Rising ADHD diagnoses spark debate over treatment and diagnosis standards

Experts raise concerns over increasing ADHD diagnoses and the rise of private assessments, questioning whether the trend risks medicalising normal behaviours or neglecting genuine cases amid long NHS delays.

Experts are warning that more people are pursuing ADHD diagnoses without following through on treatment, a trend they say deserves much closer study. In the Guardian’s reporting, psychiatrist Marios Adamou, founder of the UK Adult ADHD Network, said some people now treat ADHD as “an identity, rather than a disorder”, while poor-quality private assessments can leave patients believing they need treatment when the diagnosis itself may be questionable.

Adamou said complaints against NHS doctors have risen when clinicians refuse to accept weak private assessments. He also said he had seen figures suggesting that half of child patients did not go on to treatment after diagnosis, and that the pattern appeared to be similar among adults seen in his clinic. At the same time, he stressed that ADHD is not imaginary: brain differences are well established, and the diagnostic framework has undergone substantial scientific scrutiny. His concern, he said, is that the concept has been broadened so far that it is at risk of losing meaning.

The debate comes as demand for ADHD assessment and treatment continues to rise sharply. The BMJ reported that the number of people receiving ADHD treatment in England increased from 154,858 in 2019-20 to 233,474 in 2022-23, according to Nuffield Trust data. The same coverage said some patients are facing years-long waits for NHS assessment, with a House of Commons Petitions Committee survey finding delays of up to three years. That pressure has created a large private market, which critics say can be uneven in quality and too lightly regulated.

The Guardian said Dinesh Bhugra, the former head of the Royal College of Psychiatrists, echoed concerns about a surge in diagnosis without a clear explanation for it. Bhugra warned that doctors risk turning ordinary human responses into medical problems and said private firms can see ADHD assessment as a lucrative service. He also argued that the UK is borrowing an approach more closely associated with the United States, where diagnosis is often reduced to checklists, and said care should be more holistic, combining social, psychological and biological factors.

Not everyone involved in the debate agrees with that framing. Jessica Lister, a clinical director and consultant nurse at the private provider Care ADHD, told the Guardian that dismissing ADHD as merely social can deepen inequality in education, health, work and the justice system. Mark Pattison, Care ADHD’s chief executive, said standards should apply to both NHS and private services, while also warning that some NHS trusts still leave children waiting two, five or even 10 years for assessment. The Channel 4 documentary “The Great ADHD Myth?”, presented by NHS psychiatrist Max Pemberton, is due to air on 18 August and has sharpened the wider argument over whether ADHD is being over-medicalised or still under-recognised.