Overdiagnosis in Mental Health: Where Do We Draw the Line?

The discussion around overdiagnosis in mental health has gained momentum, particularly following UK Health Secretary Wes Streeting’s comments about the potential for excessive diagnosis and the implications this has on individuals and society (The Guardian, 2025). If you are a fellow mental health professional, this debate is directly relevant to our daily practice. We work with our colleagues to navigate the fine line between ensuring that those in need receive a diagnosis and support while also avoiding unnecessary medicalisation of normal human experiences. This conversation is crucial, as it influences public perception, healthcare policies and the allocation of resources.

Defining Overdiagnosis in Mental Health

Overdiagnosis occurs when an individual is diagnosed with a condition that meets established clinical criteria but would not have caused significant distress, impairment, or harm if left undiagnosed. In mental health, this can lead to unnecessary labelling, medicalisation of normal emotional responses and potentially inappropriate treatment.

This definition aligns with literature from Evidence-Based Medicine (EBM, 2023), Welch et al. (2011), and the British Medical Journal (BMJ, 2018), which describe overdiagnosis as the identification of conditions that do not necessarily lead to harm, require intervention or improve with treatment.

Why Discuss Neurodevelopmental Diagnoses Here?

Before diving into the discussion, I want to acknowledge a key point: when we talk about overdiagnosis, we’re not questioning the legitimacy of neurodevelopmental conditions like autism or ADHD. Many individuals have faced barriers to diagnosis for years, and increased awareness has helped countless people access the support they need. However, it’s also true that those with neurodevelopmental conditions are at a higher risk of experiencing mental health problems (Russell et al., 2022). Given this overlap, it’s important to include neurodevelopmental diagnoses in this discussion—not to challenge their validity, but to highlight the challenges around accurate assessment, resource allocation and ensuring the right people get the right support at the right time.

Recent discussions around overdiagnosis in mental health, particularly those led by Health Secretary Wes Streeting, have raised concerns among the neurodivergent community. While Streeting has primarily focused on the potential overdiagnosis of mental health conditions such as anxiety and depression—suggesting that some individuals may be receiving unnecessary labels—his comments have caused unease among those with neurodevelopmental conditions.

Why? Because there is often confusion and overlap between mental health and neurodevelopmental conditions in public discourse and even within healthcare systems. Many individuals with ADHD and autism struggle for years to receive an accurate diagnosis, and discussions about “overdiagnosis” can unintentionally create fear that genuine cases will be dismissed, underfunded or deprioritised.

Additionally, because people with neurodevelopmental conditions are at higher risk of mental health difficulties—such as depression, anxiety and trauma—there is concern that a crackdown on mental health diagnoses could also reduce access to essential support for those whose struggles are rooted in their neurodivergence.

This is why it is vital to have a nuanced conversation. We need to differentiate between mental health and neurodevelopmental diagnoses, ensuring that while we are mindful of accurate diagnosis and appropriate support, we do not inadvertently create additional barriers for those who need it most.

More Diagnoses or Just More Awareness?

One argument against overdiagnosis is that we are finally recognising mental health issues that have long been misunderstood or ignored, such as depression, anxiety, complex trauma or OCD. In addition, increased awareness around neurodevelopmental presentations such as autism and ADHD has meant that many individuals—particularly girls and women—who would have previously gone undiagnosed are now receiving recognition and support. Studies show a significant increase in autism and ADHD diagnoses among adults, which may reflect growing awareness rather than overdiagnosis (Russell et al., 2022).

Similarly, growing conversations around mental health on social media, in workplaces and in schools mean that anxiety, depression and other mental health problems are now more openly discussed. While past generations may have suffered in silence, many now seek help early, which can be a positive development.

However, alongside this progress, we must also acknowledge the risk of over-pathologising normal emotions and life challenges. Not every difficult experience or emotional state requires a clinical diagnosis or treatment. There is a danger in turning ordinary struggles—e.g. grief, stress, low mood—into disorders rather than seeing them as natural responses to difficult life circumstances.

On the other hand, there is little evidence to prove “overdiagnosis” of mental health problems / neurodevelopmental problems. If anything, underdiagnosis remains a significant issue, particularly among marginalized communities. There is evidence to show that mental health and neurodevelopmental conditions may be underreported and that people have difficulty seeking and accessing support. Statements like this can feel very personally invalidating and stigmatising for many, which may impact on them seeking help/getting better/working, etc.

When a Diagnosis Helps—And When It Doesn't

From a Clinical Psychology standpoint, the concept of overdiagnosis is particularly nuanced. Whether working with children, adolescents or adults, our role involves careful assessment, formulation and intervention—without automatically jumping to a diagnostic label. While a diagnosis can unlock support, it can also carry unintended consequences, such as stigma, dependency or a narrow focus on symptoms rather than broader psychological and social factors.

Why It’s Important to See Both Sides

Recognising both the risks and benefits of diagnosis is crucial in ensuring ethical and effective clinical practice. Diagnosis can be life-changing when it leads to appropriate intervention, but it can also pathologise experiences that may be better understood through a psychosocial lens. The challenge is to ensure that people receive the right support, at the right time, in the right way.

Examples from Clinical Work:

~ A Young Person Seeking an Autism or ADHD Diagnosis

A teenager struggling with sensory sensitivities, social difficulties and executive functioning challenges may truly benefit from an autism or ADHD diagnosis, unlocking access to specialist educational support and social understanding.
However, another teenager struggling due to bullying, trauma or significant anxiety may find that a diagnostic label does not fully capture the underlying causes of their difficulties. In such cases, a psychological formulation considering attachment history, trauma and environmental stressors might offer a more meaningful pathway to support.

~ An Adult Feeling Too Depressed to Work

Some individuals may require a formal depression diagnosis to access sick leave, therapy and medical treatment, helping them recover and return to work when ready.
Others, however, may be experiencing distress due to toxic workplace environments, poor management, financial insecurity or burnout. Labelling them with a ‘mental health problem’ without considering wider systemic issues might inadvertently place the responsibility solely on the individual rather than addressing broader structural concerns, such as exploitative working conditions.

From TikTok to Therapy: The Rise of Self-Diagnosis

A growing concern among Clinical Psychologists is the role of social media in self-diagnosis. Platforms like TikTok and Instagram have raised awareness of conditions such as BPD/EUPD, anxiety, OCD, ADHD and autism but they have also led to over-identification and potential misdiagnosis. Young people, in particular, are at risk of self-diagnosing based on short videos rather than seeking professional assessments. While greater acceptance and awareness of mental health are positive, trends of seeking labels for every personality trait or emotional state can be problematic. It is important they seek professional help in understanding the difficulties they are going through.

Dr Suzanne O’Sullivan, in her book The Age of Diagnosis (2024), critiques this cultural shift, arguing that we risk reducing complex human experiences to simplistic diagnostic categories. She warns that the desire for a label can sometimes come at the cost of deeper self-understanding and resilience-building.

“Not every struggle in life requires a diagnosis, and not every diagnosis requires treatment.” – Dr Suzanne O’Sullivan (The Age of Diagnosis, 2024)

Her work highlights how many people have become increasingly driven by the need to diagnose and categorise, sometimes at the expense of seeing the whole person in their context. On the whole, it is important to take a holistic approach.

The Impact of Overdiagnosis

The Lack of Resource for Assessment and Post-Diagnosis Support in CAMHS and Adult Services

One of the biggest failures of the current system is that while targets are set and resources are increasingly allocated for diagnosing neurodevelopmental and mental health conditions, there is often little to no funding left for post-diagnosis support/long-term planning.

In Child and Adolescent Mental Health Services (CAMHS), the demand for autism and ADHD assessments has skyrocketed. However, often what happens is once a young person receives a diagnosis (usually after years of waiting for their assessment), many families are left without structured follow-up support and often report feeling abandoned after receiving/not receiving a diagnosis (particularly as services should be aiming to be ‘needs-led’ rather than ‘diagnosis-led’). Waiting lists for post-diagnostic support, therapy and intervention services can be years long or even non-existent (due to lack of resource/government funding for services). Education services are also struggling to put the required supports in place.

Challenges in Scotland and Remote/Rural Areas

CAMHS in Scotland: Services are overwhelmed and waiting lists for neurodevelopmental assessment can stretch beyond 1-2 years while post-diagnostic intervention is often non-existent. Many families struggle to also access speech and language therapy, occupational therapy and educational support, which are crucial after a neurodevelopmental diagnosis (Public Health Scotland, 2024).
Remote and Rural Areas: Families living in rural parts of Scotland face additional barriers, including long travel times to access services, limited availability of specialist professionals and fewer local mental health resources.

A 2023 report by National Autism Implementation Team (NAIT) highlighted that existing services are in high demand, but this is not matched by capacity to meet the need (Rutherford et al., 2023).

Systemic Issues in Adult Services

Similarly, in adult mental health services, while health professionals may diagnose conditions such as depression, anxiety, BPD/EUPD or PTSD, access to evidence-based psychological therapies—such as CBT, Schema Therapy, EMDR or DBT—can be limited due to the lack of funding to employ highly trained staff.

Many individuals receive a diagnosis but no follow-up care, leading to an over-reliance on medication rather than therapy or social interventions.
Remote areas face an even greater shortage of trained therapists, meaning that people often have to travel long distances or join lengthy waiting lists for treatment.
In some cases, individuals turn to charitable or private-sector services, but these are not accessible to everyone due to financial constraints.

If the government is investing in health care services, it is vital they also invest in delivering high quality post-diagnosis support. Without this, a diagnosis can sometimes feel like an empty label—validating, but not necessarily improving an individual’s quality of life. This creates a revolving door system, where people are diagnosed, struggle without adequate intervention and ultimately end up in crisis services, A&E or seeking private healthcare they cannot afford.

Overall, while access to assessment and treatment is being more considered, challenges remain in meeting the growing demand and ensuring equitable access to services across different regions.

Law and Court Decisions

The issue of overdiagnosis in mental health extends beyond healthcare, impacting various sectors, including the legal system. For example, in employment law, some employees may cite "anxiety" as a reason for missing deadlines or not attending work. While severe anxiety disorders can be disabling, there is often a grey area where workplace stress and mental health conditions overlap. Employers and legal professionals must navigate the difficult terrain of reasonable accommodations versus maintaining workplace expectations.

Similarly, in family courts, mental health conditions are being used to challenge custody arrangements—sometimes justifiably, sometimes as a legal tactic. Courts rely on clear psychiatric assessments, but with increasing diagnoses and self-diagnoses, it becomes harder to separate clinical impairment from normal emotional reactions to stress and conflict.

The Role of Social Policy: Looking at the Bigger Picture

A key issue missing from the overdiagnosis debate is that many mental health difficulties are rooted in social and economic factors rather than inherent “psychological disorders”. A diagnosis of depression or anxiety may be valid, but it does not necessarily address the underlying cause of someone’s distress.

Consider:

Housing instability—Poor-quality housing and homelessness are strongly linked to mental health difficulties. Research from Shelter (2023) found that one in three people living in insecure housing experiences clinical levels of anxiety or depression.
Employment conditions—A precarious job market, zero-hour contracts and workplace stress all contribute to mental health issues. Work-related stress and burnout are on the rise, yet instead of addressing the underlying structural issues within workplaces, the burden is often placed on individuals to seek medical or psychological help. While personal resilience and looking after ourselves is important, workplaces and policymakers must also take responsibility for creating healthier environments. It’s about everyone playing their part—employers, governments and individuals—to build a society that prioritises well-being and sustainable working conditions.
Education and social care—Underfunded/under-resources schools and overwhelmed social services mean children with additional needs often go unsupported.

If we want to reduce mental health disability, the solution may not always lie in medical/psychological interventions, but in also fixing systemic issues. Improving social policies around housing, employment, education (the list goes on) would likely reduce the need for mental health services in the first place.

Balancing Diagnosis with a Broader Perspective

As Clinical Psychologists, our job is to help individuals understand their difficulties in context, whether that means recognising a clinical condition or exploring the social, psychological and environmental factors contributing to their distress, using a “biopsychosocial approach”. It is important to deliver therapy to those who need it, but let’s not forget, not everything requires psychiatric medication or psychological therapy—sometimes social interventions and support systems can be more effective, and many patients I see get to a stage where they are ready to move on from their diagnosis/therapy/medication.

Final Thoughts: The Need for a Thoughtful, Individualised Approach

The debate around overdiagnosis is complex. While awareness and access to mental health care have improved, we must be careful not to medicalise every aspect of human experience. Diagnoses can be powerful tools, but they must be used thoughtfully.

We need a balanced approach that:
✔ Recognises genuine mental health conditions that require treatment.
✔ Acknowledges the impact of social factors on psychological well-being.
✔ Avoids over-pathologising normal human struggles.
✔ Encourages resilience and coping strategies beyond diagnosis.

Ultimately, the goal should be to support people in the most meaningful way possible—whether that is through diagnosis and treatment, or through social change and psychological understanding.

While increasing awareness of mental health and neurodevelopmental differences is a positive step, we must ensure that diagnosis is not seen as the only problem/solution but rather as a gateway to meaningful intervention and support. The government must invest in addressing the root causes of distress—such as poverty, housing instability, workplace conditions and access to education—rather than simply stating “mental health conditions are being over-diagnosed” and withdrawing financial and service-based support from those who need it. Cutting resources, such as Personal Independence Payment (PIP), while failing to address these underlying systemic issues will only lead to greater levels of mental illness, not fewer.

Instead of placing the responsibility solely on individuals to navigate an increasingly fragile support system, investment must be made in early intervention, social support and sustainable, evidence-based services that help people get well but also help them stay well. Medicalising distress without tackling its root causes does nothing to reduce suffering or empower people to lead fulfilling lives in the long-term. If the government truly wants more people to return to work, the solution isn’t to strip away essential support but to create conditions where people can thrive—through adequate healthcare, social stability and well-funded mental health services.

However, we must also be realistic—systemic change requires investment. Adequate funding for services, community support and policy-driven change must be prioritised if we want to see real improvements in mental health and well-being.

Moving forward, the challenge isn’t about “over-diagnosis”—it’s about ensuring those who struggle have access to the right support and that those who have diagnoses have access to meaningful, life-improving support. As professionals, we must continue to advocate for better post-diagnostic care, thorough assessments/formulations and policies that address the social determinants of mental health. And for those navigating their own mental health journey, remember: a diagnosis can be helpful, but it is only one piece of the puzzle. Real change happens when we address the bigger picture.

Sending love,

Dr Dot x

(dot@drdot.co.uk)

References

BMJ Evidence-Based Medicine. (2023). Overdiagnosis in mental health: Medicalizing normal experiences? Evidence-Based Medicine Journal, 23(1), 1-5. https://ebm.bmj.com/content/23/1/1
Children’s Commissioner for England. (2023). State of children's mental health services report. Retrieved from https://www.childrenscommissioner.gov.uk
EBM. (2023). Overdiagnosis in mental health: Medicalizing normal experiences? Evidence-Based Medicine Journal, 23(1), 1-5. Retrieved from https://ebm.bmj.com/content/23/1/1
O’Sullivan, S. (2024). The Age of Diagnosis: The Medicalisation of Modern Life. Chatto & Windus.
Public Health Scotland. (2024). Child and adolescent mental health services (CAMHS) waiting times: Quarter ending December 2024. Retrieved from https://publichealthscotland.scot
Russell, G., Mandy, W., Elliott, D., White, R., Warren, K., & Totsika, V. (2022). Trends in diagnoses of autism and ADHD in adults: Evidence of increased awareness or overdiagnosis? Autism, 26(2), 292-306. Retrieved from https://journals.sagepub.com/doi/10.1177/13623613221129248
Rutherford, M., Boilson, M., Johnston, L., MacIver, D., Curnow, E., & Utley, I. (2023). Adult Neurodevelopmental Pathways: Report on Actions, Outcomes and Recommendations from Pathfinder Sites in Scotland. National Autism Implementation Team.
Shelter. (2023). The impact of housing insecurity on mental health: A national report. Retrieved from https://www.shelter.org.uk
The Guardian. (2025). Wes Streeting: There is overdiagnosis of mental health conditions. Retrieved from https://www.theguardian.com/politics/2025/mar/16/wes-streeting-there-is-overdiagnosis-of-mental-health-conditions
The Times. (2023). Most GPs say everyday stress is mislabelled as mental illness. Retrieved from https://www.thetimes.co.uk
UK Government. (2023). National Neurodevelopmental Specification for Children and Young People: Principles and standards of care. Retrieved from https://www.gov.scot
Welch, H. G., Schwartz, L., & Woloshin, S. (2011). Overdiagnosed: Making people sick in the pursuit of health. Beacon Press.

Overdiagnosis of Mental Health Conditions: A Clinical Psychologist’s Perspective