A leading psychiatrist says children are not being overdiagnosed with ADHD despite concerns about a spike in prescriptions for powerful stimulants.
NHS statistics show that 125,000 children and teenagers in England are taking drugs such as Ritalin for symptoms such as poor concentration, a quarter more than 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 Children’s Hospital, said that overall ADHD was not yet present. undertreated and this is leading to high levels of mental illness in young people.
Speaking to the Times Health Committee, Heyman said: “My understanding is that the increase in prescribing is largely related to increased diagnosis and increased awareness. In general, it is still not treated properly [rather] rather than overtreatment.
There is a problem of the over-medicalisation of ordinary suffering, ordinary ebullience and excessive enthusiasm in young people.
She said the public should rest assured that ADHD diagnosis follows a very strict process. However, she said private adult ADHD clinics may be less stringent in providing a diagnosis.
Autism, ADHD and learning disabilities are some of the real factors that lead to mental illness in children and adults, Heyman said. Detecting, diagnosing and managing such problems is not only a health issue but also a broader social and educational issue. Until we get that right, we’ll be dealing with some of the more acute mental health issues.
NHS data shows that prescriptions for ADHD drugs to support attention and hyperactivity have increased sharply, with 233,000 patients prescribed the drugs last year. Prescriptions for adults increased 32% last year, while for children the figure increased 12%.
Heyman says that, in addition to the increase in ADHD diagnoses, psychiatrists have also seen an increase in children in their teens with tics since the pandemic.
She said: “What we have seen quite widely is an increasing number of children presenting with physical symptoms as an expression of distress. We’ve noticed, especially right after the pandemic, that more and more children, such as adolescents, are presenting with really florid tics that look like Tourette’s syndrome, but actually don’t have it. Many developmental features of tics.
In fact, it is a much more general phenomenon where a child exhibits physical complaints that are 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 the crisis stage where they become suicidal or drop out of school.
Latest NHS statistics show one in six children aged seven to 16 have a mental health disorder, up from one in nine before the pandemic. This has led to long waiting lists for specialist NHS services, which see 700,000 children and young people each year.
Heyman says growing awareness of mental health among young people may be contributing to this increase. She said: Suffering has become very normal and … there is a lot of education in schools, helping children understand emotions and raise problems if they have them. But there is a downside to that currency, which could perhaps weaken the recovery a bit. It’s a careful balance between raising awareness about mental health and treatment with the ability to turn something that might not be an issue into one.
But the much bigger problem remains that children with serious mental illness are not receiving evidence-based treatment. And that’s really different from physical illness.
The Times investigates the crisis facing the health and social care system in England. Learn more about the Times Health Board
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