ADHD not overdiagnosed despite rise in Ritalin prescriptions

Children are not being over-diagnosed with ADHD despite concerns about a rise in prescriptions for powerful stimulant drugs, a leading psychiatrist has said.

NHS statistics show 125,000 children and teenagers in England are taking medicines such as Ritalin for symptoms such as poor concentration, an increase of a quarter since before the Covid pandemic.

Isobel Heyman, consultant child and adolescent psychiatrist at Great Ormond Street Hospital and head of children’s mental health at Cambridge Childrens Hospital, said overall ADHD remained undertreated and this was leading to high levels of illness. mental health in young people.

Speaking to the Times Health Commission, Heyman said: My understanding is that the increase in prescriptions is largely linked to increased diagnosis and increased recognition. are still generally slightly outsourced [rather] than overtreating.

There is a problem of overmedicalization of ordinary distress, ordinary exuberance and excessive enthusiasm among young people.

She said the public should be reassured that ADHD diagnoses follow a very strict process. However, she said private adult ADHD clinics might be less rigorous in providing a diagnosis.

Autism, ADHD and learning disabilities as a group are one of the true determinants of poor mental health in children and adults, Heyman said. Detecting, diagnosing and managing them is not just a health problem, it is a vast educational and social problem. Until we do, we will be battling some of the most acute mental health problems.

NHS data shows there has been a massive rise in prescriptions for ADHD drugs to help with concentration and hyperactivity, with 233,000 patients given the drugs last year. Prescriptions for adults increased by 32 percent last year, while for children they increased by 12 percent.

Heyman said that in addition to an increase in ADHD diagnoses, psychiatrists have seen an increasing number of adolescent children suffering from tics since the pandemic.

She said: What we are seeing quite widely is an increasing number of children exhibiting physical symptoms as a manifestation of distress. We noticed, especially right after the pandemic, that an increasing number of children, adolescents for example, were exhibiting very pronounced tics that resembled Tourette syndrome, but actually did not exhibit many of the developmental characteristics of tics. .

In fact, it is a much more general phenomenon: a child presenting physical problems is often a sign of underlying emotional distress.

Heyman said earlier treatment is needed to help children with mild to moderate mental health problems before they reach a crisis stage where they are suicidal or miss school.

Latest NHS statistics show that one in six children aged 7 to 16 are likely to have a mental health condition, compared to one in nine before the pandemic. This has led to long waiting lists for specialist NHS services, which serve 700,000 children and young people a year.

Heyman said increased awareness of mental health among young people could contribute to the increase. She said: Distress has become very normalized and… there’s a lot of education in school, which helps children learn emotional skills and raise issues if they have them. But this piece has a downside, which can perhaps undermine resilience a bit. It’s a delicate balance between raising awareness of mental health issues and getting treatment, and making something that might not be a problem a problem.

But the much bigger problem is that children with significant mental health problems are not receiving evidence-based treatments. And it’s really different from a physical illness.

The Times investigates the crisis facing England’s health and social care system. Read more about the Times Health Commission