I hated myself so much…and now I love myself. I’m not perfect. But I’ve accepted myself now.
That was how one person described the impact of receiving an autism and ADHD diagnosis when my colleagues and I interviewed them about their mental health.
For this participant, finally understanding why they had struggled for so long had transformed how they felt about themselves.
Their experience highlights an important issue as the NHS considers changes to how people receive support for autism and ADHD.
A recently published independent review, commissioned by the government, recommends that people in England should be able to receive help according to their needs without waiting for a formal diagnosis.
This could make an enormous difference to people who currently spend years waiting for an assessment. But while earlier support is welcome, diagnosis can have benefits that go far beyond helping someone access treatment.
Autism and attention deficit hyperactivity disorder (ADHD) are conditions that affect how people experience and respond to the world. Autism can affect communication, social interaction and how someone experiences their surroundings. ADHD can affect attention, organisation and the ability to control impulses. Both vary considerably from person to person.
Demand for assessments has increased dramatically. By the end of 2025, more than 560,000 ADHD referrals and 254,000 autism referrals remained open in England.
These growing waiting lists mean people can struggle for years without understanding their difficulties or receiving appropriate help.
Mental health problems are also common among autistic people and those with ADHD. These can include anxiety, which involves excessive worry or fear, and depression, which can cause prolonged low mood and a loss of interest in everyday activities.
Providing support before diagnosis could help people who are struggling now, rather than leaving them waiting until their difficulties become more severe.
Why diagnosis can change lives
As part of MINDS (Mental Illness, Neurodivergence and Distress) a research project investigating how autistic adults and people with ADHD experience mental health difficulties and access care – my colleagues and I interviewed 25 adults who were autistic, had ADHD or had both conditions. We asked about their experiences of getting mental health support through their GP surgeries.
Participants described how receiving a diagnosis helped them understand experiences they had previously blamed themselves for. Some had spent years struggling, without knowing why.
For others, diagnosis provided a way to explain their needs to friends, family and healthcare professionals. It also helped them find approaches that made everyday life easier.
These experiences show how diagnosis can improve someone’s understanding and acceptance of themselves, particularly after years of confusion or self-criticism.
The government review acknowledges these benefits and recommends that assessments should remain available. However, there is a risk that overstretched NHS services could increasingly restrict access to them.
In West Yorkshire, for example, a minimum two-year wait has been introduced for routine autism and ADHD assessments carried out by independent providers through the NHS. People with urgent needs may be assessed sooner.
Offering support without a diagnosis could ease some of the pressure on these services. But it should not become a reason to make assessments harder to obtain.
Diagnosis doesn’t guarantee support
Our research also revealed that receiving a diagnosis did not necessarily mean people could access suitable mental health care.
Many participants described difficulties getting help from their GP surgery. Some struggled to explain what they were experiencing or understand whether their difficulties were related to autism, ADHD or a separate mental health problem.
Others felt that healthcare professionals did not fully understand their experiences.
Several described being referred from one service to another, only to be turned away because their needs were considered too complicated or because they were not unwell enough to qualify for help.
Some participants were offered cognitive behavioural therapy (CBT), a talking therapy that helps people recognise and change patterns of thinking and behaviour that contribute to emotional distress.
Although CBT can help autistic people and those with ADHD, some participants found particular techniques unsuitable. A few said the treatment made them feel worse.
One autistic participant described how repeatedly facing situations that caused anxiety, an approach sometimes used in therapy, felt like an “assault” on their nervous system.
For some autistic people, distress can be linked to overwhelming sensory experiences, such as loud noises or bright lights. Therapy may need to take these differences into account.
National treatment guidance already recommends adapting talking therapies to meet autistic adults’ needs. But our findings suggest that in addition to adapting therapies, we need to provide a different kind of support to address a wider range of needs.
Years of unsuccessful attempts to get help had left some participants feeling abandoned.
What needs to change?
GP surgeries already provide mental health support to many autistic people and people with ADHD. If more people become eligible for help without a diagnosis, demand on these services could increase further.
GPs will need sufficient time, training and resources to understand people’s needs and help them find appropriate support.
The government’s proposal offers an opportunity to improve care, particularly for people who currently face long waits. But its success will depend on whether services can provide suitable help, both before and after diagnosis.
For some people, diagnosis can transform how they understand themselves. Others urgently need practical help or treatment for their mental health. Many need both.
As one participant described the experience of finally receiving a diagnosis but finding little support afterwards:
You just get to the end of the diagnosis and then you fall off a cliff. It’s a bit like a conveyor belt in a supermarket without a trolley at the end.
The challenge now is to ensure that people receive the help they need while waiting for an assessment, and continue receiving appropriate support afterwards.
Hannah Bowers receives funding from National Institute for Health and Care Research (NIHR). The MINDS interview study is funded by the National Institute for Health and Care Research (NIHR) School for Primary Care Research (project reference SPCR758). The research is led by Dr Hannah Bowers at the Primary Care Research Centre, Univeristy of Southampton, in collaboration with partners at Keele University, University of Bristol, University of Exeter, Nottingham Trent University, and University College London. This work is currently in preparation to be submitted to a peer-reviewed journal. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.