Some of the most affluent areas of England have had the sharpest rises in the proportion of young people claiming disability benefits for ADHD and autism since the pandemic, according to new research.
Claims for the personal independence payment (Pip) benefit for these health conditions were typically proportionally far higher in deprived areas with higher rates of poverty, low educational outcomes and insecure employment.
However, the fastest growth in ADHD and autism-related Pip claims has been in some of the country’s most prosperous areas such as Wokingham, Warwick, and parts of Hampshire and Surrey.
This trend probably reflects swifter access to ADHD and autism diagnoses in more affluent areas, say the researchers, in part highlighting the ability of wealthier families to skip long NHS waiting lists and pay privately for clinical diagnoses.
They say the relative gap in Pip claims between rich and poor areas is shrinking, with growth rates in wealthy places such as Runnymede in Surrey outstripping the likes of Blackpool and Stoke-on-Trent.
The research also found that Pip claim rates for ADHD and autism were higher among white people than other ethnic groups. This was reflected in lower than expected claims in ethnically diverse areas such as Newham and Brent, in London, and Leicester.
One of the sharpest rises was seen in leafy Surrey Heath (a 630% increase in Pip clams for autism and ADHD since 2019), while in contrast, the relatively deprived towns of Mansfield and Great Yarmouth saw 30% and 50% increases respectively.
The researchers say this shift is counterintuitive and unique to ADHD and autism. There is no evidence of similar trends in learning disability, depression, anxiety or physical conditions. Records from GPs show higher rates of new ADHD diagnosis in relatively affluent areas.
Sally Gainsbury, a senior policy analyst at the Nuffield Trust, which carried out the research, said the findings probably reflected “substantial inequality in access” to private and NHS diagnostic services, meaning “people with better resources and more support are often able to get to the front of the queue quicker”.
It may also reflect the ability of more privileged individuals to navigate a notoriously difficult and unpredictable Pip claims process, Gainsbury said. Obtaining a clinical diagnosis is likely to increase the chances of a successful Pip claim.
Pip is designed to help claimants with the extra costs of disability, such as energy, transport and food. It is not means-tested or linked to employment status and is paid to individuals whose condition impairs their ability to carry out everyday tasks.
About 205,000 16- to 24-year-olds received Pip for disabilities linked to ADHD or autism in April this year, a more than threefold increase since 2019, at a cost in 2025-26 of £1.36bn. The average Pip claim for this cohort was £8,800 a year.
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The sharp rise in numbers of young people claiming Pip and other disability benefits, particularly since the pandemic, has been at the centre of a political debate about the sustainability of working-age disability benefits spending, which is forecast to rise from £14bn in 2019 to £34bn in 2030.
The issue has become a culture war topic. Rightwing media and politicians have questioned the validity of Pip claims they say are the result of exaggerated mental health symptoms, and alleged overdiagnosis of neurodivergent conditions.
The Nuffield Trust research comes in advance of a government-commissioned report on mental health, autism and ADHD diagnoses. It is expected to recommend a “needs-based” system whereby overstretched NHS services target patients most acutely affected by ADHD, such as those who are at risk of self-harm or unable to work.
Led by Prof Peter Fonagy, a clinical psychologist and psychoanalyst at University College London, the interim review published earlier this year concluded that the system forces children and adults to obtain a formal diagnosis in order to get support.
