Seven in 10 GPs Say Adult ADHD Is Over-Diagnosed — But Is the Real Problem Something Else?
Seven in 10 GPs Say Adult ADHD Is Over-Diagnosed — But Is the Real Problem Something Else?
A Berkshire doctor once referred more than 1,000 patients for ADHD assessments. Only one came back without a diagnosis. A Dorset GP put it even more bluntly: “I dont think I have ever seen a private provider not give a positive diagnosis.”
Thats not a statistical anomaly. According to a new survey of 829 GPs conducted by the medical publication Pulse, seven in 10 family doctors believe adult ADHD is over-diagnosed. Nearly half — 410 respondents — called it “very over-diagnosed.” Another 173 said it was “slightly over-diagnosed.”
The numbers are striking on their own. But the story behind them is messier, more human, and far more uncomfortable than a simple headline about over-diagnosis suggests.
The Queue That Never Ends
To understand why GPs are raising alarms, you have to understand the pressure theyre under. Long NHS waiting lists have pushed a growing number of patients toward private ADHD assessments. Some pay more than £1,000 out of pocket. Others access private providers at taxpayers expense through Englands Right to Choose scheme, which lets NHS patients select their provider.
That system creates a quiet but powerful incentive. Private clinics get paid per assessment. And according to the GPs surveyed, those clinics almost never say no.
One doctor estimated that more than eight in 10 patients referred for specialist assessment ultimately received an ADHD diagnosis. Another described being “stunned by how superficial some assessments are,” warning that significant trauma and adverse childhood experiences could go unnoticed.
Thats the crux of the concern: not that ADHD doesnt exist, but that a rushed assessment may miss whats really going on.
A Sixfold Increase in Prescriptions
The debate isnt happening in a vacuum. NHS figures show that around 268,000 adults were prescribed stimulants and other ADHD medications in the latest quarter. Before the pandemic, that number was fewer than 47,000. Thats a 474% increase — nearly six times as many adults receiving medication in just a few years.
Something is clearly changing. The question is what.
Prof Peter Fonagy, the clinical psychologist leading a government-commissioned review into rising demand for ADHD, autism, and mental health services, has argued that the surge doesnt appear to reflect an equivalent increase in the underlying prevalence of the conditions. But hes also pushed back on the idea that ADHD is simply being over-diagnosed. In his interim report, he suggested that underdiagnosis, misdiagnosis, and overdiagnosis can all coexist.
Hes pointed out, for instance, that women and girls have historically been under-recognized. And hes rejected the lazy narrative that a “snowflake generation” is suddenly seeking help for every twinge of anxiety.
Instead, Fonagy argues that rising demand may reflect improved awareness and greater openness about mental health — not a collapse in resilience.
The GPs Arent So Sure
Not everyone buys that explanation. Dr Katie Bramall, chairman of the British Medical Associations UK GP committee, was herself diagnosed with ADHD through the NHS. She defends the high diagnosis rate, noting that lengthy waits and demanding paperwork mean the patients who actually reach assessment are often the most severely affected.
“Im sure the same is true for many other pathways to specialist referral,” she said.
Henry Shelford, chief executive of ADHD UK, echoed that point. He said the survey findings actually demonstrate “how carefully GPs are referring.” In his view, family doctors know how long the waits are — and many are setting the bar high to avoid making the queue worse.
Thats a fair point. But it doesnt fully answer the question of why private providers almost never seem to reject a diagnosis.
Dr Liz Clarke, a Greater Manchester GP partner, argues that assessments should be integrated into wider mental health services. Separate pathways focused on individual conditions, she warns, can miss overlapping problems and lead to inappropriate medication or psychological treatment.
“We should not have to pay twice for what should be the same assessment,” she said.
What Happens Next
Prof Fonagys final report is expected to be published shortly and will inform the governments new national approach. One of his key expected recommendations: provide more support based on peoples needs, without requiring a formal diagnosis. Hes also expected to warn that requiring a diagnosis to access help could actually “amplify demand” for diagnostic labels.
Thats a subtle but important shift. If support were available without a label, would the rush for assessment slow down? Or would it simply reveal how many people were struggling all along?
The Pulse survey was unweighted and described by the publication as a snapshot of GP opinions rather than a scientific study. But snapshots matter. They tell us what the people on the front lines are seeing.
And what theyre seeing is a system where private clinics rarely say no, NHS waits are brutal, and patients are stuck in the middle — desperate for answers, sometimes getting them too quickly, sometimes not at all.
The real takeaway isnt that ADHD is fake or that everyone is over-diagnosed. Its that the system is struggling to tell the difference between a person who needs help and a person who needs a different kind of help entirely.
Thats not a diagnosis problem. Its a care problem. And until we fix it, the arguments will keep going in circles.
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Mike Brown
Mike Brown – One of those authors who helps readers not get lost in today's news flow. He dives into political affairs as well as world events, social trends, and everyday stories that matter to everyone. The main focus of his work is fact-checking, clear language, and the ability to lay out the key points so that the reader gets a comprehensive and reliable picture of the topic in just a few minutes.
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