Rising number of people seeking ADHD diagnosis without treatment, say experts

Overview

The upcoming Channel 4 documentary The Great ADHD Myth? has ignited a fierce debate in the UK over the nature of attention deficit hyperactivity disorder (ADHD). Presenter Dr Max Pemberton, an NHS psychiatrist, concludes in the film that ADHD is "a social construct, not a disorder of the brain." The documentary, which aired this week, features experts skeptical of ADHD and its treatment, and includes the story of a 10-year-old boy, Mason, who was taken off his medication and made lifestyle changes to see how it affected his behavior.

The program has drawn sharp criticism from medical professionals and advocacy groups, while Channel 4 defends it as part of a legitimate public debate. Meanwhile, experts are also highlighting a separate but related trend: a rising number of people are seeking ADHD diagnoses without pursuing treatment—a development that some psychiatrists attribute to an expanding, and potentially diluted, understanding of the condition.

Backlash Over the Documentary

ADHD UK, a charity, has filed a formal complaint with media regulator Ofcom about the documentary, insisting that "ADHD is not a myth. It is not a social construct." The Royal College of Psychiatrists also warned against what it said was "invalidating the condition." Prof Subodh Dave, the college's president, said that invalidating ADHD would be a disservice to people with the condition and experts involved in their care. He called for a focus on improving access to assessments and addressing waiting lists that leave many without support for years.

The documentary's handling of young Mason drew particular attention. The end caption revealed that Mason returned to his medication two months after filming, with improved school performance, despite his mother initially saying he would stay off it. ADHD UK pointed to the caption as evidence that the program's own content disproved its conclusion, yet the show aired "their version anyway."

Katya Rubia, a professor of cognitive neuroscience at King's College London, went a step further by withdrawing her support for the documentary. Rubia, who contributed academic commentary, said the program "cherrypicked, largely misrepresented, truncated, and presented my comments out of context." She cautioned that "biased programs like this one" could lead to increased suicide risk by encouraging parents to take children off medication, which can have longer-term adverse effects such as increased anxiety and depression.

Channel 4's Defense and Additional Criticisms

Channel 4 has defended the program, saying that there is "considerable public debate on various aspects of ADHD," and that it is legitimate for that debate to be explored. In a statement, the broadcaster said the film "does not deny the lived experience" of those diagnosed with ADHD, but rather presents the views of senior medical experts questioning conventional understanding.

Other experts have criticized the documentary as one-sided. Prof Anita Thapar, chair of NHS England's independent ADHD taskforce, said the program used sensationalized language, including comparing medication to corporal punishment. According to an ADHD UK survey, 94% of over 4,000 respondents said the documentary added to stigma surrounding ADHD, and 88% said it failed to make clear that skeptical views were in the minority.

Dr Max Pemberton, the documentarian's host, concluded schools rather than medications are the solution, but critics argue that such a narrative oversimplifies the condition.

Experts Highlight Diagnosis Without Treatment

Amid the controversy, psychiatric experts have noted a related trend: an increasing number of people are seeking ADHD diagnoses without pursuing treatment. Dr Marios Adamou, founder of the UK Adult ADHD Network, said many people now view ADHD as "an identity, rather than a disorder," and that poor-quality private providers are giving assessments that lead individuals to believe they have a condition needing treatment. He cited recent figures that showed 50% of child patients do not pursue treatment after diagnosis, and observed a similar trend among adult patients in his own clinic.

Adamou suggests that the ADHD concept has been expanded to the point of becoming "meaningless," even while acknowledging it is both a social construct and a brain disorder. He argues that the diagnostic criteria have been validated, but the idea has broadened too much, leading to overdiagnosis and a rise in complaints against NHS doctors who are forced to accept or reject these private assessments.

Another expert, Prof Dinesh Bhugra, former head of the Royal College of Psychiatrists, agreed there is a "splurge of diagnosis," and voiced concern about the "medicalization of normal responses." He also criticized private companies for engaging in what he called "profiteering," saying that ADHD assessment has become "an easy way to make money."

Others, however, warn against dismissing the condition. Jessica Lister, of the private provider Care ADHD, said that treating ADHD as a social construct trivializes the condition and perpetuates inequalities. Mark Pattison, also from Care ADHD, stressed that standards of diagnosis need to apply equally across the board, noting that NHS trusts have children waiting years for assessments.

Context and Further Background

ADHD is a well-established neurodevelopmental disorder, and the NHS estimates that around 2.5 million people in England live with the condition. Research from University College London suggests nearly a 20-fold increase in UK adults diagnosed between the early 2000s and 2018, and some studies indicate the condition may still be under-diagnosed.

The Guardian and The Times each gave the documentary a four-star rating, with Guardian describing it as "the most controversial show of the year"—though these reviews have been disputed by the documentary's critics.

The debate over The Great ADHD Myth? reflects a wider societal tension: while there is growing recognition of ADHD and increased demand for diagnoses, experts are divergence over whether the rise in diagnostic claims reflects greater awareness or an overboard expansion by the condition's definition.