BBC ADHD Documentary - concerning title

[FloorWipes]

It's not aired yet but I'm not feeling happy about this going by the title.

https://www.bbc.co.uk/programmes/m001m0f9

It is already so hard to get help or be believed and I'm finding it hard to imagine that this will help.

Wait oh my gosh they've just changed the title!

It was called False Diagnosis: The ADHD Scandal

Panorama have a history of crappy ADHD documentaries, have you heard of the "Kids on Pills" one they did in 2002?

@BertieBotts I hadn't heard about it until I started googling this one! I saw that one was found to be inaccurate and they had corrections/apologies?

It just seems like the real scandal is how underdiagnosed ADHD is and how hard it is to get help through the NHS. That scandal has led to the emergence of private clinics, some of which are contracted to perform the assessments the NHS can't do.

The very last people to blame are desperate individuals spending money they don't have to get help they really neex, but it seems like these are the people who will suffer most from this sort of reporting. I already don't feel like I can tell anyone about my ADHD and this just sort of confirms it.

To be honest, I don't think the new title is all that much of an improvement - obviously we'd have to see what the actual content of the programme is, but it kind of looks like they went in with the assumption that people are being over-diagnosed rather than being historically under-diagnosed (which is generally accepted for both ADHD and autism).

I mean...sure, when you have to rely on clinical diagnosis because nobody can afford the actual scans, there's going to be some variation in the criteria applied, but nothing like the levels that would be implied by dedicating an entire programme to "exposing" it.

@xyxygy

I agree and I'm really not sure that other conditions come in for the same level of suspicion. You can very easily get a diagnosis of depression and a prescription for antidepressants for example but I dont see anyone suggesting that's a scandal.

Just been thinking about this some more...the general perception of the process is that you get seen by somebody, then get a binary diagnosis, then you get drugs.

What they don't often know is that you get a complete report on why you've been given that diagnosis - essentially, all the supporting evidence that was used to arrive at that conclusion, and how each part of the diagnostic criteria relates to that evidence (which, if given by a private assessor, can then be handed to the NHS for inclusion in your health records). Those are all absolutely required by the governing bodies, so I'm not entirely sure how there can be any kind of scandal at all. If Panorama are going to try to spin it that way, I'd be willing to bet they conveniently miss all of that out.

I'd imagine they'll focus entirely on children too, because "forgetting" that ND children grow into ND adults who might be able to advocate for themselves in a handy trick.

I'm autistic (no ADHD for me, although we strongly suspect DP has ADHD), and I just know this programme's going to make me angry.

The description says this one is about adults.

But yes I do agree. I'm going to watch this but I expect that it will be a very frustrating watch.

Fair, I read it on a small screen without glasses...poor choice, obviously.

Yep.

You know, I was thinking this about depression the other day - GPs give out and supervise the taking of antidepressants all the time - why on earth couldn't they do the same for ADHD meds?? They aren't that different are they?

Is this stigma still hanging over from that whole "ADHD kids are just badly behaved and need discipline/exercise/less sugar and ADHD adults are just lazy and need to pull their socks up" "Oh and medication makes you into a zombie 🧟‍♀️"

Or is it because it's "legal speed" and has the potential to be abused/sold on? (Maybe GPs could have the power to prescribe the non-abusable ones at least with psychiatric input required for the abusable ones?)

Because it's basically a defective neurotransmitter pathway in the brain. You'd fix any other defective pathway. You'd correct high blood pressure without (overly) worrying about the safety of the medication. You'd give somebody glasses to correct their defective eye lenses, and nobody would worry about you being dependent on them. We even make it the law for people wear them when they drive!

It's nuts. I was listening to a Russell Barkley interview the other day and he was saying about how he is now campaigning for untreated/unmanaged ADHD to be considered a public health issue, because it will statistically take more years off your life than smoking. And that anybody who is being advised by medics to do anything along the lines of stop smoking / exercise more / lose weight / improve diet / quit alcohol or drugs / stop gambling / anger management (etc etc) and is having trouble doing that should be immediately screened for ADHD as a first resort, because he thinks that 9/10 that's what's behind it.

I like how the OU ad right next to this page BTW has this title:

"Explore the wider challenges that people with a learning disability face in society, and how this impacts on their health"

Tagging in as I'll be interested to watch this

Reading the strapline, it looks as though the programme is focussing on on-line diagnosis, which is going to be slightly more questionable purely because you can observe less of the person and get a slightly more muted perception. It would be worrying, though, if the debate about antidepressant prescriptions and what constitutes depression were to overlap into neurodivergence. Of course, a person can be (and sadly often is) depressed as well as autistic or ADHD. Hopefully the programme will point out that there are reputable private routes to assessment and diagnosis, and will also point out why so many adults feel they have to take these routes. Inaccurate diagnoses happen when criteria and assessment tools designed for children and based on observed behaviour are used with adults who have learned to manage how they present to others (often at cost).

@BertieBotts I think it's the legal speed thing but I genuinely don't get the pearl clutching over it. People will get illegitimate access to stimulants in a variety of ways regardless. I don't think not prescribing to the people that do benefit from them is going to stop this! What might reduce stimulant abuse however is treating ADHD in all the people who are undiagnosed and untreated!

Having had a contracted out by the NHS private autism assessment, I think there is a risk that these private companies are paid per assessment so there is motivation to be quick and not to be thorough. I saw a psychologist for 40 mins and a psychiatrist for about 20 mins, both over Zoom. I probably spent longer doing the questionnaires before the appointments. It didn't feel very thorough and as a result its difficult to fully accept the diagnosis. The scandal is the lack of availability of assessments on the NHS within a sensible time frame.

Two articles this morning:

https://www.bbc.co.uk/news/health-65534449

https://www.bbc.co.uk/news/health-65534448

I came on to see if anyone was taking about this! It feels hugely damaging to a late-diagnosed ND population who already experience debilitating imposter syndrome

I do hope they give equal focus to the scandal of under-diagnosis

Have watched it now on iPlayer.

I think the Harley Psychiatrists assessment they show looks - from what we see anyway - quite shocking in its brevity and quality. The other 2 private assessments shown don't seem too bad to me though.

It does cover how hard it is to access assessment on the NHS but it doesn't look at the issue of underdiagnosis at all or anything really about what ADHD is and how it can present.

I'm not sure how to feel.

I don’t know why there are two different articles as they say pretty much the same thing. One of them does contain the immortal line “if you’re willing to pay for an assessment you’ll get a diagnosis”
This is just going to give the “ADHD isn’t real/everyone has it these days/it’s massively over-diagnosed” people more ammunition. Using just one journalist and speaking to a couple of people anecdotally doesn’t really mean much.

To quote from the BBC article The whole time she plays with her hair and I get the sense she isn't focusing completely. Oh the irony.

I am currently listening to this on the Jeremy Vine show.
I have read the news article and will also watch the program tonight.
As a 50 year old who has struggled all of her life and has just plucked up the courage to make an appointment to ask the gp about an assessment, I am now retreating. Inattentive ADHD is one of the only things which totally resonates with me but with articles coming out such as this one today, I am now put off again as I feel I will not be taken seriously.
Understandably, we can not have private health professionals diagnosing people with conditions for the sake of it but so many of us who may or may not be neurodiverse will go back to the sidelines of life and always wondering for fear of being taken advantage of or not being taken seriously.
So not sure what I make of this today.

I'd love to see a follow up exploring the wider context and - more important- including lived experience of ND people who went through NHS and private practices who were sadly missing from this document. As ND parent with a ND child and having recieved little support from the NHS, this felt terribly one sided.

The diagnoses weren’t provided by psychiatrists. They basically had a questionnaire and added up all the points- might as well have just done an online test at home.

90% of patients assessed were diagnosed as having ADHD, how do you think that compares to being assessed by a psychiatrist (medical doctor) in the NHS ?

The incentive of course, is the private script and ongoing therapy.

Someone upthread asking why GPs don’t diagnose and treat? Well if it takes a psychiatrist 3.5hours to do an assessment then how on earth is a GP with a 15 minute slot going to have time to perform that let alone get trained to do that assessment.

Personally I think it’s a disgrace, totally exploitative, undermines those with a genuine diagnosis and perhaps allows other MH issues to be brushed under the carpet.

I think the psychiatrist vs non psychiatrist thing is a bit of a red herring. There are many types of experienced clinicians out there. Also, adding up points against there diagnostic criteria is essentially the way ADHD is diagnosed. Ideally information is corroborated by multiple sources. There are no approved blood tests, brain scans or other tests as yet that are used in the UK.

People don't generally fork out lots of money for private consultations for fun, so from this self selecting group of individuals, what percentage would we expect to be diagnosed assuming 100% accuracy? I think that's really hard to say.

I hope this will not be a missed opportunity. BBC comments on fb are full of ND comments regarding the impact on this piece on them and their treatment in both private and public settings. I hope it will lead to better safeguarding, regulating and monitoring of private practices AND NHS services too - people are being misdiagnosed not only in private sector.