Accusations that young people represent a "snowflake generation" are fundamentally misguided, according to the head of an independent review into mental health, ADHD and autism. In an exclusive interview, Prof Peter Fonagy argues that mental distress among children and young people has genuinely increased, with anxiety, depression, self-harm and eating disorders becoming increasingly prevalent. He contends that the challenges facing today's youth—economic uncertainty, employment instability and social media pressures—have created an environment substantially more difficult than that faced by previous generations.
The review was commissioned nine months ago by Wes Streeting after the then-health secretary suggested young people were over-diagnosed and "written off". The government's official collection for the review was last updated on 11 September 2026, indicating fresh material has been added ahead of the final publication expected later this week. The findings are expected to shape government policies affecting NHS services, benefits provision and support for young people not in education, employment or training.
Fonagy, a clinical psychologist and adviser to NHS England on children and young people's mental health, chose to speak to the BBC before publication because he was concerned that debate surrounding ADHD and autism diagnoses would overshadow the broader mental health crisis. The review was formally launched on 4 December 2025, with an interim report published on 31 March 2026.
Why Fonagy believes the crisis is genuine
Fonagy's personal experience informs his conviction that young people face real mental health challenges. As a teenager, he experienced suicidal thoughts after relocating to London from Hungary without his parents. He credits therapy from a local service with saving his life, an experience that has driven his commitment to improving support for young people.
The review, which involved more than 100 experts and families with lived experience of mental health problems, concludes that the rise in mental health difficulties since the 1990s is genuine. Approximately one in four young people aged 16 to 24 now struggle with mental health issues.
"It's harder to be young now,"Fonagy told the BBC, emphasising that his review
"dismisses the idea of a snowflake generation."
"I'm in awe of the way they have adjusted to an environment that is far more difficult than I ever had to face."He points to economic and employment uncertainty alongside social media pressures as creating a
"very toxic"environment.
"They are a generation that has real serious challenges that I would not wish to have had when I was their age. Adults have let them down. We're the first generation that probably collectively feels we had a better life than our children will have. So, to the person who says it's a snowflake generation, just try living 24 hours as a 16-year-old."
What does the evidence show?
The data supporting increased mental distress is contested. Some sources rely on self-reporting, and sceptics argue that greater awareness and reduced stigma around mental health mean more people are coming forward rather than there being a genuine increase in problems. Critics also question whether society is now over-medicalising ordinary distress, assigning diagnoses to temporary stress that individuals should learn to manage independently.
Last year the BBC found that many GPs held concerns about over-diagnosis and felt normal life stresses were being inappropriately medicalised. Fonagy, however, remains adamant that young people are experiencing a real rise in mental health problems. He acknowledges that greater awareness is leading to increased numbers seeking medical help, but maintains this does not negate the underlying increase in genuine distress.
The trend affects both boys and girls, though it becomes particularly pronounced in girls from around age 12. Fonagy identifies sexual aggression from boys as a significant concern, but emphasises that societal expectations placed on girls and young women are also a contributing factor.
"It's very difficult to be a young woman now in secondary school."
Young people are struggling with diverse conditions ranging from eating disorders and anxiety
"that's so powerful people avoid going to school"through to depression
"so strong people cannot sleep at night and lose their appetite and feel their life is not worth living."Fonagy notes that the pandemic exacerbated these problems through the disruption it caused to young people's lives.
What do young people themselves say?
Young people interviewed by the BBC who have experienced mental health difficulties emphasise the importance of government action on the review's findings. Omari, 22, struggled at school but felt teachers did not listen to his concerns.
"I made an attempt on my life because I was really struggling with bullying. I was 15. Suddenly, when I did end up in hospital, they all wanted to care. But it's like you're a bit too little, too late here."He expresses frustration that without implementation,
"it's all very well having this flashy report, but it's useless if they don't put that into practice."
Mattea, 17, currently in temporary social housing and struggling with anxiety and depression, voices concerns about her future.
"I don't know what's going to happen to my life."She feels adults have abandoned her responsibility.
"No one's going to come and sort my life out for me. I have to do it on my own."
Why current NHS provision is inadequate
Fonagy is unequivocal in his assessment that the NHS is not equipped to meet current demand.
"It's not fit for purpose."He points to alarming figures showing that one in three people referred to mental health services remain on waiting lists after a year without receiving help. This systemic failure leaves vulnerable young people without timely access to support.
Some positive developments are underway, including the rollout of mental health teams working closely with schools. However, Fonagy emphasises that addressing the crisis requires coordinated action across society—spanning education, employment, housing and family support systems. He particularly criticises cuts to youth services over the past decade, which have eliminated spaces where young people can gather, socialise and develop a sense of belonging.
"We need to have opportunities for them to participate, because participating in things… maintains good mental health."He notes that loneliness among young people has increased since 2000, linking this rise to escalating phone and social media use, which has reduced face-to-face contact and disrupted sleep patterns—both damaging to mental wellbeing.
What can families and communities do?
Beyond addressing phone use, Fonagy identifies practical steps families and friends can take. Simple attentiveness matters significantly.
"Saying to someone, 'I notice you're not quite the same as yesterday. Is there anything the matter?' Knowing there is someone who knows makes an enormous difference."This emphasis on connection and observation reflects his broader conviction that mental health support operates at multiple levels.
What happens next
The final report is expected to be published within days of this interview. According to reporting on 17 September, the review could recommend that people displaying ADHD symptoms be triaged and offered support without necessarily receiving a formal diagnosis, potentially reshaping how the NHS approaches these conditions. The government has indicated the final report will be published shortly and will inform a new national approach across mental health, ADHD and autism services, feeding into the broader NHS 10 Year Health Plan.
Fonagy's overarching hope is that society can work collectively to address the crisis.
"I want young people to hear that when they feel anxious, depressed or distressed, that it's a real problem, but a problem we can do something about. When I needed help, I got it. I want everyone to have that chance."
