Why the Government’s Review of Mental Health Diagnoses Misses the Point
ALN SEND Support and Employment Reform Are the Real Answers**
Learn Without Limits CIC — December 2025
This week, the Health Secretary Wes Streeting announced a review into rising mental health diagnoses in the UK, linking it to the growing benefits bill.
It has sparked fear among disabled and neurodivergent people including thousands of families here in Wales that the Government may be preparing to question whether people are truly unwell.
But the Government is looking in the wrong direction.
If ministers want to understand why so many disabled and neurodivergent adults end up claiming benefits, they must start with the real upstream causes:
ALN SEND support failures in childhood
and
a broken employment support system that absorbs millions and delivers very little
Tomorrow, we will be meeting with Torsten Bell MP for Swansea West and a Junior Treasury Minister to outline a set of reforms that would genuinely reduce long-term benefit dependency. Not by blaming individuals but by fixing the systems that have failed them.
This is what we will be asking for.
1. ALN SEND failures in childhood create adult dependency and Wales is the clearest example
In Wales, the ALN Act promised early identification and joined up support.
Families were told the system would be simpler, fairer, faster.
The reality
• children waiting years for ALN SEND and neurodevelopmental assessments
• mainstream schools unable to meet specialist needs
• panels repeatedly refusing specialist placements
• CAMHS turning away complex cases
• parents feeling forced into Elective Home Education because support was not available
• many ALN SEND learners missing months or even years of education
• children internalising the message that they are the problem
By adulthood, these young people face
• gaps in basic qualifications
• chronic anxiety from years of unmet need
• no supported internships or vocational pathways
• unresolved trauma linked to exclusion isolation and school based distress
• very little understanding from employment agencies or employers
None of this is the fault of the young person or their family.
It is the result of structural failures across education health and local authority processes.
When ALN SEND needs go unidentified or unsupported in childhood the result is predictable.
You get a generation of adults who were set up to struggle long before they reached the labour market.
2. Employment support in Wales is uniquely failing disabled and neurodivergent people
Wales has one of the lowest disabled employment rates in the UK.
But the narrative that disabled people do not want to work is simply false.
The real story is this
• fewer suitable vacancies especially in rural and deprived areas
• employers with very limited understanding of autism ADHD trauma or PDA
• workplace adjustments applied inconsistently or not at all
• FE colleges delaying ALN SEND support until well after enrolment
• DWP contractors routinely misunderstanding ALN SEND profiles especially for women and PDA learners
Meanwhile employment programmes offer little more than
• generic CV workshops
• endless cycles of reviews and goal setting
• no specialist support for job carving workplace adjustments or employer advocacy
Disabled people are not resisting work.
They are being failed by the agencies that are paid to support them.
**3. The biggest inefficiency in the benefits system is not disabled people
It is the employment contractors being paid for failure**
Employment support agencies are paid primarily for
• signing people up
• keeping them attending
• completing administrative milestones
They are not paid for
• getting disabled people into work
• ensuring adjustments are actually implemented
• helping people stay employed
• matching ND profiles to meaningful jobs
• supporting transitions beyond the first few weeks
The incentives are the wrong way round.
Providers earn more money by keeping people active on their books for long periods rather than helping them into work.
So people are repeatedly recycled through programmes even when nothing changes.
People are strung along not supported
Reviewing mental health diagnoses does nothing to solve this.
Reforming the employment support market would.
4. What Learn Without Limits CIC will be asking the Treasury to do
We believe there are five reforms that the Treasury can lead which would reduce long term benefit dependency while improving outcomes for disabled and neurodivergent people.
**ACTION 1
Reform the way employment support providers are paid so they are rewarded for outcomes not paperwork**
At least half of provider payments should depend on
• securing paid work
• keeping someone in work for 13 and 26 weeks
• reducing support need
• improving wellbeing outcomes
This removes the current incentive for providers to keep people “engaged” without helping them progress.
**ACTION 2
Launch a Treasury led review of ALN SEND educational and employment pathways in Wales**
This review should examine
• the economic cost of delayed ALN SEND identification
• the long term impact of school absence exclusions and EOTAS patterns
• outcomes for ALN SEND learners entering adulthood
• performance data for DWP contractors working with neurodivergent learners
• the cost savings achieved when early support is provided instead of late crisis intervention
This places the Treasury in the lead on evidence driven reform.
**ACTION 3
Pilot a Supported ALN SEND Employment Guarantee in Wales**
Wales is ideal for a national pilot because
• population size is manageable
• ALN SEND needs are clearly recorded
• employment inactivity is high
• measurable change would appear quickly
The Guarantee would provide
• supported internships
• specialist neurodiversity job coaches
• incentives for employers who provide sustained placements
• enforcement of workplace adjustment duties
• supported transitions from FE to employment
**ACTION 4
Require ALN SEND expertise in every DWP contract operating in Wales**
Funding agreements should require
• mandatory ALN SEND competency training
• specialist ND advisers in each Welsh region
• clear performance reporting by disability type
• audited compliance with adjustment requirements
Public money should not go to providers who cannot support disabled people properly.
**ACTION 5
Champion a Treasury wide message that early support saves money**
If the Government wants to reduce adult benefit dependency it must invest earlier in
• ALN SEND identification
• specialist placements
• therapeutic support
• stable transitions from school to FE to employment
Every pound spent early saves several pounds later in adulthood.
**Conclusion
Stop blaming individuals
Fix the systems that failed them**
Rising mental health claims do not indicate widespread over diagnosis.
They reflect the cost of a generation whose needs went unsupported for years during childhood and adolescence.
Instead of questioning whether people are truly unwell the Government should be asking
• why ALN SEND children wait years for assessments
• why their education breaks down
• why Wales has such low disabled employment rates
• why contractors are not held accountable for poor outcomes
The problem is never the individual.
The problem is the structure of the systems around them.
We will be asking the Treasury to take the lead in fixing those systems.
If Ministers want fewer disabled people stuck on benefits the solution is simple
Support ALN SEND children properly
Rebuild employment support
Reward genuine outcomes not box ticking
Change the incentives and you change the entire story
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