needs to recognise and respond to mental health needs sooner.
Mental Health UK welcomes the review and the direction of travel it sets out. This report needs to reset our national approach to mental health, and the government’s upcoming Mental Health Strategy is the best way to do it.
The review paints a worrying picture of the nation’s wellbeing
The Fonagy’s Review finds that common mental health conditions and psychological distress have ‘substantially increased’ over the past two decades. The proportion of adults (aged 16 to 64 years) meeting the criteria for a common mental disorder has increased by almost half (to 22.6%).
The review team also found deep-rooted barriers that prevent people from accessing the right support at the right time, with the current fragmented system ‘not working for the people it is meant to serve’ and more than 7 in 10 people’s difficulties worsening when they’re made to wait longer than six months for support.
At Mental Health UK, we know that behind these statistics are millions of people left to cope alone and too often prevented from reaching their potential.
Children and young people are experiencing poorer mental health
The Review’s findings on children and young people are particularly stark. More young people are experiencing symptoms of poor mental health than at any point since records began. A quarter of people aged 16-24 now have the symptoms of a common mental health condition, with young women reporting the highest rates. This is a contributing factor towards one million 16-24-year-olds not being in education, employment or training (NEET), something our recent Supporting Young People report explores.
Four factors appear to be contributing particularly strongly to young people’s challenges:
- uncertainty about jobs, housing and money
- comparisons with each other in school, college and on social media
- lack of belonging and in-person interactions
- minimal recovery time through poor sleep and lack of exercise.
Finally, conversations about ‘overdiagnosis’ of mental health conditions can be left behind us. Fonagy says emphatically that there isn’t a ‘snowflake generation’, that mental ill health is rising, and acknowledges that children and young people are growing up in fundamentally different times, needing a fundamentally different approach.
Help shouldn’t have to wait for a formal diagnosis
A central tenet of the review is that support should be based on someone’s needs, even without a formal diagnosis of a mental health condition. With people currently waiting far too long for assessment and support, and a reactive system often only kicking in when someone reaches crisis, this is a pragmatic and welcome step.
We agree that, while still very important, diagnosis shouldn’t act as a gateway to support, and that putting in place the right kinds of interventions early should always be the priority. We see the effects that being left to cope without support can lead to, affecting people’s long-term wellbeing as well as their education and employment prospects. We want to live in a society that steps in, where timely mental health support is the norm, and everyone can access the help they need when they need it.
The Fonagy Review is also clear that mental health and neurodevelopmental conditions (such as ADHD and autism) often overlap and recommends that these services be brought closer together so that individuals’ wider needs can be seen and supported.
Mental health factors extend far beyond the NHS
The scale of poor mental health the review has uncovered needs a concerted response across health, education, employment and other facets of life. Improving the nation’s mental health cannot be the role of the NHS alone and must extend into the aspects of our lives that affect mental health – like our online environments, community spaces, schools and workplaces, housing and financial circumstances.
Through our Mental Health UK programmes, including Bloom and Into Work, we see the positive impact that properly supported mental health can have on people, schools and workplaces. We think mental health should underpin all government decision-making, and the review recommends this too.
The upcoming Mental Health Strategy should be a turning point
Of course, reviews mean very little unless their findings and recommendations are acted upon. The UK Government is in the middle of developing a new Mental Health Strategy (because health is a devolved issue, this strategy will apply to just England), and this is the biggest opportunity we have to put improving mental health front and centre of government policy.
Responding to the review, the government has committed to ‘a major overhaul of mental health support’ as part of the strategy. It’s vital that this overhaul focuses on strengthening prevention and early support for mental ill health, as well as shoring up timely access to specialist treatment and medications for those who need them.
The strategy should also make clear how organisations like Mental Health UK can be part of making that difference, putting good mental health first in homes, schools and workplaces and recognising that the government isn’t expected to have all the answers.
And when it’s published towards the end of this year, we’ll be looking for clear signs that the government is serious about turning its Mental Health Strategy into a reality.
The Fonagy Review should act as a wake-up call: investing in our mental health is good for people as individuals, and good for the foundations of our families, communities, workplaces, and country.
