BBC Panorama exposed private clinics in the UK that are diagnosing ADHD without following proper procedures. This problem can solved by not doubting the sincerity and willingness of those who ask for assistance. People who are paying, waiting, and inviting are in distress. The notion that they are making it all up contributes to the stigma and stereotypes that have associated with people who have hidden disabilities for many years. It is important not to misinterpret examples in the show.
There is a huge difference between a reporter who plays a role and thousands of people looking for help. Do not doubt your own experience or yourself if you received an online evaluation after testing and found that medication was helpful. Those still experiencing difficulties should seek further evaluation and intervention.
Monique Botha, a neurodiversity researcher, said, “People are looking for what they want. Most people who make an appointment end up with a diagnosis. ” It’s only scandalous to think that people cannot reliably diagnose themselves.”
ADHD is on the rise, but it is not overdiagnose.
In the UK, ADHD diagnoses have increased dramatically in recent years. The number of prescriptions for ADHD medication has nearly doubled in the last two years. The number of ADHD medications prescribed is still well below the estimated 3–7% of people who suffer from ADHD. Women are the fastest-growing group because they were previously exclude due to gender criteria. We do not want women to doubt themselves and distrust their doctors because of a fever.
The NHS is facing a capacity problem. It is evident that there are capacity issues in the NHS. The public is becoming more aware of ADHD, autism, and neurodivergence. As a result, the number of people seeking diagnosis and treatment has increased. Evidence suggests that there is a systematic underdiagnosis, and those who are persistent or can afford private health care receive it more often. Many shortcuts are available, ranging from the private clinics featured in the TV show to online assessments. There are many ways to get this label at a low cost.
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Are shortcuts safe to use?
No. It’s dangerous to take a shortcut when diagnosing. Panorama pointed out that this is a UK-wide scandal.
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To solve this problem, we need to train more diagnosticians and not seek shortcuts. Registered nurses, psychologists, and GPs can all play a greater role in identifying those who have more complex needs. The NHS does not diagnose ADHD or autism. The NHS won’t take dyslexia and dyspraxia into account. Self-medication is a common problem for people who suffer from depression, anxiety, and self-medication.
A diagnosis can be a life-changing experience. We can’t let people feel exposed or unsupported at a vulnerable time. We must first invest in research to understand mechanisms and clear supportive intervention pathways before we even consider shortcuts.
What should we diagnose?
ADHD can manifest as symptoms like inattention, poor focus, difficulty with working memory, emotional dysregulation, and excessive movement. ADHD isn’t responsible for all of these symptoms. Post-traumatic stress disorder, thyroid dysfunction, and long-term COVID can all co-occur, or they may be the only causes of the same behavioral patterns. These symptoms must excluded in order to make a diagnosis. Even if they are not serious, they deserve professional attention. You don’t need to pay for a psychiatrist if you’re fine. What if it’s not ADHD? How can we help?
A thorough background assessment is require to diagnose ADHD. It will be determine if the symptoms have present all through life. This is more likely to indicate a neurodevelopmental condition than an acquired condition due to trauma or illness. The detailed background assessment and interview cannot rushed. A professional who is skill must carefully listen and observe while considering other options.
The NICE Guidelines support this approach and state that all professionals who diagnose patients should be properly trained and regulated, including nurses and medics. Panorama’s examples could have been more rigorous. This is something to consider. Let’s not be naive: shortcuts are often used in the context of a poorly funded public healthcare system and can lead to misdiagnosis.
Should online assessments be eliminated?
No. Professor James Brown from Psychiatry UK cited two peer-reviewed papers that examined online ADHD assessments in a systematic manner as opposed to a handful of anecdotal case studies.
You can still use high standards to assess ADHD remotely.
As a profession and as a society, we should recognize the potential for these platforms to provide high-quality evidence-based health care if they are properly designed and implemented.
Remember that a professional who has the experience to thoroughly review the process can be just as effective online or in person. It is not important which forum you use, but how much time and effort you put in. There is evidence that suggests neurodivergent people prefer to build rapport online.
Jon Chanter is CEO of Psychiatry UK. He says that psychiatry is the best medical specialty for online consultations. It is rare that a physical examination is required, and clients enjoy the convenience and privacy of consulting a doctor from home.
Richard Mellor, a colleague of Mellor’s, also agrees. “I was surprised that it is easier for the patient to feel in control when establishing a therapeutic relationship online.”
For many years, online questionnaire screening has been used to triage patients. This tool can be very useful in the assessment of a patient, but it should not replace diagnosis. Online questionnaires should meet basic psychometric standards, and they must be clear to allow people to get immediate help if needed.
What is the true scale of the scandal?
The removal of diagnostics is dangerous. Society needs to be cautious, particularly when it comes to preventative healthcare and not just crisis-driven healthcare. This is happening across the country. The only option left for people is to self-medicate or seek out private options.
Untreated neurodivergence can lead to higher incarceration rates, decreased employment rates, and poorer health outcomes. Undiagnosed ADHD can lead to substance abuse, smoking, and eating disorders. We may need to improve diagnostic standards, but ignoring someone who is in distress until it’s too late is not a psychological or medical decision.
When they are provided with the accommodations and flexibility they require, neurodivergent individuals often achieve success in both school and at work. We must prioritize early assessment and provide adequate assistance to ensure that our citizens reach their full potential.
Simple and cost-effective treatment can be provided for hundreds of thousands of people diagnosed with ADHD who otherwise would be more susceptible to social health risks. Medical care should not be denied to anyone. It could be more efficient and safer. This is not a false diagnosis. This is the scandal. But underfunded services are not prepared to plan or prepare for a population. Shevonne Mathews made the following comments:
It would be better to focus on the NHS waiting list to assess adult ADHD and the systemic injustices of differential access to specialists, misdiagnosis, and underdiagnosis, especially for women and ethnic minorities. This would complement the voices of neurodivergent adults instead of risking to antagonize the ongoing efforts of lived experience advocates and ND-led organizations to change outdated, harmful narratives.
