Fewer than 1 in 15 young people with a mental health disorder received a diagnosis from NHS mental health services, King's study estimates

Fewer than 1 in 15 young people with a mental health disorder received a diagnosis from NHS mental health services, King's study estimates

• Diagnoses from NHS mental health services rose from 2.6% of the population in 2009 to 4.4% in 2024, this study of 17-year-olds in South London found.

• Fewer than 1 in 15 of those estimated to have a mental health disorder were diagnosed by NHS mental health services. Among those also estimated to have seen any health professional for help with their mental health, it was still fewer than 1 in 4.

• Of those estimated to have a disorder and to have seen any health professional, girls were less likely to be diagnosed than boys and young people from Black, Asian, Mixed or other ethnic backgrounds were less likely to be diagnosed than White young people.

Fewer than 1 in 15 young people in South London estimated to have a mental health disorder may have received a diagnosis from NHS mental health services, according to a new study from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London.

Diagnosis is an important step towards delivering recommended evidence-based treatment, and NHS mental health services are the main state-funded providers of such treatment for young people with mental health disorders. But little is known about how many young people with disorders receive a diagnosis from these services.

In this study of 17-year-olds in South London, researchers compared the number diagnosed in NHS mental health services between 2009 and 2024, based on electronic health records, with the number living in the general population during the same period, based on Office for National Statistics data.

They then compared the number who were diagnosed with estimates of the number in the population who would have met criteria for a mental health disorder, and the number who would have also seen any health professional for help with their mental health. These estimates came from interviews with over 2,000 young people in the nationally representative Environmental Risk (E-Risk) Longitudinal Twin Study and were weighted to reflect the characteristics of South London 17-year-olds.

The proportion of 17-year-olds in South London who received a diagnosis of any mental health disorder from NHS mental health services rose from 2.6% in 2009 to 4.4% in 2024, suggesting that more young people’s mental health needs are being identified by these services.

Looking at five disorders assessed by the E-Risk Study researchers (depression, generalised anxiety disorder, PTSD, conduct disorder and ADHD), it was estimated that, across the study period, fewer than 1 in 15 young people with any of these disorders would have received a diagnosis from NHS mental health services.

Dr Stephanie Lewis, lead author of the study from the IoPPN at King’s College London, said:

"It’s encouraging that more young people are receiving diagnoses from NHS mental health services than in the past. But our findings suggest that most young people in the population who meet criteria for a mental health disorder don’t receive a diagnosis from these services, even when they’ve had some healthcare contact for these problems. This research highlights the importance of strengthening young people’s mental healthcare, so that more young people with disorders can access services that recognise their needs and provide effective, tailored treatment."

Diagnosis provision by NHS mental health services varied according to gender and ethnicity. Among young people estimated to have a disorder and to have seen any health professional for help, girls were less likely than boys to receive a diagnosis, as were young people from Black, Asian, Mixed or other ethnic backgrounds compared with White young people.

According to the researchers, part of this gap appears to arise because many young people with these disorders had not seen any health professional for help. For some, this could reflect barriers such as uncertainty about when help is needed or where to get it, concerns about confidentiality, and practical difficulties attending appointments.

The researchers add that this does not fully explain the gap because, among those estimated to have a disorder and to have seen any health professional for help with their mental health, including GPs and counsellors, fewer than 1 in 4 received a diagnosis from NHS mental health services. This suggests that the gap could also reflect barriers within the healthcare system. These barriers might include difficulty accessing mental health services because of high thresholds and limited capacity, as well as possible difficulty recognising disorders within these services related to time and resource constraints, clinical complexity, or concerns about labelling.

Professor Andrea Danese, senior author of the study from the IoPPN at King’s College London, said:

"Diagnosis matters because NHS treatments are disorder-specific, and without it, young people cannot be matched to the care most likely to work. Our findings show that most young people with a disorder are not receiving one, including many who have sought help. Our findings reinforce the message from the Fonagy review, which was published last week. The case now is for investing in the capacity to assess."

Researchers say the figures reported are likely to reflect or overestimate practices nationwide. The findings are consistent with and expand those from the STADIA* trial: in eight large National Health Service Trusts in England, around one in eight children referred to community mental health services received a recorded diagnosis within a year, although two thirds of those assessed screened at high probability of a common mental disorder.

ENDS

For further information, contact: Louise Pratt, Institute of Psychiatry, Psychology & Neuroscience, King's College London Tel: +44 7848 5377 | Email: ioppn-pr@kcl.ac.uk