The Royal College of Psychiatrists in Scotland's 'fault line' report, and what our FOI data shows

On 30 July 2026 the Royal College of Psychiatrists in Scotland (RCPsychiS) published Mental health at the fault line. It warns that a decade of health and social care integration has left the country's mental health services fragmented, and it calls for an urgent independent inquiry into the effect on patient safety. Neurodevelopmental services, which is where ADHD and autism assessment sits, are named among those affected.

One finding stopped us. The College describes a system so fragmented that its own shape cannot be mapped:

"There is no single mental health governance structure in Scotland. The interaction between NHS Boards, IJBs, HSCPs, local authorities, education services and third-sector organisations varies significantly between areas and between specialties. The level of variation is so great that it is impossible to accurately map a single national picture of how mental health services are planned, funded and governed."

Royal College of Psychiatrists in Scotland, Mental health at the fault line

That is the exact wall our own data keeps hitting.

What we have been finding

Since 24 June 2026 we have asked all 14 Scottish health boards, directly, how long people wait for an ADHD or autism assessment and how many are on the list. Eleven have replied so far. No two answered in the same way.

• NHS Grampian reported a median adult ADHD wait of 194 weeks in Aberdeen City, with 1,823 adults on the list. In the same board, Aberdeenshire has no adult pathway at all, and Moray's list has been inactive since September 2021, the board's own description, with 567 adults still on it.
• NHS Greater Glasgow and Clyde has 8,886 adults waiting for an ADHD assessment.
• NHS Dumfries and Galloway confirmed it has no adult ADHD or autism assessment service.
• NHS Lothian cannot separate ADHD from autism at all: its combined figures show adults waiting a median of 177 weeks, the longest board-wide adult median reported, with more than 25,000 people on its lists in total.
• Only 5 of the 14 boards could give an adult ADHD figure at all. Four refused on cost grounds, one has no service, one could only provide combined figures, and three have not replied.

You can see the full set on our waiting times page, and every original response on our FOI tracker.

Why the report and the data fit together

The College is describing, from the top down, a system that has drifted apart board by board. Our FOI replies show the same thing from the ground up: different definitions, different pathways, some services paused or never built, and no shared national dataset to hold it together. When RCPsychiS says a single national picture cannot be mapped, our board-by-board results are part of the reason why.

The College goes further, and takes neurodevelopmental services as its own worked example. Within a single board, it notes, different HSCPs and integration authorities commission separate ADHD and autism services, "each with different eligibility criteria, referral routes and delivery models", so that "patients may still face long waits for assessment and support, despite significant spending elsewhere in the system". That is the top-down description of exactly what our responses show, board by board.

There is a specific gap underneath both. Public Health Scotland's national CAMHS statistics do not capture it. PHS explains that where a child is waiting for an assessment for a neurodevelopmental condition, "such as autistic spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD)", they "may not meet the national referral criteria as set out in the CAMHS national service specification, and therefore will not be counted in CAMHS statistics" (Public Health Scotland, CAMHS waiting times). There is no adult equivalent, so for ADHD and autism the waiting-time figures are not collected centrally in the first place. We ask for them one board at a time because there is no other way to get them.

If you are the one waiting

In practice this means where you live changes what you face, often by years. Our State of ADHD and autism care in Scotland page tracks what has been promised against what the boards actually report, and our health board pages set out the position and the routes open to you in each area.

Where we stand

We are independent, and not tied to any board, government, political party or clinical provider. We publish what boards tell us, with the date and a link to the original document, so anyone can check it. We have added the RCPsychiS report to the evidence we track, alongside our own data, on the State of ADHD and autism care page.