Panorama Private ADHD clinics exposed

[Youdoyoubabe]

Nothing surprising there really but good to highlight it on national television. Everyone has some characteristics of ADHD.

Yes, funding is right in the middle of all these mess. But there's no money for years to come, so there's no quick fix unfortunately!

I agree with you, like everything else, a health issue to be diagnosed and treated earlier is far less costly than being picked up later when it's ina full explosive state. But we don't have the money as a country.

I'm all for the strikes by nurses, NHS staff and teachers to get fair pay. I can't think how we can cope if anyone gets ill without a private insurance. I can't picture how my children can be educated in the next ten years with nearly all state schools are crumbling and good teachers are leaving (with less qualified come in just because cheaper). But i also can see the dilemma this government is having. They run out of ideas to fix this mess. I still don't trust labour, but I think it's due for a change. For better or for worse...

Again, no quick fix. But I appreciate the program made at least one valid point (yes, unfortunately they didn't mention the crisis within the NHS system). Those private clinics need to be accountable for their actions and patients need to be protected from those ill practice.

FFS.

If a diagnosis of trans gets you funding for additional support for learning difficulties in school then you'd have a point.

It's not purely about getting drugs. It can be about NOT medicalising your child but getting them adequate support to be able to cope with 'normal teenage feelings'. I don't want inadequate support to lead for complications and additional mental health problems (which might need medicating) because of that lack of provision.

I don't want special treatment. I want support based on his actual needs. The ones that are so bloody obvious they cause issues for the teacher within the classroom on a daily basis and can be disruptive to the rest of the flaming class.

Agree. The "too powerful" statement is lack of proper research and nothing more than an onlookers opinion. Very irresponsible.

ADHD medication have been around for decades and have been well researched. They don't stay in the patient's body for more than that many hours. The mechanism these medicines do is specific, and target what an ADHD patient needs.

@Spidey66 I suggest you look into it properly before setting out statements like this. It discourage those who need help to use the tool that can support them finally have a normal life like their neurotypical peers.

Because you don't have first hand experience, you don't have an idea how much it dictated a person's whole life. Everything, everyday.

I regret didn't diagnose DC earlier and was put off by the idea of giving him drugs. But I was completely wrong. If I had started earlier, he might have caught up with the normal development like other children. Now we have a steep hill to climb and years to catch up.

Please do proper research before you judge and give advice to those who are in the pit.

I agree with you, like everything else, a health issue to be diagnosed and treated earlier is far less costly than being picked up later when it's ina full explosive state. But we don't have the money as a country.

This is a fallacy.

There is ALWAYS money for issues that there is political will for even if they a great white elephant.

As a country we are able to borrow money still. And fiscally if in the long term it would produce smaller bills in the future it's a sound strategy to do this.

There is a conscious decision going on here to say, we don't care if this costs us a huge amount more in the future cos we can't be arsed to push this up the political agenda for some reason.

The NHS is a mess because of this nonsense of kicking the can down the road for subsequent governments to deal with so there can be popular tax cuts or to make the books look better now for political purposes. None of this is in the public interest.

The bottom line is the government don't care. Nor do the opposition. It's an issue they don't give two fucks about. And THATs why they refuse to invest in our health. Not because there is money or not.

You are spot on there.

Kicking the can down the road is exactly what it is and has always been a problem in psychiatry in particular.

For me having a diagnosis which highlights exactly how and why I get overwhelmed in certain situations would help me generally deal with doctors rather than constantly being bullshit and being treated with utter contempt as if I'm nuts.

Honestly from seeing the hostility towards ADHD medication and treatment it's actually making me question the hostility towards trans medication and treatment.

Perhaps what everyone can agree on is that in general mental health is incredibly neglected and undersupported. Perhaps for everyone on every waiting list there ought to be access to programs for people to access talking therapy (and not six weeks, but as long as you need), courses/support with things like nutrition, social connections, finding meaning through work/study/volunteering, financial assistance (to navigate the systems rather than free money, though overhaul of the benefits system would be great), sleep clinics, exercise pointers. If you don't have a diagnosable MH condition and just needed some support and direction these ought to work wonders and cut the waiting lists right down. But there are people on waiting lists who are seriously and terribly struggling.

ADHD medications aren't a magic wonder drug, I'm doing titration right now and it's uncomfortable, it's confusing, there are side effects even from the lower doses. They are helping me, but it's a balance as to how much of this is actually just placebo, and how much of the side effects are really worth it.

The thing is that ADHD has cost me so much in my life that I'm firmly on the side of make treatment and understanding more accessible. But I think this programme did a very poor job of actually showing the difference between someone identifying with some ADHD traits and wondering if they might have ADHD vs how diagnosable ADHD really affects someone's life day to day. It's just lazy not to show this. This is very well researched. It totally feels like whoever designed this programme went in with an agenda and everything followed that, rather than a proper investigative approach.

I did that test someone linked, I scored low/unlikely to have ADHD. I had a "gold standard" diagnosis from a leading psychiatric institute in Germany, it was very thorough. But that test is a poor one and simply takes the DSM criteria (which were written for adult observation of children, and don't apply easily to adults. "driven by a motor" FFS) literally. There was also no guidance as to when to select "rarely" vs "sometimes" vs "often" - this is subjective and will affect scores.

The best screener that I know of is the Barkley Adult ADHD ratings scale. It has guidance as to when to pick each of the qualifiers - rarely is 1-2 times in the last 6 months. Sometimes is roughly/nearly half the time. Often is most of the time, Very often = always or nearly always. Adults with ADHD score very highly on this screener and adults without ADHD tend to score low.

GPs regularly prescribe antidepressants - why is this seen as different? Couldn't non-stimulant ADHD medication be put in this category too?

It's not that simple, is it? Just borrow more money as a country which leads to a small bill?

carnegieendowment.org/chinafinancialmarkets/86397

" WHEN IS DEBT A PROBLEM?

There are at least four separate consequences of rising debt that can adversely affect the current and subsequent performance of an economy. These include transfers, financial distress, bezzle (or fictional wealth), and additional spillover adjustment costs termed hysteresis.

Transfers: When rising government debt creates an ex ante disparity between total demand and total supply in an economy, as discussed above, there must be some automatic adjustment mechanism that restores an equilibrium between the two by transferring income from one sector of the economy to another. This transfer mechanism can itself distort the economy in ways that directly undermine growth, though this is not always necessarily the case. This seems to be the main and perhaps only adjustment mechanism that naïve MMT proponents acknowledge.

Financial distress: Rising government debt can also indirectly undermine economic growth. When there is enough uncertainty about how real debt-servicing costs will be allocated through the explicit or implicit transfers described above, the debt can cause various sectors of the economy to change their behavior in ways that protect themselves from being forced to absorb the real cost of the debt. These behavioral changes either undermine growth, increase financial fragility, or both. What is more, this behavior tends to be highly self-reinforcing.

*Bezzle": As I explained in this August 2021 Carnegie piece, under certain circumstances, the rapid rise of debt can lead to the systematic creation of fictional growth and bezzle. This fictional wealth, the creation of which distorts economic activity, can consist either of inflated asset prices or of the capitalization of expenditures that should more properly be expensed. But bezzle is only temporary, and it is always eventually amortized, although its creation can persist for many years.

Hysteresis: Finally, as adjustments occur, rising debt can create a kind of hysteresis in which the equilibrating adjustment mechanism creates additional future adjustment costs. The most obvious example is when rising government debt triggers a financial crisis, which in turn either locks the economy into debt-driven deflation or leads to a political crisis. Most economists, when asked to explain why too much debt is a problem, will argue that debt becomes a problem to the extent that it leads to a financial crisis. Besides being totally circular, this argument is wrong for other reasons. A crisis is simply one of the ways—and not even the most costly way economically—in which an economy can adjust from excessively high debt levels.

Debt is a problem when it sets off one or more of these four reactions, which in turn causes economic growth to slow. Each of these mechanisms works in different ways, and while the last one is largely self-explanatory, it is useful to consider the other three ways in greater detail.

I'm not saying I understand all these terms in this quoted article. I cite it solely in an attempt to show it's not that simple. The society needs a balanced health. By artificially inject money that doesn't belong would distort the economy and further push it away from self balancing.

I don't know what the answer is. I honestly agree with you on how things SHOULD BE. But I don't believe borrowing more money as a country is the solution.

A large amount of those politicians obviously don't care enough. But it doesn't mean there's an easy solution to the huge mess that this country is in right now.

I did that test someone linked and scored 34, likely to have ADHD. I don't. I do have anxiety.

I self diagnosed years ago and have a diagnosis - from a psychiatrist at a private clinic.

i don't disagree with the asessment but I was a bit dubious - though it was nothing like the assessments on the tv programme. He was a psychiatrist and a specialist and spoke to me for at least two hours. It was not tick box

nonetheless I was very surprised at the speed towards which I was pushed towards drugs. Particularly as I felt as I managed, albeit chaotically, without them.

Also, not surprisingly, the online ADHD groups I'm in are talking a lot about this.

And people who've been diagnosed through the NHS are laughing at the 3 hour assessment. It's all been an hour, which is what I had with my private diagnosis, by a psychiatrist.

The whole thing is a joke, but it's feeding into a narrative that sadly far too many are keen to hear.

I can categorically state the NHS clinic I worked in did 3 hour assessments and still do AFAIK

We were one of the biggest in the country, covering a population of about 2million people.

@FancyasFuck can I ask how long ago you worked there? I definitely think that the increase in referrals would mean that many clinics don't have the luxury of 3 hour appointments.

I also had a lot of paperwork to complete before, had to get detailed information from 2 other people that knew me, and that was submitted before the appointment so the doctor had read it before and went through it with me.

Was a similar thing done when you worked there, or was it all discussed on the day? Did people bring someone into the appointment with them?

The problem here is that this documentary only wants to tell a bit if the story, in such a way that plays to the societal appetite for ‘oh you’re all social media influenced attention seekers’ and not the bits that actually take the condition seriously and explore how the NHS’s current failure to assess for ADHD creates the problem
of unscrupulous pay for diagnosis private services.

It is important to look at the problems behaving problems behind problems. This particular problem is just a manifestation of a deeper problem. Or a whole set of deeper problems. These are problems that may well be made much, much worse by pretending it’s just medication-seeking people wanting to jump on a bandwagon.

Same as the apparent ‘problem’ of dreadful parents determined to have their children diagnosed with ADHD when (apparently) they just don’t fit in at school. If that is what is actually happening, it’s a response to the actual problem of the education system being not sit for purpose and unable to actually educate the children within it. Not fitting in at school is a blame the victim way of saying that the school is not meeting the child’s needs.

Going all out to delegitimise ADHD diagnosis only makes things harder for neurodivergent people and their families. That’s irresponsible journalism from
the BBC, who will know that they’re choosing not to tell the whole story.

They haven’t even touched on how an adult in that situation would never even get near a sodding NHS psychiatrist because their GP would have palmed them off with some sertraline and a leaflet about self referring for CBT. Nor that, even if they somehow managed to have a GP who would refer them, they’d wait 3 years to be seen by someone who knows that not diagnosing ADHD is desirable. The trauma would be uncovered but then they’d just discharge him from the ADHD service and he’d be back to a GP palming him off with sertraline and fucking CBT.

The ‘oh there is no money’ excuse for this is not good enough. Especially as it’s just pushing the fact that NHS services are extremely poorly designed and often not fit for purpose such that they fail everyone involved in various ways.

I just checked their website and it still says the assessment will last 2 or 3 hrs. 2 hrs is the standard for a transition I.e someone already diagnosed elsewhere and have been on meds in the last year. 3 hrs for all new assessments.

Everything you said in the last 2 paragraphs we did. We also asked for school reports if available but fine for someone to bring them on the day so long as they completed all the other stuff and sent it back to us prior so we could go through it before the assessment.

We'd ask people to bring someone with them who knew them well, preferably from childhood if they could. If they didn’t we felt like we needed more corroborative information after the assessment we might ask to speak to someone who knew them well on the 'phone so we could get more information.

The problem here is that this documentary only wants to tell a bit if the story, in such a way that plays to the societal appetite for ‘oh you’re all social media influenced attention seekers’ and not the bits that actually take the condition seriously and explore how the NHS’s current failure to assess for ADHD creates the problem of unscrupulous pay for diagnosis private services

I agree.

My daughter also has Tourette’s and last year channel 4 decided to do a documentary that managed to imply that 1) Tourette’s is contagious and 2) sufferers are just anxious and have watched too much TikTok.

It’s lazy reporting (I’m not going to claim it’s deliberate, but…) it just plays into the stereotypes that those with hidden disabilities/neurodivergent are all fakers out for attention.

It was such a waste of a brilliant opportunity to educate the general public on the difficulties of getting a diagnosis, the lack of support available and of the difficulties of living with these conditions

I scored 30. It’s never occurred to me that I had ADHD.
I was told by a child psychiatrist that the medication for ADHD is basically speed. Does anyone know if that’s right? This was about 15 years ago. There were also some people expressing concern about the effect on the heart of a developing child. Does anyone know whether longitudinal studies were done to disprove this?

I used a private clinic to get DS assessed for ASD. They used long school questionnaires, we filled tons of parent questionnaires, we got a parent meeting on zoom and a 90 min face-to-face assessment and ended up with a "not meeting threshold". (ADHD was suggested, but not diagnosed as child too young)

So not all clinics are the same.

Aderall, a drug commonly used to treat ADHD in the USA, is made from amphetamines. Don’t one I the exact combination.

Aderall is banned in Europe.

https://www.theguardian.com/society/2023/jan/29/adderall-shortage-us-adhd-ritalin-drugs

Thank God Adderall is banned in the UK. Just out of interest I was googling and read this about the growth of online ADHD clinics in the US. Comparisons with the prescription opioid crisis. And a crackdown on dodgy profit driven private clinics. Maybe they thought the UK market was ripe for the picking. Where is the quality control of these private providers and online pharmacists?

I agree with this, the media reporting one side. However there is also a professional side where I think saying for example with Tourette’s - that one is media copycat and one is ‘real’ - well everyone seems to shy away from. Even with the term ‘functional tourettes’ which is what the social media ‘type’ is now called, professionals do seem to be tip toeing around this not wanting to upset individuals who truly believe they have the same ‘tourettes’ as anyone else, and their parents.

I’m not sure that there IS any way around it - someone is going to be upset. If we don’t call out there is a phenomen of social media copycat diagnosis, then we take away from those whose Tourette’s/inset diagnosis is not social contagion.

Haven’t RTFT yet so apologies if this has been said already.

If we use diabetes as an example here - if for some reason there were huge waiting lists to see the right person if you thought you had diabetes (which has very clear and identifiable symptoms) and people had to start going to private diabetes clinics for an ‘assessment’ … chances are huge amounts of them would come out with a diagnosis of diabetes because they’d only be there paying their £600-1000 because they were pretty sure already. It’s the same with ADHD surely? No one pays out the money for a laugh so of course the people who do are going to be pretty sure and pretty badly affected. If weakens a lot of their argument if you think about it like that!

Just as a warning to how powerful these drugs are, and how they can do wrong in people who don't have ADHD. Please note this is anecdotal evidence but I thought I'd share it to demonstrate why the ADHD diagnosis must be made after a comprehensive assessment and not just a tick box questionnaire.

I once assessed a young lady in her early 20s. She came from the Phillipines and was a post graduate student. Her parents had paid £££ for her to get her degree and post grad in the UK, believing it to be a superior education to what she would get in the Philippines. So that she wouldn't let them down, she would spend every hour studying and bought Ritalin online in order to stay awake and help her concentrate. She ended up having to leave college as she ended up in an acute psychotic episode and honestly it was so, so sad to see as again, she was really suffering.

My point in this is certainly the young student did not have ADHD and as a result the Ritalin did not have the effect its supposed to and ended up causing a mental health crisis which previously did not exist. And that's why a clear diagnosis needs to happen before these drugs are prescribed,. They're very powerful.

People on here won't give a shit about the collateral damage as long as they get their own diagnosis for them or their child.

Someone else ends up seriously ill? Fuck them.

I don't think diabetes is a good comparison because it's much easier to diagnose. If your blood glucose levels aren't high, you don't have diabetes. Conditions like ADHD are much more subjective, and what one professional sees as a clear diagnosis will not be seen as ADHD.

However, keeping with the diabetes analogy, giving treatment for diabetes to someone who doesn't have diabetes can have dangerous consequences. The same is true of ADHD. Giving someone treatment for ADHD when they don't have it is dangerous, which is why we need to ensure the diagnosis is correct.