Professor Peter Fonagy, Chair of the Independent Review into Mental Health Conditions, ADHD and Autism (2026), with his letter to a young person.
12 October 2026
Dear young person,
I have spent much of my professional life trying to understand why some children and young people struggle with things that others seem to manage without difficulty, and what we can do to help. I have been a psychologist for more than forty years, worked with countless young people and their families, and recently chaired a government review of mental health, ADHD and autism. But I want to tell you something about my own life, because I think it may explain why I care so much about yours.
I came to England in 1967, when I was fifteen, speaking almost no English. I was sent to live with a family in Kew Gardens and attended a secondary modern school (for those who failed the entrance to a grammar school- it was before comprehensives started) where I felt completely out of place. The other boys seemed interested mainly in football teams, about which I knew almost nothing. I couldn't find a way of connecting with them. Within a year I had become severely depressed, stopped wanting to eat or leave my room, and had begun thinking very seriously about ending my life.
I tell you this not because I think my experience was the same as yours. It almost certainly wasn't. But I do know something about what it feels like to be young, frightened, isolated and unable to imagine that life might become different.
What saved me was not a system. It was a neighbour who noticed that something was wrong and knew where to send me.
That turned out to be a clinic in Hampstead founded by Anna Freud for children displaced by war. Many years later, in one of those rather improbable turns that life occasionally takes, I was asked to lead the organisation that had grown out of that clinic. I have never quite got over the coincidence.
I needed quite a bit of therapy, and it saved my life. But what made the difference was not simply the expertise of the person treating me. It was that she seemed able to look past everything that was wrong with me and see someone who might yet have a future.
I remember arriving for a session in a battered Ford Anglia that I loved beyond reason. I talked endlessly about this rather unremarkable car. Instead of interpreting my enthusiasm or trying to redirect me towards my difficulties, my therapist got up, walked to the window, looked at it and said, "Peter, that is a wonderful car".
It was a small moment, but something important happened. She had shown an interest in something that mattered to me, rather than simply in what was wrong with me. Only then did I begin to believe that she might have something worth telling me.
Looking back, I suspect that much of my subsequent research on trust and how we come to understand ourselves and other people has been a rather long footnote to that afternoon.
There was another difficulty. I have severe dysgraphia, a neurodevelopmental condition that makes writing extraordinarily difficult. My school saw this largely as evidence that I was an educational failure. I certainly came to see myself that way.
When I eventually reached University College London following an interview with a compassionate lecturer, someone recognised that my difficulties with writing did not mean that I had nothing worth saying. They allowed my examination papers to be transcribed, long before there was any legal obligation to make such adjustments. I have worked at UCL ever since. I don't think that is entirely a coincidence either.
My difficulty happened to be writing. Yours may be something quite different. You may struggle with attention, communication, anxiety, relationships, getting to school, managing demands that other people find straightforward, or simply finding somewhere you feel you belong. You may have a diagnosis, be waiting for one, or have no idea why things seem harder for you than for other people.
I have met many young people who work extraordinarily hard just to achieve what others appear to manage effortlessly. The effort is often invisible. People see the missed deadline, the absence from school, the unfinished work or the withdrawal from friends. They do not always see what it has cost you to get as far as you have.
One of the things I hope we can change is the assumption that people must first be given a diagnostic label before their difficulties deserve to be understood or supported. Diagnosis can be enormously helpful. It can explain experiences that have been confusing for years and open the way to effective treatment. But it is not the whole person, and it does not tell us everything about what someone needs. It tells us about deficit but says nothing about strengths.
Mental health conditions, ADHD and autism can overlap, but they are not the same. They differ in how they arise, how they develop and what kinds of help are useful. Two people with the same diagnosis may need very different support, while someone without a diagnosis may be struggling enormously. Understanding the individual matters at least as much as understanding the category.
I also want to say something about the world in which you are growing up. I sometimes hear people of my generation describe yours as a generation of snowflakes, as though young people today have somehow become less resilient or less capable of dealing with ordinary life.
As someone who still works clinically with young people, and as a father, I find myself thinking almost exactly the opposite.
I am astonished by the courage of many of the young people I meet.
You are growing up in a world that is in some ways much more difficult than the one I knew. Your performance is constantly measured, your relationships can be publicly scrutinised, and there are endless opportunities to compare yourself with people who appear more attractive, successful, confident or happy. Much of this happens in digital environments from which it is difficult to escape.
You are expected to make important decisions about your future in circumstances that often feel uncertain, while opportunities for belonging, rest, privacy and simply being young have become harder to find.
And then, when you struggle, some adults tell you that you lack resilience.
I don't think you are fragile. I think you are outnumbered.
That doesn't mean every difficult feeling is a mental health disorder, or that every difference needs a diagnosis. Feeling unhappy, anxious, uncertain or overwhelmed is sometimes part of being human. But it does mean that we should take your experience seriously, rather than dismissing it as weakness or assuming that you simply need to try harder.
There is something else I have learnt, both from my own experience and from many years of research. We often think that people must first recover before they can return to education, work, friendships and ordinary life. But the relationship works in both directions. Belonging, having something to do that matters, feeling useful, being understood and having people who are interested in you are not simply rewards for becoming well. They are often part of how we become well.
That is why I hope you will not judge yourself entirely by how well you are managing at this particular moment. Your present difficulties do not tell us everything about your capacities, your future or the person you may become. I cannot promise you that things will be easy, or that the help you need will always be available when you need it. I know only too well that our services often fail young people, sometimes very badly. That is one reason I agreed to chair the Review.
But I can tell you that the right help, offered at the right moment by someone who genuinely wants to understand you, can change the direction of a life. I know that not only from research, but because it happened to me.
I was extraordinarily fortunate. A neighbour noticed. A therapist became interested in my car. A university understood that I could think even when I struggled to write. None of these people could have known what difference they would make. I have spent much of my life trying to understand how we might make that kind of help less dependent on good fortune.
So, if I could leave you with one thought, it would be this: please don't assume that the difficulties you are experiencing now define who you are or what you may become. And don't accept the idea that needing support makes you weak. We all become who we are partly through the understanding, kindness and opportunities that other people make available to us.
You deserve to be noticed, understood and supported, not because you have proved that you are ill enough, or because you have found the right diagnosis, but because what happens to you matters.
And those of us who are older have a responsibility to make sure that the world gives you a better chance than it sometimes does now.
With warmest wishes,
Peter Fonagy
Professor of Contemporary Psychoanalysis and Developmental Science, UCL
Adapted from the Foreword to the Independent Review into Mental Health Conditions, ADHD and Autism (2026).
See also our collections, 'My letter to…' and 'Neurodivergence'
SOURCE:
https://www.bps.org.uk/psychologist/you-are-not-fragile-you-are-outnumbered(accessed 19.10.26)
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