Bold statement: Mental health is being over-medicalized in a world that already feels overwhelming, and that clash between needing help and avoiding over-diagnosis is shaping how patients are treated today. But here’s where it gets controversial: many GPs say normal life stress is frequently labeled as illness, while still struggling to connect patients with real support. This tension sits at the heart of a nationwide debate about how mental health, ADHD, and autism services are funded and delivered in England.
A BBC survey of more than 5,000 GPs across England reveals a split view: 442 of the 752 respondents worry about over-diagnosis, with more doctors feeling it happens to some extent rather than extensively. In contrast, 81 clinicians believe mental health problems are under-diagnosed. The concerns aren’t limited to diagnosis alone; access to effective help is a recurring worry for many practitioners.
The Health Secretary has ordered an independent review to understand rising demand for mental health, ADHD, and autism services and to identify gaps in support. Responses from the survey show the gravity of the issue for frontline doctors, highlighting how challenging it is to balance clinical judgment with patient expectations.
One memorable GP note from the survey sums up a key tension: “Life being stressful is not an illness.” Another emphasizes a collective memory that tough times—such as heartbreak or grief—are painful but normal, and coping takes skills. Some clinicians argue that labeling normal emotional struggles as anxiety or depression can drain resources away from those with more severe needs. A few practitioners were openly critical of some patients, describing them as dishonest or exploiting the system.
Nationally, about 20% of adults report having a common mental health condition like anxiety or depression, with higher rates among young people. For ages 16–24, the rate climbs to roughly one in four. The survey indicates that younger adults (19–34) are perceived as needing more mental health support, with some clinicians noting a perceived drop in resilience since the Covid era and a focus on diagnoses over coping strategies. Others argue the opposite: under-diagnosis is the real problem, with calls for more acceptance, help, and proactive assessment.
There are nearly 40,000 fully-qualified GPs in England, and it’s uncertain whether the survey participants reflect the broader GP population. When asked about shifts in time spent on mental health, most veteran clinicians reported increases, driven by three main factors: gaps in high-quality mental health services elsewhere, socio-economic issues like housing, employment, and finances, and the reality that some patients pursue a label for what are actually normal life challenges.
Earlier this year, Health Secretary Wes Streeting told BBC that mental health conditions were being over-diagnosed and that too many people were being “written off.” He later described those comments as divisive and said they failed to capture the problem’s complexity. The reality is nuanced: ADHD affects millions, including undiagnosed individuals, and some NHS ADHD services have limited capacity to accept new patients due to demand pressures. Patients report real difficulties in accessing proper care and ongoing support.
A consensus among GPs is clear: the NHS is not meeting rising demand in mental health care. A large majority—508 of 752—said good-quality adult mental health services are rarely or never available locally. Even more—around 640—express concern about getting adequate help for young patients. Some clinicians described the state of services as a national tragedy, with alarming anecdotes about thresholds for serious risk and disengagement when crises subside.
The survey also explored prescribing behaviors: a large share of GPs—447—admit they sometimes prescribe antidepressants to ensure patients receive some form of help quickly, even when longer-term therapies are not readily accessible. This highlights the difficult balance between immediate relief and long-term outcomes.
Professor Victoria Tzortziou Brown, chair of the Royal College of GPs, frames the dilemma well: clinicians must avoid over-medicalizing normal feelings while also resisting the urge to dismiss real mental health concerns. The goal is to support people appropriately without undermining clinical judgment or discouraging help-seeking.
An independent review is underway to assess demand and to produce recommendations that clinicians, patients, and services can act on. The aim is to listen to diverse evidence and craft genuinely useful guidance that improves both diagnosis practices and access to care for those who need it most.
Additional reporting by Phil Leake.
Controversial question to consider: should society recalibrate how it defines mental health symptoms versus normal life challenges to prevent both over-diagnosis and under-treatment? What’s your view on whether current systems strike the right balance, and how would you improve access to effective care for different age groups?
