The review finds that mental distress has increased substantially, particularly among children and young people, while recorded diagnoses of ADHD and autism have risen sharply. However, the evidence suggests that the underlying prevalence of ADHD and autism has remained broadly stable, with greater awareness, changes in diagnostic practice and previously unmet needs contributing to increased demand.
The report highlights significant gaps in support, lengthy waiting lists and fragmented services across health, education, employment, welfare and social care. It calls for a shift towards earlier intervention and a system that responds to people's needs, rather than making diagnosis the main route to accessing support.
Support should be based on need
One of the review's central recommendations is to move away from a “diagnosis-dependent” system towards a “needs-led plus diagnosis” approach.
The report argues that people are often required to wait for a formal diagnosis before they can access support, even when their difficulties are already affecting their everyday lives.
It also highlights how reliance on diagnosis as a gateway to services can exclude people who have genuine support needs but do not meet specific diagnostic thresholds.
The review recommends developing a shared assessment framework that identifies people's needs and helps them access the right support earlier. It also calls for more integrated assessment and support across different services.
For VODG, this reinforces the importance of a system that recognises people as individuals, with different aspirations, circumstances and support needs, rather than relying on labels or eligibility thresholds to determine what help is available.
Earlier intervention and support in the community
The review identifies a range of factors contributing to rising mental distress, including financial insecurity, housing pressures, loneliness, and pressures in education and employment.
It argues that improving mental health requires more than clinical intervention, with greater emphasis needed on prevention, early support and the wider context affecting people's lives.
It also highlights the importance of community-based support and the role of voluntary and community organisations in improving mental health and wellbeing. This reflects the wider role of social care in supporting people to maintain their independence, relationships and participation in their communities.
For VODG, this reinforces the importance of recognising the contribution of voluntary sector providers and community-based services within a wider system of support. Prevention and early intervention need to be reflected in how services are commissioned and funded.
A more integrated, and VCFSE-inclusive, approach
The report finds that support remains fragmented across health, education, employment, welfare and social care.
It recommends more integrated pathways, with multidisciplinary teams bringing together expertise from different services. The review specifically highlights the need for the voluntary sector to be represented in neighbourhood multidisciplinary teams.
The report also calls for better coordination between services throughout people's lives, recognising that needs can change and varying difficulties frequently overlap.
For VODG, this highlights the importance of treating social care and the wider VCFSE sector as an essential part of the wider support system. Providers bring expertise in understanding people's circumstances, and they should be supported with clear responsibilities and sufficient capacity to ensure that people do not fall between services.
Improving participation
The review highlights the impact that mental health conditions and neurodevelopmental needs can have on education, employment and wider social participation.
It argues that participation in education and work can support mental health, wellbeing and recovery when people receive appropriate support. Success should not be measured by the number of assessments completed or diagnoses made, but focus on whether people's lives are improving, their participation and quality of life.
This reflects VODG's Glorious Ordinary Lives work, which places people's rights, choices, relationships and aspirations at the centre of social care. A more effective system should recognise that people with the same diagnosis need tailored support.
Workforce, commissioning and accountability
The review also identifies concerns about the capacity and capability across the multidisciplinary workforce.
The report states that rising need, greater awareness and recognition, and demand are running up against limited capacity leading to waiting lists and thresholds for services rising.
The report recommends overhauling the commissioning, funding, and oversight of mental health and neurodevelopmental services, alongside investment in the multidisciplinary workforce.
For VODG members, these findings raise important questions about how integrated services will be commissioned and delivered in practice. Greater coordination will require a workforce with the right skills, appropriate training and opportunities for development, as well as sustainable funding for the organisations delivering support.
Commissioning arrangements should recognise the value of preventative and community-based support, rather than focusing on short-term reductions of demand in the system.
What does this mean for VODG?
The review provides further evidence of the need for a more joined-up, needs-led approach to support to enable and enhance people's ability to participate in everyday life.
Social care and voluntary sector organisations should be recognised as essential partners in this approach, and reform should focus on improving a person’s circumstances rather than measuring success through service activity alone.
The review makes clear that reform will require sustained investment, workforce development and stronger collaboration across government and public services, for which VODG will continue to advocate.
Read the full report here.