Panorama Private ADHD clinics exposed

[Youdoyoubabe]

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

Exactly this. They also didn't show the leading private ADHD clinic (Psychiatry UK). Could it be that some (many?) private clinics are actually professionally run?

And how funny the journalist got an appointment with a top specialist within the NHS. Wouldn't it have been more balanced to show 3 (more average) NHS assessments?

There is a flip side to giving a diagnosis to someone who potentially doesn't have ADHD, and that's dismissing someone who's been struggling their whole lives because, despite having all of the symptoms, they have a job. And that's something that's going on in the NHS, it's almost like they want to cap the number of diagnoses or something...

When I worked in the field I reassessed a few people who had had private diagnoses and been put on meds, that on investigation, had a severe mental illness, sleep disorder or physical health problem instead.

I had a tonne of abuse from one person who said without the meds they literally couldn't get out of bed. Because they had chronic depression and not ADHD, but hadn't been assessed properly...

Everyone has some characteristics of ADHD.

yes, but what is key as that most are missing other characteristics. I've just gone through lengthy interview sessions for one of my DC. I recognised many things in myself but it also brought into focus the ways I differ from someone with ADHD.

bleating on about "oh, we ALL have...." is just stupid.

Wanted to add but pressed to soon, I am not surprised parents who children mask all day and come home and behaviour is awful I'm not surpsied they are reaching out to these private clinics! It's years waiting list on nhs. I was refused a referral to nhs adhd services initially by first doctor as she didn't belive I had it. Didn't seem like she know much about adhd let alone decide I didn't! I seen a second doctor who did know about it as had child with it and did refer me I didn't know they had child with it when I seen them. So it's complete lottery about who knows enough about it.

@begaydocrime42 another example. If someone had committed a crime and said they were psychotic at the time, we wouldn't just rely on self reported symptoms, there would be a number of medical reports by psychiatrists who gathered background information, history, reports from friends and family as well as obviously sitting down and speaking to the person involved. It wouldn't all be self reported!

I got 10

This is exactly part of the damage the programme will do.

'Poor social habits'

I put most of my problems down to the Internet and SM. Too much phone use. I've stopped being able to concentrate for longer than 3 minutes unless I'm really interested

The stigma and problems that people who have an accurate diagnosis have to put up with is dreadful.

My brother had symptoms of ADHD as a child but my parents never followed through with it because it was 1988 and it wasn't understood well. DH had clear issues as a child too. No one who knows him ever questions suggestions he has ADHD. And my own problems were definitely ingrained as a child. Then got worse resulting in breakdown before I ever had a smart phone.

I don't think a lot of people have a clue about ADHD tbh. It's depressing.

The thing is, people who actually have adhd and who have had it diagnosed know that they have it. It’s not something that can be explained away by poor sleep hygiene, bad diet or stress. So how do you propose that these individuals are distinguished from the so called “fakers”?

@NotAnotherBathBomb that psychiatrist is a practicing psychiatrist, he see's patients, why not show him?
The unpopular fact is that the nhs does have really good staff. The psychiatrist I worked with in an adult learning disability team is one of the leading experts in brain injuries and learning disabilities. The person who I know who works in mental health assessment has research published in the lancet and is part of an Oxford based research group. These are NHS staff who assess and see patients. I know who I would trust over them and gun for hire, working from home psychiatrists who just to £800 zoom calls all day.

Quite. They are obviously useless ...

...more stigma.

Your DDs diagnosis is probably solid but what's being highlighted is many are not.

And what do you think is going to happen to the education system, which is already under-resourced when they have to provide extra support to children who possibly don't have a valid diagnosis? And the number grows year on year?

Some NHS child clinics are closing Autism assessment referrals unless there are specific risks because they've had a 350% increase in referrals in the last 2 years and the waiting list was impossible. So they have to prioritise the most in need and now expect the schools to manage the issues without Autism even being assessed and make adjustments for children who might be NT but having difficulties for a completely different reason. Children could be being neglected, abused, have a physical health problem which will be overlooked because now the school will just assume it's all down to being ND.

This issue knocks on to virtually everything.

It's healthcare privatisation by stealth, putting strain on other services already at breaking point and will even have global impacts in terms of research.

I am finding this really difficult. I perform these assessments privately (children not adults) on top of my full time NHS job

I work for a very well respected provider and I try very hard to be robust. I am a doctor. I do face to face appointments and they usually take two hours. I will not diagnose without information from school and conners from school and home. If school information is not supportive, I always get a QB test. If there is suspected it confirmed comorbid asd, I always get a QB test.

But, I diagnose a high proportion that I see. I always felt this was to be expected as parents are obviously sure enough to put over 1000 pounds on the line. Also we screen for free, and advise that people don't have an assessment if they don't meet screening criteria.

Local camhs is a godforsaken mess. 4-5 years for assessment. Very difficult to get any referral accepted. Also periodically they send letters out to their whole waiting list saying that if they still want an assessment, they should get in contact. Loads of the parents also have ADHD and the letters fall by the wayside and the child is taken off a 4 year waiting list.

I actually sometimes think camhs underdiagnose. They are stretched very thin, a diagnosis means follow up and if medication is started, alot of follow up. They have an incentive not to diagnose as strong as the private clinics incentive to diagnose. When I have done NHS contracts for ADHD, I have been advised to basically dissuade parents from considering medication, because the resources for follow up are simply not there. Remember ADHD is a common condition, between 3-5% of the population. That's 1-2 children in every school class.

Also the whole 'it's not ADHD, it's trauma' thing. This is often cycled out for kids, but no help is offered. The kids I see often have had trauma in their first 2 years, so have been exhibiting symptoms their entire life. They show symptoms at home and at school, there functioning is crippled by their symptoms..... But a sniff of trauma and some clinicians will refuse an ADHD diagnosis....even though we know children can have both.

Essentially, as much as you try and corroborate your history and get as much information as possible, there is an element of the clinicians opinion and experience in any diagnosis. I think oversight and hierarchy and a function to discuss difficult and borderline cases (all of which I have) is important. But some times it is a judgement call, based on the evidence in front of you and intevitably sometimes you will get that wrong. The weight of that weighs very heavily on me and I can promise I care about the patients not just the paycheck.

The reason the waiting lists are so long is because of funding cuts and pandemic where there was no diagnosis or very little and also it being more widely known. When parents of Neurodiverse children realise that they are also Neurodiverse and go for assessment. I can totally accept that I'm sure some assessment clinics are out there for the money and may abuse the system but I'm not going to belive all of them are. I know of private diagnosis clinics that I know people have been diagnosed they are not money making and by trying to say all are is unfair to the genuine ones.

@FancyasFuck support in schools is supposed to be based on need not diagnosis.

How do you suppose children and young people who are at absolute breaking point, who are intelligent but at risk of failing all their exams due to adhd, at risk of labelling, delinquency and crime, are we to ignore these kids and their needs because they are a minority and the nhs is crumbling.

What literally is your suggested solution?

Don’t you think that families would prefer a (more rigorous) widely accepted free nhs diagnosis if it was available to them??

@LeanIntoChaos I really appreciate your insightful and comprehensive post. I do hope that the “adhd is over diagnosed by quack independent clinics” people read it

I actually sometimes think camhs underdiagnose. They are stretched very thin, a diagnosis means follow up and if medication is started, alot of follow up. They have an incentive not to diagnose as strong as the private clinics incentive to diagnose. When I have done NHS contracts for ADHD, I have been advised to basically dissuade parents from considering medication, because the resources for follow up are simply not there. Remember ADHD is a common condition, between 3-5% of the population. That's 1-2 children in every school class.

And this is what I wish the documentary also showed, for balance. Thank you for your insight.

I haven't watched the programme or caught up on the thread fully. I have one child diagnosed with ASD via NHS and one on the NHS waiting list which is 26 months long. I am getting child 2 assessed privately, by a clinic who follow NICE guidelines to the letter, because the damage from waiting for so long is likely to be so high given how he is currently affected.

What I can see straight is that no other professionals other than psychiatrists are qualified to diagnose.
This is not correct. The NHS website says that either a psychiatrist or a suitably qualified paediatrician can diagnose ADHD, and list a whole lot more professionals who can diagnose ASD.

I totally agree with this. I have had my initial appointment for adhd diagnosis (last year!) just deciding if they will allow me a assessment and when I mentioned autism traits (my daughter diagnosed with autism at 2) they were very quick to minimise and actually said they wouldn't go for autism assessment too. So I definitely belive that nhs would rather undiagnose

So has the (biased) documentary given the impression that only psychiatrist can or should conduct assessments? This couldn’t be further from the truth so I hope people haven’t been mislead by this.

When I have done NHS contracts for ADHD, I have been advised to basically dissuade parents from considering medication, because the resources for follow up are simply not there. Remember ADHD is a common condition, between 3-5% of the population. That's 1-2 children in every school class.

Is this not because the medication comes with risk for children and they’d rather most children tried to manage/be managed without as a first step? Potentially 3-5% of children on string stimulants would be a concern of any decent not for profit health service?

This is quite laughable, I think you can’t have any idea what a child with adhd who needs stimulant medication is like. There’s no talking away, training away or sleep hygiening away genuine adhd symptoms.

Did you whistle blow that the NHS advised you to dissuade people from having the medication they need?

@User98866 absolutely do not want 3-5% of the paediatric population on medication. Any responsible clinician is very careful with this stuff. First line is always behavioral and environmental modifications. I always say that. I also always emphasize how serious these meds are. But....we are talking about kids who have waited 4 years. Kids who have been picked up at 7 by professionals but never formally assessed. I'm seeing at 15 about to take gcses with severe ADHD. School have already put in place movement breaks and time out cards etc.

If the patient meets the threshold for licensed medication they certainly should not be dissuaded from taking it. We wouldn’t suggest this for other conditions.

Once the diagnosis is confirmed and the threshold for medication is passed (ie symptoms are so great that they significantly affect everyday life and can’t be controlled behaviourally), clinicians should be presenting medication options neutrally with risks and benefits. Like any other meds.

The NHS is quite obstructive if you raise ADHD as a possibility. Your GP is very likely to palm you off with antidepressants and tell you that there’s no point in referring you to the huge ADHD assessment waiting lists.

I‘ve known I have ADHD for 20 years. Long before it was some sort of tik tok trend, I was scrabbling around to understand problems I’d had all my life that were becoming increasingly problematic as I tried to adjust to adult life. It took me til last year - and my boss encouraging me to have an assessment - to pursue a private diagnosis.

I tried my GP but he actually told me that there was no point because, even if I were diagnosed, they rarely medicate adults (as if I were just looking for some stimulants in the NHS). So I looked into private options. The psychiatrist who diagnosed me is also an NHS psychiatrist. Many of them are - it’s so common to have a private practice alongside part time NHS work. She very much encouraged coaching as a treatment option but said I could be assessed for medication (requiring a GP referral for heart assessment and blood tests).

I haven’t actually pursued medication because, frankly, I can’t face trying to go through my GP given how dismissive he was previously. But the point wasn’t medication - it was getting a better understanding of what was going on so
i could approach things differently.

The worst thing about all this is that, despite the very real and not at all ‘we all have a touch of ADHD’ nature of how it has affected my whole life, I have always worried that a private diagnosis is easily dismissed. And this is just more fuel to all the people who are so desperate to tell women with ADHD that they’re just attention seeking.

The structure of the panorama ‘investigation’ is extremely dubious. The NHS psychiatrist knew it was all for tv. Where there are problems with unscrupulous adhd clinics taking advantage of people influenced by tik tok, sensationalist stuff like this isn’t going to help anyway.

Not least when (as many posts on this threads show) the programme is perceived as exposing, not clinics, but people with ADHD as ‘frauds’. The cultural landscape made that outcome an inevitability. The BBC should be ashamed of that.