By Stephen Taylor — The ADHD Specialists.
Channel 4’s The Great ADHD Myth? airs this week, and I already know what Monday morning will look like at the clinic. Patients who have spent years working out why school, work or relationships kept going wrong, who finally got an assessment and a name for it, will sit across from me and ask some version of the same question: did I imagine this?
I want to answer that honestly, which means not pretending the programme has nothing worth listening to. It also means not letting a single psychiatrist’s account of his own three-week experiment with medication stand in for the evidence base built by thousands of researchers over forty years.
What the Programme Gets Right
The rise in ADHD diagnoses is real, and it deserves scrutiny. NHS England’s most recent data show new assessment referrals up over 20% year-on-year, and roughly 700,000 people currently sit on English ADHD waiting lists. Channel 4’s own press materials cite a 200% increase in diagnoses between 2020 and 2025. Any service growing that fast should be asked hard questions about consistency and quality.
I’d also agree that a diagnosis handed out after a rushed ten-minute call, with no developmental history and no collateral information, isn’t good medicine. It never was, for ADHD or anything else. If the documentary’s message were “assessment standards vary too much and that needs fixing,” I’d be first in the queue to say yes.
That isn’t the message. The message, built around the presenter’s own diagnosis and difficult few weeks on medication, is closer to “ADHD is a story we tell ourselves about normal human variation.” That’s a much bigger claim, and it doesn’t hold up against what we actually know.
The Presenter’s Own Starting Point
The documentary is fronted by Dr Max Pemberton, an NHS psychiatrist who was assessed for the film and received a diagnosis of ADHD, combined type, which he says he doesn’t accept. It’s worth knowing that before the assessment ever happened, he had already written in The Spectator that ADHD is “wildly over-diagnosed” and that the fix is “better parenting” rather than medication. A companion piece in The Times this week frames his diagnosis as a surprise that unsettled his assumptions. It’s fair to ask how much it actually did, given where he started.
That doesn’t make him wrong. It does mean the programme isn’t quite the neutral inquiry it’s being sold as, and it’s worth watching with that in mind.
The Genetics Point Is True, and Also Incomplete
One claim doing a lot of work in the accompanying press coverage is that there’s “no ADHD gene,” only many small genetic variants, most of which overlap with depression, autism and schizophrenia. That’s an accurate description of the genetic architecture. ADHD is polygenic: no single gene causes it, and the DNA variants involved each carry a small individual effect.
What tends to get left out is that this is completely normal for highly heritable traits, and doesn’t mean the genetic contribution is weak. Twin studies consistently put ADHD heritability at 70–80%, among the highest of any psychiatric condition, a figure restated in the 2021 World Federation of ADHD International Consensus Statement, a document signed by more than 80 researchers across 27 countries and published in Neuroscience & Biobehavioral Reviews. Height is polygenic too, shaped by thousands of variants each with a tiny effect, and nobody uses that to argue height isn’t real or isn’t inherited. The same logic applies here.
A Brain-Scan Quote Worth Questioning
The Times piece quotes Professor Katya Rubia of King’s College London, a leading ADHD neuroimaging researcher, saying that many people with the diagnosis have “entirely normal brains” and that no scan can tell you who has ADHD. That sits oddly next to her own published research career, which has spent decades identifying structural and functional brain differences in ADHD, and which currently uses machine learning on MRI scans specifically to help with diagnosis.
It’s possible she made a narrower, defensible point in the original interview: that individual brain scans overlap too much with typical brains to diagnose any one person from imaging alone, which is a genuine and fairly mainstream caveat about group-level neuroimaging findings. As reported, though, it reads as a far stronger claim than her body of work supports. I’d want to see the full interview before treating that quote as representative of where the neuroscience actually stands.
“Diagnostic Overshadowing” Isn’t Being Used Correctly
The Times piece also borrows the term “diagnostic overshadowing” to describe how, after diagnosis, every ordinary struggle gets reinterpreted as a symptom. That’s a real phenomenon, closer to confirmation bias or the sociological idea of labelling. But diagnostic overshadowing has a specific clinical meaning: it describes physical or psychiatric symptoms being wrongly attributed to an existing intellectual disability, so a genuine additional condition gets missed. Repurposing a technical term to describe something else lends the argument a borrowed authority it hasn’t earned.
What a Proper Assessment Actually Involves
This is the part I can speak to directly, because it’s the job. A robust ADHD assessment is not a checklist, a five-minute call, or a rating scale filled in alone. It requires a full clinical and psychosocial history, developmental and psychiatric history, an assessment of current mental state, collateral information from someone who knew the person as a child where that’s available, and active consideration of other explanations — anxiety, depression, trauma, sleep disorders, and substance use among them — before ADHD is confirmed.
In adult practice, that takes time. I work to the UK Adult ADHD Network’s Assessment Quality Assurance Standard, which calls for a full psychiatric and neurodevelopmental review, a semi-structured interview that probes for real-life examples of impairment rather than accepting a tick-box answer, and a minimum of two hours for the assessment and the discussion that follows it. None of that is unusual by the standards of psychiatry generally. NICE expects the same level of comprehensive assessment before diagnosing depression: severity, course, functional impact, coexisting conditions, previous treatment, and the person’s wider life circumstances. Psychiatric diagnosis, done properly, is a clinical judgement built from history and observed functioning. It was never meant to be a blood test.
Symptoms need to be persistent, present in more than one important area of a person’s life, and cause real, measurable impairment. That’s the actual bar for a diagnosis. It is not “does this sound like me sometimes,” and it was never meant to be settled by an hour and a half of questions on a laptop alone.
The Evidence for Treatment, Left Out of the Story
Pemberton’s account of three difficult weeks on lisdexamfetamine is presented as broadly instructive. It’s a genuine and understandable account of one person’s experience, and medication doesn’t suit everyone; that’s exactly why treatment decisions are individualised and monitored. But it sits alongside 133 randomised controlled trials, covering roughly 18,000 people, that support ADHD medication’s efficacy: better school performance, fewer accidents and injuries, and a reduced risk of suicide. None of that features in the piece. A single bad experience is real. It isn’t the whole evidence base.
The Question That Actually Matters
I don’t believe everyone who relates to ADHD traits has ADHD. I don’t believe every assessment reaches the same conclusion, or that medication is the only answer, or the right one for every person diagnosed. Good care includes psychoeducation, environmental and workplace adjustments, behavioural support, and, when it’s appropriate, chosen and properly monitored, medication.
So the question worth asking isn’t “is ADHD real?” That’s been settled by forty years of twin studies, neuroimaging, genetics and clinical trials, more thoroughly than most conditions in medicine. The question worth asking is whether the person in front of us has had a sufficiently thorough assessment, and what support will actually reduce their impairment and the risks that come with it — missed education, job loss, relationship breakdown, accidents, and, in the most serious cases, suicide.
We should absolutely hold ADHD services to a high standard, ours included. We should do that without treating the people who come to us for help as lazy, drug-seeking, or looking for an excuse. Most of them have spent years wondering what was wrong with them before they ever asked for an assessment. They deserve a careful answer, not a debate that starts from doubting them.
If this week’s documentary has left you unsettled about your own diagnosis, or wondering whether it’s worth being assessed properly, that’s a reasonable thing to want to talk through. Get in touch and we’ll go through it together.
Stephen Taylor is an Advanced Nurse Practitioner, Independent Prescriber and Cognitive Analytic Therapist, and the founder of The ADHD Specialists. He is also a late-diagnosed neurodivergent person.
Sources
- NHS England, ADHD Management Information, November 2025.
- Channel 4, press release for The Great ADHD Myth?, July 2026.
- Pemberton, M., prior commentary on ADHD over-diagnosis, The Spectator.
- Faraone, S.V. et al. (2021). The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder.
- Neuroscience & Biobehavioral Reviews. PMID: 33549739.
- Rubia, K., King’s College London, Department of Child and Adolescent Psychiatry — publication record.
- NICE, Attention deficit hyperactivity disorder: diagnosis and management (NG87).
- NICE, Depression in adults quality standard (QS8).
- Adamou, M. et al. (2024). The adult ADHD assessment quality assurance standard. Frontiers in Psychiatry.
- ADHD UK, public response to Channel 4’s The Great ADHD Myth?, citing 133 RCTs (~18,000 participants) and current NHS prescribing data.