No system in world could meet ADHD and autism assessment demands, MSPs hear

The level of demand for assessment for ADHD and autism in Scotland is so high that “no mental health system in the world” would be able to meet it, MSPs have been told.

Tom Arthur, the minister for mental wellbeing, also told the Health, Social Care and Sport committee in the Scottish Parliament on Tuesday that a new approach towards the two neurodevelopmental conditions must be implemented.

Mr Arthur said: “A traditional NHS waiting-times approach is not sufficient.

“The Royal College of Psychiatrists in Scotland – this was specific to adult cases – they published a paper and they, in terms of the increase in demand we have seen in recent years, spoke about it as unprecedented and unforeseen.

“The mental health system in Scotland cannot cope with it, but no mental health system in the world can meet that level of demand.

“This is a global phenomenon, we are seeing it elsewhere in the UK and we are seeing it internationally as well.”

The committee is meeting to conclude oral evidence as part of the ADHD and autism pathways, and support an inquiry it agreed to undertake in April 2025.

The inquiry is to consider long waiting times for ADHD and autism diagnoses, the impact of high demand and delays on individuals and healthcare staff, how these conditions are currently diagnosed and managed, and explore solutions to improve the capacity of services, referral pathways and support.

Mr Arthur said there should be a move away from NHS waiting lists for diagnoses and that those who are seeking support should receive it on a needs-based approach.

He said: “We have to rethink our entire approach, it has to be a whole system, whole society and it has to be a needs-based approach.

“I do recognise the importance of assessment and diagnoses, and I recognise the clinical value of that particularly in regards to medication in the case of ADHD, but I also recognise an approach that is needs-based can ultimately be most effective and most impactful in helping to ensure people are supported and their needs are met.

“Given the level of demand, given the increase we have seen even in the last five years is such that that approach, that particular paradigm and model, is not one that is going to be sufficient.

“Anyone who is waiting for assessment should be sensitively signposted to support that is available and would reiterate that point that diagnosis is not and should not be a prerequisite for support.

“Education authorities, local authorities, should not be using a diagnosis for gatekeeping to access services.”

Mr Arthur made a statement to parliament in June which included a commitment to set up a cross-sector taskforce to address the provision of neurodevelopmental services for children and young people in Scotland.

He also announced a further £500,000 of additional funding to deliver improvements in these services.

The statement accompanied the publication of a review of the implementation of the national neurodevelopmental specification.

While an increased focus on a neurodevelopmental and multidisciplinary approach was praised in the review, the majority of people surveyed felt the specification had had limited impact.

There were also major challenges to implementation, including increasing demand, limited funding and poor communication between partners in the specification’s delivery.