A review we welcome
This week the government published its independent review into mental health conditions, ADHD and autism. I want to start by saying plainly: I welcome it.
I have spent nearly four decades working in mental health. For much of that time, people with ADHD were missed, misunderstood or told they were simply not trying hard enough. A national review that takes ADHD this seriously is something many of us have hoped for.
The review asks for a shift from a system that depends on diagnosis to one that is led by need, with diagnosis alongside it. It asks for better assessment, joined-up care, and real support after a diagnosis is given. These are the right priorities. Below I want to share how we already work at The ADHD Specialists, and some honest thoughts on the parts of the review I have found harder to sit with.
How we assess
The review is clear that the risk of getting a diagnosis wrong rises when an assessment is brief, fragmented, done without information from other people, or focused on only one condition. I agree, and this is how we have always tried to work.
- We are registered with the Care Quality Commission (CQC). The review recommends that all ADHD and autism assessments become CQC-regulated. We already are, and we think every provider should be.
- We gather information from more than one source. We collect informant reports from people who know you well, and use recognised rating scales such as the Conners. Your own account matters most, but it is strengthened by others who have seen you across your life.
- We look at the whole person, not one condition. ADHD rarely travels alone. Anxiety, low mood, trauma, sleep problems and autism can all overlap with it, or look like it. Our assessments are built to consider these. We offer ADHD assessments, autism assessments and combined ADHD and autism assessments, as well as other psychiatric assessments, so we can follow the question that best fits each person.
- We offer face-to-face and online appointments. This helps people reach us, while keeping the depth of the assessment the same.
A good assessment does not just answer “ADHD or not”. It tries to understand what is really getting in the way of your life, and what will help.
A diagnosis is a beginning, not an ending
One finding in the review stayed with me. In a survey of clinicians, 40% said there was no ongoing support at all after an autism diagnosis. The review makes the point that a diagnosis on its own is not an outcome.
I could not agree more. People do not come to us wanting a label. They want their lives to work better: at home, at work, in their relationships.
That is why care at The ADHD Specialists continues after assessment. As an independent prescriber, I can offer medication where it is right for you, with careful review. As a Cognitive Analytic Therapist, I can also offer therapy that helps people make sense of the patterns they have lived with, often for decades. Our clinical work is supported by consultant psychiatrists and specialist supervision.
We also run a monthly supervision group for doctors, nurses and therapists working with ADHD. The review calls for better training across the whole workforce. Sharing what we have learned is one small way we try to help with that.
On overdiagnosis, and on shame
I want to be honest. The parts of the review about possible overdiagnosis are the parts I have found hardest to read.
That is not because the questions are wrong. Misdiagnosis is real, and it causes harm. A wrong diagnosis can lead to the wrong treatment, and can hide what is really going on. Any clinician who cares about ADHD should care about getting it right.
It is worth being clear about what the review actually says. It does not conclude that ADHD is being overdiagnosed on a large scale. It says the balance of risks may be shifting, and that we need better data to know. It also found that people coming forward today are no less affected than those diagnosed in the past. Their difficulties are real.
My difficulty is with how these findings can travel once they leave the report. Headlines about overdiagnosis can reach people who have spent their whole lives being told they are lazy, careless or “too much”. For many adults with ADHD, shame is not a side issue. It is often the deepest part of the story.
This is the focus of my doctoral research at Northumbria University, where I am studying ADHD and shame. Again and again, people describe years of feeling that something was wrong with them as a person, rather than understanding how their brain works. When a public debate suggests they may simply be seeking a label, that old shame can be stirred up again.
So I hold two things together. We must take misdiagnosis seriously. And we must make sure that concern never becomes another reason for people to doubt themselves or stay away from help.
Why experience and evidence matter
The review reminds us there is no blood test or brain scan for ADHD. Diagnosis rests on careful clinical judgement. It means looking at how long difficulties have been there, whether they show up in different parts of life, and how much they affect someone day to day.
That is exactly why I believe ADHD assessment belongs with experienced mental health clinicians, working to the evidence.
Experience helps you tell ADHD apart from anxiety, trauma, low mood or poor sleep, and notice when more than one is present. Evidence-based practice means using recognised criteria, validated tools and current guidance, rather than quick checklists or a single conversation. Together, they are the best protection we have against both missing ADHD and wrongly diagnosing it.
They also protect people from shame. A careful, thorough assessment tells someone their story has been taken seriously. Whatever the outcome, they leave with a clearer understanding of themselves and a plan for what comes next.
Looking ahead
This review is a real opportunity. I hope the government acts on it, and I hope the debate that follows stays focused on people rather than labels.
At The ADHD Specialists, we will keep doing what we believe in: thorough, regulated, evidence-based assessment, care that continues after diagnosis, and treating every person who comes to us with respect.
If you are wondering whether ADHD might be part of your story, you deserve a careful answer. We are here when you are ready.
Stephen Taylor, Advanced Nurse Practitioner, Independent Prescriber and Cognitive Analytic Therapist. Doctoral Researcher, Northumbria University. Founder, The ADHD Specialists.