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Beyond Overdiagnosis: Tackling Stigma and Health Inequalities

On 29 August 2025, the Learning Disability Today website reported that the National Autistic Society (NAS) had challenged a Policy Exchange report alleging “overdiagnosis” of neurodivergence in children and young people. 
The think tank argued that the increasing number of Education, Health and Care Plans (EHCPs), Special Educational Needs and Disability (SEND) diagnoses, and prescriptions for ADHD medications may point to a broader systemic issue.

The NAS expressed disagreement with the report’s conclusions. Tim Nicholls, its Assistant Director of Policy, Research and Strategy, said the report “gets only one thing right – the SEND system is failing children”.
He criticised the “poorly evidenced claims and ill-thought-out ideas,” noting that sweeping, broad claims about overdiagnosis distract from real problems such as long waiting lists for assessments and a lack of adequate support once a diagnosis is made.

Why the Overdiagnosis Narrative Is Harmful

Claims of widespread overdiagnosis can reinforce stigma.
Suggesting that autism, ADHD or other learning disabilities are being diagnosed too often implies that some people are gaming the system or that these conditions are simply trends. 

This narrative undermines families seeking support and could deter individuals from pursuing assessments that are crucial for accessing the help they need.

Accurate diagnosis is essential because it enables access to specialised education, therapies and benefits. 
Without a formal diagnosis, children may not receive reasonable adjustments in school, and adults may struggle to secure appropriate employment or social care.

In fact, evidence suggests that people with learning disabilities and autistic individuals are underserved rather than over-served. 
The Learning from Lives and Deaths (LeDeR) 2023 report, produced by researchers at King’s College London, found that adults with a learning disability die an average of 19.7 years earlier than the general population, and autistic adults die 23.7 years earlier. Even more worrying, the report concluded that 46% of deaths among people with a learning disability and 48% of deaths among autistic people were avoidable.
Respiratory disease was the leading cause of death for those with learning disabilities, while suicide was among the leading causes for autistic adults. 
These figures point to systemic failures in prevention, timely diagnosis and treatment—not overdiagnosis.

 

A Call for Person‑Centred Healthcare

Southdown, a specialist support provider for people with learning disabilities, responded to the LeDeR findings by urging health services to adopt a person-centred approach. 
The organisation argues that early deaths are not inevitable; they occur because “health services must be accessible, staff must have the right training, and people must be heard and treated appropriately, without delays”. 

Southdown believes everyone has the right to receive the support they need to be well, and that improving health outcomes requires collaboration between health institutions, social care providers, families and communities. 
This approach reflects broader calls for improved training and awareness among healthcare professionals, so they recognise the early signs of health problems in people with learning disabilities and adapt communication to their needs.

HomeCareDirect’s Role in Reducing Health Inequalities

HomeCareDirect (HCD) recognises that the debate over overdiagnosis masks a more pressing issue: health inequalities. 
As a nurse-led provider of personalised home‑care services, HCD works with individuals and families to design and manage care packages funded through Personal Health Budgets (PHBs) and direct payments. 
Our clinical team ensures that every client receives regular health monitoring and that personal assistants (PAs) are trained to recognise changes in health conditions, from respiratory symptoms to mental‑health concerns. 
We collaborate closely with local GPs, community nursing teams and hospital services to ensure that clients receive the right intervention at the right time. 

Continuous training, covering topics such as epilepsy management, positive behaviour support and mental‑health first aid, helps our PAs provide high-quality care that respects cultural differences and individual preferences.

This nurse-led oversight is crucial in a system where avoidable deaths remain so high.

By integrating social care with healthcare, HCD aims to identify health issues early, arrange prompt referrals and support clients through hospital appointments. 
We can also advocate for our clients in multidisciplinary meetings, ensuring that their voices are heard and that any reasonable adjustments are made.

Practical Advice for Families

Families who suspect a loved one may be autistic or have a learning disability should seek a thorough assessment rather than be deterred by narratives about overdiagnosis.
Keep a diary of behavioural and developmental concerns and insist that your GP or school makes an appropriate referral for an assessment. 
Once a diagnosis is confirmed, familiarise yourself with the services available, such as EHCPs for children or PHBs for adults, and don’t hesitate to ask for reasonable adjustments in education or healthcare settings.

Monitoring health conditions at home is also vital. 
Many medical problems present differently in people with learning disabilities; for example, they may express discomfort through changes in behaviour rather than complaints of pain. Family carers and PAs should be trained to spot these signs and seek timely medical advice.

Mental‑health support is equally important; depression and anxiety can be underdiagnosed in autistic adults, and suicide risk is high.
Establish a network of professionals, nurses, psychologists, and social workers who understand your relative’s needs and make use of respite services to prevent carer burnout.

Finally, share campaigns like the National Autistic Society’s response to the Policy Exchange report. 
Challenge misconceptions by emphasising that accurate diagnoses open doors to support and that health inequalities, not overdiagnosis, are the real crisis, according to Learning Disabilities Today.

Together, we can push for better training of professionals, more accessible services and policies that prioritise the lives and well-being of people with learning disabilities and neurodivergent communities.