ADHD and all that

Credit: The Times Newspaper

Today Wes Streeting, Health Secretary, says he has commissioned a review of ADHD and other mental health diagnosis with a Clinical Psychologist.  Well he could ask me for free.

Indeed I admit to sending an email to his personal inbox in the past, but I've had no reply as yet, and yes, I don't ever expect to receive one.

My study over the last twenty odd year is as follows:-

The issue of diagnosis is significant at a number of levels.

1) Parents and Adults are invested in the idea of diagnosis.  It's part of our culture.  There were diagnosis in the past, there always have been, and they are loaded with meaning.  It was ever thus.  A diagnosis in some way solidifies the problem.  It simplifies it, and can often help people feel that they have got a handle on it.  All labels also come with side effects.  Waiting on an NHS list is a bit like being on a housing list, where I entertain a hope about something that is always in the future. 

2) Waiting lists are not inevitable.  Some waiting lists are use to manage the problem itself.  Like the Hillsborough enquiry, it was so long all the police officers that were in the firing line were retired (so they couldn't be fired.)  Waiting lists are to do with taking on more work than you can deliver on.  It's like cash flow, or a ferry port where more people arrive than the number of boats available.  In the NHS the waits are seen as a good thing, because they emphasis the importance of the job.  ADHD and ASD assessments for children are now up to 4 years.  What is the maximum waiting time permitted?  6 years? After a while the service becomes a non-service (and a nonsense.)  What I would do is have a clear priority model, where early signs of difficulties are supported by appropriate people without the need for formal diagnosis.  The focus should be on functioning services and success.  

3) The other problem with diagnosis is that it simplifies.  What I am saying is that 'nature and nurture' co-exist, and both are always involved. Parents are sensitive to the idea that they have a part to play in 'the problem', Naturally they feel blamed and judged.  But of course they are involved.  No child is an island, and this is no bad thing.  A third of children are said to show some signs of insecurity in the bonding and attachment.  This means it's part of life, or normal.  There is a risk that the label can dull necessary action. It is always good to look at strengthening human bonds and ties.  This is often a prime need for children.

So Wes, I would suggest, have some clearer criteria about who and what goes to a doctor for diagnosis.  

Have a clear plan for children who do not need a doctor, including better funding for educational psychology, and family support workers in Local Authorities.

We all need to be educated about neurodiversity and see it as more normal within society.  Universities such as Leeds are doing great work to show the strengths of neurodiversity.  

The first five years continue to be the most significant for the development of positive mental wellbeing.

And finally Wes, stop picking on people who need to use the benefit system to provide them with security (it's called social security).  Get on with that idea to enable people with mental ill health to work by underwriting their sickness, so that they are more attractive to prospective employers. It's called 'Give in a go' and it due to come in in a years time (not 4 please.)