Let me start with a number that doesn’t appear anywhere in the Centre for Social Justice report published this week, nor in The Times coverage that amplified it.
Women with ADHD lose, on average, seven years of healthy life compared to their neurotypical peers. Men lose five. Not because ADHD is inherently life-limiting — but because unrecognised, unsupported neurodevelopmental conditions exact a cumulative toll across decades: on mental health, on relationships, on employment, on physical health, on survival itself.
I know this as a clinician. I know it as a late-diagnosed neurodivergent person. I know it because the patients I see — many of whom waited years or decades for anyone to take their presentation seriously — carry those years in them. The missed education. The broken relationships. The careers that never happened. The mental health crises that did.
When a report claims that children are being diagnosed too easily, it is making an argument with consequences. Those consequences are not abstract. They are measured in years of life.
What the Report Is Actually Built On
The CSJ report centres on a Savanta survey of GPs. Seventy-five per cent agreed that diagnostic boundaries for ADHD and autism have expanded to include behaviours “previously considered within the normal range.” Sixty-six per cent said diagnoses are given too easily. The same proportion believed most children they saw with suspected ADHD or autism “primarily present with behavioural or environmental difficulties, rather than a neurodevelopmental condition.”
These are opinions. They are not evidence.
A survey of what GPs *believe* about neurodevelopmental conditions tells us about GP knowledge and training — not about diagnostic accuracy across the system. And what the research already tells us about GP knowledge in this area is not reassuring. A systematic review in *BMC Family Practice* found that GPs in gatekeeper settings consistently held “mixed and often unhelpful attitudes” about ADHD’s validity, had significant training deficits, and were frequently reluctant to refer. Up to two-thirds of children meeting diagnostic criteria for ADHD receive neither diagnosis nor services.
The belief that a child’s presentation is “primarily behavioural” rather than neurodevelopmental does not reflect clinical sophistication. It reflects a category error. Behaviour *is* how neurodevelopmental conditions present. Inattention, dysregulation, social difficulty, and impulsivity are not alternatives to ADHD and autism — they are how ADHD and autism look in a consulting room. A clinician who cannot make that distinction is not in a position to conclude that overdiagnosis is occurring. They are demonstrating precisely why specialist assessment exists.
What the Evidence Actually Shows
In March 2026, a team of 32 UK experts — clinicians, academics, and patients — published in the *British Journal of Psychiatry* that there is “no evidence ADHD is overdiagnosed in the UK” and that it may in fact be underdiagnosed. They warned that “alarmist” rhetoric risks denying people care, and identified the primary problem as services that “cannot adequately support” those who need help.
Dr Judith Brown, head of autism evidence and research at the National Autistic Society, was direct: “The problem is not ‘overdiagnosis’, but rather a lack of urgent attention on the growing waiting times crisis and dedicated funding for quality autism assessment and diagnosis services.”
These are not fringe voices. They represent the current mainstream of clinical and research expertise in this field. The CSJ report does not engage with this evidence. It does not attempt to refute it. It simply proceeds as though it does not exist.
On Benefits Reform
I want to be clear about something the report obscures: the benefits system and the validity of clinical diagnosis are separate questions.
There may be a legitimate conversation to have about how disability benefits are structured, means-tested, and allocated. I am not opposed to that conversation. It is a policy conversation, and policy conversations are appropriate territory for think tanks and politicians.
What is not appropriate is using that policy conversation to cast doubt on the clinical validity of neurodevelopmental diagnoses — or to imply, without evidence, that families are manufacturing medical need for financial gain.
The report places significant weight on rising Child Disability Living Allowance claims — nearly doubling from 420,000 in 2016 to almost 900,000 — as evidence that financial incentives are distorting diagnostic behaviour. This argument has a structural flaw: according to Citizens Advice, parents do not need a formal diagnosis to apply for CDLA. It “can usually help,” the guidance notes — but it is not required.
The causal chain the CSJ implies — that families pursue diagnosis in order to claim benefits — is not supported by the benefits system’s own rules.
The families accessing means-tested Universal Credit uplifts for disabled children are, by definition, already in financial hardship before any diagnosis enters the picture. Carer’s allowance of £86.45 per week for a minimum of 35 hours’ care amounts to less than £2.50 an hour. The idea that families engineer a multi-year diagnostic battle for this return requires either profound ignorance of what these children’s daily lives look like, or a willingness to ignore it.
The “Lucrative Industry” Attack
Baroness Maclean described private diagnostic clinics as a “lucrative industry” charging “up to £3,500” for assessments that “feed directly into legal entitlements.” She cited 25,000 annual tribunal appeals as evidence that incentives are misaligned toward more diagnoses and more placements.
I run a private specialist ADHD and autism assessment practice. I want to address this directly.
Private assessment costs what it does because it involves multiple hours of specialist clinical time, validated psychometric instruments, differential diagnostic reasoning across complex presentations, and detailed written reports that meet medico-legal standards. The £3,500 figure represents the upper end of a varied market. Many specialist practitioners, including my own practice, charge significantly less.
The 25,000 tribunal appeals are not evidence of a diagnosis industry. They are evidence of local authorities routinely denying children their legal entitlements — forcing families who are already exhausted and financially stretched into adversarial legal processes to obtain what thorough assessment has already established those children need.
Private assessment exists at scale for a single reason: NHS waiting times of two, three, sometimes four years. The independent sector did not create that gap. It exists because the state created it — and then left it unfilled.
The Social Media Point
The report cites a University of British Columbia study finding that more than half of the most-viewed short video content about ADHD online was misleading. This is a genuine concern. Reductive, symptom-list driven social media content that strips out functional impairment criteria is a real clinical challenge — one that specialist practitioners navigate daily.
But the solution to misinformation is better information and more accessible rigorous assessment. Not fewer diagnoses. The study examined online video content, not clinical practice. Moving from “some TikTok videos are inaccurate” to “children are being overdiagnosed” is a leap this report does not come close to earning.
What “Unruly” Reveals
Joe Shalam, the CSJ’s policy director, described children affected by “tidal forces of social media and screen time, falling behavioural standards and the devastation of the pandemic” — exhibiting “entirely normal, if unruly, behaviour.”
I have spent nearly four decades in clinical mental health practice. I have never used the word “unruly” in a clinical context. It is not a clinical word. It is a disciplinary one — and its appearance here is telling.
It locates the problem in the child’s character and the family’s values. Not in neurobiology. Not in a school system stripped of inclusion support. Not in CAMHS waiting lists that stretch beyond any reasonable definition of timely intervention. Not in the political choices that produced those conditions.
The patients I see every day do not experience their ADHD or autism as “unruly behaviour.” They experience it as a lifetime of feeling fundamentally out of step — with systems, with expectations, with themselves. Many of them come to me having lost those years I mentioned at the start. Having internalised decades of being told they were difficult, lazy, dramatic, or simply not trying hard enough.
That is what misidentification costs. That is what this report, however unintentionally, risks perpetuating.
The Political Context
The Centre for Social Justice was co-founded by Sir Iain Duncan Smith. Its position on welfare spending is well-established and consistent. This report arrives as the government prepares significant welfare reform, at a moment when disability benefit expenditure is under sustained political pressure. The Streeting review into neurodevelopmental diagnosis rates is due to report this month.
Baroness Maclean said we should take heed of the GP survey because these are “the frontline clinical judgments of the doctors who see these children every day.” Proximity is not expertise. A GP who sees a child for ten minutes and attributes their presentation to screen time and poor boundaries is not offering clinical judgment. They are offering an opinion shaped by training that, by the field’s own assessment, is inadequate for this task.
The Real Debate
Baroness Maclean is right that something has gone badly wrong with how England supports children with additional needs. On that, she and I agree completely.
Where we diverge is on the diagnosis.
What has gone wrong is not that too many children are being identified. It is that identified children are not being supported. CAMHS is overwhelmed. SEND funding has been cut to the bone. School inclusion support has been systematically eroded. The children who fall through every gap are disproportionately those whose needs were never recognised — girls, children from ethnic minority backgrounds, those without parents who have the capacity or resources to fight a system that defaults to denial.
The cost of failing those children is not a bureaucratic abstraction. It is five to seven years of life. It is the mental health crisis that comes from decades of unmet need. It is the person sitting in my consulting room at forty-five, finally understanding why their life has felt the way it has, and grieving the years they cannot reclaim.
That is the honest debate this country urgently needs.
Stephen Taylor is an Advanced Nurse Practitioner, Independent Prescriber, and Cognitive Analytic Therapist with nearly four decades of clinical experience in mental health. He is the founder of The ADHD Specialists (theadhdspecialists.com) and a late-diagnosed neurodivergent person.