Experts Dismiss Health Secretary's Assertion of ADHD Overdiagnosis in the UK
A coalition of leading experts has strongly contested Health Secretary Wes Streeting's claim that attention deficit hyperactivity disorder (ADHD) is overdiagnosed in the United Kingdom. In a comprehensive paper published in the British Journal of Psychiatry, the group argues that the condition is, in fact, likely underdiagnosed, with rising rates reflecting increased awareness rather than over-pathologisation.
Alarmist Rhetoric Could Harm Patient Care
The team of 32 clinicians, academics, and patients expressed concern that what they describe as "alarmist" rhetoric surrounding a fear of overdiagnosis could effectively "deny" individuals the essential care they require. This warning comes directly in response to Streeting's recent decision to order a review into the diagnosis of mental health and neurodevelopmental conditions, including ADHD.
Streeting reportedly tasked leading experts with investigating whether common human emotions have become "over-pathologised" in contemporary clinical practice. However, the authors of the new paper highlight that health records demonstrate a significant rise in ADHD diagnosis rates within clinical services between 2000 and 2018.
Data Reveals Underdiagnosis, Not Overdiagnosis
Despite the increase in diagnoses, the experts point to data suggesting that current rates remain "substantially below the ADHD population prevalence in the UK." They assert that this provides no evidence at present that ADHD is overdiagnosed at a population level. According to their research, approximately one in twenty children (5.4 percent) and 3.3 percent of adults are estimated to have ADHD in the UK.
Professor Chris Hollis, a co-author from the University of Nottingham, explained the situation clearly. "While the incidence of ADHD diagnosis has increased significantly since 2020 - particularly in women and young adults - NHS administrative data in England shows no evidence of overdiagnosis," he stated. Professor Hollis described the recent rise as a "catch-up" after "many years of under recognition and under diagnosis."
Real Concern Lies in NHS Waiting Times and Support
Professor Hollis emphasised that the primary issue should not be overdiagnosis but rather the "unacceptably long waiting times, sometimes over years, that people experience in the NHS for diagnosis, support and treatment." This sentiment was echoed by Professor Samuele Cortese from the University of Southampton, who served as lead author of the paper.
Professor Cortese noted that despite an "alarmistic tone" surrounding increasing diagnosis rates, the reality is that many individuals continue to go undiagnosed and their needs remain unmet. "This is quite concerning, of course, because if not treated properly, ADHD exposes to significant risk for the individual and their family," he warned.
Significant Risks Associated with Untreated ADHD
The paper outlines several serious risks linked to untreated ADHD, including accidental injuries, traumatic injuries, car accidents, suicide, substance misuse, and increased risk of death. Professor Cortese stressed that attention should shift away from debates about increases or decreases in diagnosis rates and instead focus on improving treatment and support for those living with the condition.
While the experts did acknowledge that some misdiagnoses may occur due to "low-quality assessment, poor adherence to national guidance, or inappropriate differential diagnosis," they maintained that the predominant challenges remain underdiagnosis and undertreatment. "While misdiagnosis and inappropriate diagnosis do occur, the available evidence indicates that under diagnosis and under treatment remain the predominant challenges," the paper concludes.
