Mental-health care cannot have parity with physical healthcare while its years-long queues remain outside official waiting-list figures. A Guardian editorial responding to England’s Fonagy review makes that omission a test of whether the promise means anything in practice.
The editorial takes the review’s finding of worsening distress, especially among young people, as a reason to stop treating rising demand as evidence that ordinary life has been overmedicalised. It argues that services are failing to meet real needs. Tighter regulation of private ADHD and autism assessments is warranted, but the queues that drove people toward those providers also need attention.
Its account of diagnosis-dependent support is particularly useful: thresholds became a form of triage when demand overwhelmed services. Letting people receive help before diagnosis could remove a barrier. It does not, by itself, create the capacity that made the barrier attractive to an overstretched system.
The editorial welcomes stronger departmental accountability and a proposed ten-year plan bringing mental-health and neurodevelopmental support into one service. It also identifies what the review leaves insufficiently explicit: a larger share of health spending and waiting-list targets. Some changes to queue management may be inexpensive; that is not an argument that the wider reform can be delivered without new funds.
This is an editorial argument, not a separate evaluation of the review’s evidence. Its contribution is a concrete standard for reform: make unmet need visible, make someone responsible for addressing it, and resource the services expected to respond. Changing the route into care matters only if care is available at the other end.