一项由政府委托开展的调查指出，由于难以应对日益激增的心理健康、多动症及自闭症治疗需求，相关医疗体系正逐渐陷入“系统性崩溃的境地”，致使众多患者迫切渴望获得帮助。
is heading into a “world of system failures” as it struggles to cope with relentlessly rising demand for mental health, ADHD and autism care, leaving those affected desperate for support, a government-commissioned inquiry has found.
这份警示性报告由彼得·福纳吉教授牵头撰写，旨在分析近几十年来人们对心理健康及神经发育障碍治疗需求的急剧增长情况。
The stark warning was made in a review led by Prof Peter Fonagy into the sharp rise in demand over recent decades for help with mental health and neurodevelopmental conditions.
报告指出，目前存在自闭症与注意力缺陷多动障碍被过度诊断的风险日益升高；同时呼吁政府加强对私人诊所的监管力度，因为许多患者因无法及时获得正规评估而只能求助于这些机构。报告撰写者还建议，医疗服务的提供应主要依据患者的实际需求，从而缩短大量患者等待正式诊断所需的时间。
It found there was an increasing risk of overdiagnosis of autism and attention deficit hyperactivity disorder (ADHD) and urged ministers to toughen the regulation of the private clinics to which many people are turning because they cannot get assessed quickly by the The experts behind the review also called for access to care to be based primarily on a person’s needs so fewer people would have years-long waits for a formal diagnosis.
调查显示，自20世纪90年代以来，英格兰各年龄段的心理健康问题患者数量均显著上升，其中18岁以下青少年增幅尤为明显。
The review found that the number of people suffering mental distress has risen significantly across all age groups in England since the 1990s, especially the under-18s.
1993年至2024年间，16至64岁人群中患有常见精神障碍的比例从15.5%升至22.6%。而在同一时期，16至24岁人群中的这一比例更是从约六分之一跃升至四分之一。
The number of 16- to 64-year-olds with a common mental disorder increased from 15.5% in 1993 to 22.6% in 2024. However, it jumped more sharply – from about one in six to one in four – among 16- to 24-year-olds over the same period.
这份长达607页的报告指出，种种证据表明，那些对年轻人所面临的困境持怀疑态度的人其实大错特错。
The evidence shows that sceptics are wrong to cast doubt on young people’s struggles, the 607-page report found.
“有时人们将这些问题归咎于个人过失，甚至声称年轻人是在无中生有、完全是心理作用所致，这完全是无稽之谈，”担任该报告副主编的著名精神病学专家西蒙·韦塞利教授说道。
“That’s sometimes been attributed to personal failures, people being told they’re making it up, it’s all in their head, which is absolute nonsense,” said Prof Simon Wessely, a leading psychiatrist and vice-chair of the review.
这份报告的结论可能对英国政府的相关举措产生深远影响：政府正致力于减少那些既未接受教育、也未就业或接受培训的年轻人数量——目前这类人群已接近100万；同时也有助于控制不断攀升的福利支出，目前因健康原因无法工作的人数已创下280万的新高。此外，对于那些需要应对越来越多有特殊教育需求学生之种种挑战的学校而言，这份报告同样意义重大。
The report’s conclusions may have significant implications for the government’s drive to reduce the number of young people in the UK not in education, employment or training – now almost 1 million – and the size of the welfare bill, with a record 2.8 million people too sick to work; and also for schools as they grapple with the demands arising from the growing number of pupils with special educational needs.
作为伦敦大学学院的精神分析学家及临床心理学家，福纳吉驳斥了那种认为年轻人比以往几代人更脆弱、心理承受力更差的偏见。他在报告中指出：“心理健康问题的增多是不争的事实，这些问题确实影响了人们的日常功能，而仅仅用‘公众意识提高’这一理由是无法解释这种现象的。”
Fonagy, a psychoanalyst and clinical psychologist at University College London, dismissed the notion that young people in particular were “snowflakes” who were less resilient than in previous generations. “The rise in mental health problems is real, is affecting everyday functioning and cannot be explained by greater awareness alone,” his report said.
他痛心地指出，种种社会经济因素给年轻人带来了前所未有的压力。“如今社会不确定性加剧：经济压力、工作不稳定、住房价格高不可攀……但或许更为关键的是，年轻一代普遍缺乏‘自己的生活会比父母更好’的希望。自二战以来，调查数据首次显示出这种趋势。”福纳吉还提到，对心理健康及神经多样性相关帮助的需求激增，导致大量患者长期排不上号，症状也不断恶化。
He lamented that an array of social and economic circumstances had piled unprecedented pressure on young people. “There is increased uncertainty – financial pressures, insecure work, unaffordable housing – but perhaps more important, a lack of hope among young people that their lives will be better than their parents, and that’s the first time since the second world war that surveys have noticed that.”The explosion in demand for help with mental ill-health and neurodiversity has left people stuck on waiting lists for years at a time and with worsening symptoms, Fonagy said.
截至去年年底，英格兰地区有超过56万名民众正在等待ADHD诊断，这一数字是2019年的17倍；另有25.4万名民众在等待自闭症诊断，等待诊断的总人数因此突破80万大关。其中绝大多数人——占比高达90%——等待时间已至少达三个月。
At the end of last year more than 560,000 people in England were waiting to be assessed for ADHD – 17 times more than were doing so in 2019. Another 254,000 people were waiting for a diagnostic assessment for autism, taking the total number waiting to more than 800,000. Almost all – 90% – had been waiting for at least three months.
6至11岁儿童被诊断出患有自闭症的病例数量也大幅上升。2000年至2025年间，这一比例增长了20倍，达到4.58%；而在12至17岁的青少年群体中，该比例更是从0.1%跃升至4.06%，增幅高达40倍。与此同时，6至11岁儿童中被诊断出患有注意力缺陷多动障碍的比例在五年内增长了6倍以上；12至17岁青少年中的这一比例则增长了15倍以上，分别达到2.7%和3.9%。
The number of six- to 11-year-olds being diagnosed with autism has also soared. It jumped 20-fold to 4.58% between 2000 and 2025 and by even more among those aged 12 to 17 over the same years, from 0.1% to 4.06% – a 40-fold jump. And the proportion of children aged six to 11 with an ADHD diagnosis has increased more than sixfold in five years and more than 15-fold in 12- to 17-year-olds, to 2.7% and 3.9% respectively.
报告指出，目前已有400万儿童正遭受“严重的心理困扰”，若当前趋势持续下去，到2030年这一数字可能升至450万。此外，18岁以下有自残行为的青少年人数也可能从190万增加至250万。
While 4 million children already suffer from “high psychological distress’’, if current trends continue, that could reach 4.5 million by 2030, the report warned. The number of under-18s who self-harm could also rise from 1.9 million to 2.5 million.
韦塞利警告称，自闭症与注意力缺陷多动障碍的诊断率呈指数级增长，这意味着英国已步入一个“临界点”——此时人们面临被误诊为这两种疾病的风险正日益升高。
The exponential rise in diagnoses of autism and ADHD means the UK has reached a “tipping point” where people are at risk of being misdiagnosed with either condition, Wessely warned.
研究人员并未发现大规模过度诊断的现象，但他们指出，现有证据“表明我们正进入一个新阶段：诊断不足、误诊与过度诊断之间的风险平衡可能正在发生变化，而误诊与过度诊断的风险也将成为制定相关政策及提供医疗服务时必须重点考量的因素”。
The authors did not find that overdiagnosis was occurring at scale, but added that the evidence “suggests we are entering a phase in which the balance of risks between underdiagnosis, misdiagnosis and overdiagnosis may be changing, with the risks of misdiagnosis and overdiagnosis becoming increasingly important considerations for policy and service delivery”.
他们还提到，如今越来越多的青少年主动认定自己属于神经多样性群体——甚至有多达五分之一的中学生如此自认——这导致“社会层面与医学层面的界限正逐渐模糊”。
The increasing tendency of young people to self-identify as neurodivergent – as many as a fifth of secondary school pupils do so – means that “the line between the social and the medical is beginning to blur”, they added.
这项历时10个月的调研还发现，“独立医疗机构开展的自闭症及注意力缺陷多动障碍评估在一致性与质量方面存在严重问题，且此类评估活动背后还存在经济利益的驱动因素”。
The 10-month review found “strong concerns about the consistency and quality of ADHD and autism assessments being carried out by independent providers, and the financial incentives associated with assessment activity”.
报告建议，政府应禁止相关服务机构直接向公众做广告宣传，并确保所有提供此类服务的诊所均受护理质量委员会的监管。
Ministers should ban direct-to-public advertising of such services and ensure that all clinics offering them are regulated by the Care Quality Commission, it said.
越来越多的年轻人同时患有心理健康问题以及注意力缺陷多动障碍或自闭症，甚至两者兼有。报告指出：“这种情况其实很普遍，并非个例。”例如，在16至24岁群体中，患有常见心理健康问题的年轻人里，有61%具备自闭症特征，57%表现出注意力缺陷多动障碍的症状。
Growing numbers of young people have a combination of mental ill-health and ADHD or autism, or both. “Co-occurence is the rule rather than the exception,” the report said. For example, 61% of 16- to 24-year-olds with a common mental health condition also had autistic traits, and 57% had ADHD symptoms.
报告强调，鉴于这些年轻人的特殊需求，英国国家医疗服务体系应当整合心理健康服务与神经发育障碍相关服务，转而推行以需求为导向的服务体系。
The report said their needs meant the NHS should bring together mental health and neurodevelopmental services and move to a “needs-led” system.
英国皇家儿科与儿童健康学院支持方纳吉的呼吁，即诊断结果不应再成为决定患者能否获得治疗的唯一依据。
The Royal College of Paediatrics and Child Health backed Fonagy’s call for diagnosis to no longer dictate who received care.
该学院的医疗服务事务专员张荣尼博士指出：“很多时候，只有获得诊断才能获得有效的治疗。这就导致许多儿童及家庭在等待诊断期间只能独自苦苦支撑，几乎得不到任何帮助。”
“Too often, a diagnosis is the only route to accessing meaningful help. This means that children and families can be left struggling alone while waiting for assessments, with little or no support available in the meantime,” said Dr Ronny Cheung, its officer for health services.
他补充道，如果英国国家医疗服务体系能推行以需求为导向的服务模式，就能确保青少年顺利且迅速地获得全面、可靠且高质量的医疗服务。
The NHS moving to a “needs-led” approach would “ensure children and young people can seamlessly and more quickly access a robust, holistic and reliable standard of care”, he added.
卫生大臣伊薇特·库珀在制定将于今年年底发布的心理健康战略时，将参考方纳吉提出的各项建议。
Yvette Cooper, the health secretary, will draw on Fonagy’s recommendations in putting together the forthcoming mental health strategy, which is due by the end of the year.
她在回应中表示，英国国家医疗服务体系将建立以需求为导向的服务体系，从而让民众能更快获得治疗。她还要求英格兰国家医疗服务体系研究如何加快提供咨询、诊断及治疗服务。
In her response, she promised that the NHS would provide a “needs-led” system under which people would get much faster care. She has asked NHS England to establish how it can provide faster advice, assessments and treatment.
她强调：“显然，心理健康服务体系亟需改革，要更加注重为青少年提供早期干预，帮助他们顺利完成学业、顺利就业并维持正常生活。”此外，她还承诺会对所有私立诊断诊所实施监管，但并未承诺实施方纳吉所主张的广告禁令。
She said: “It is clear that mental health services need to change to focus more on the early support young people need to stay in education or work or keep their lives on track.”She also pledged to ensure all private assessment clinics are regulated but did not commit to the advertising ban Fonagy said was needed.