Attention Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental condition affecting executive function, remains significantly underdiagnosed and undertreated in England, prompting growing concern among healthcare professionals and patient advocates. Characterized by difficulties in planning, impulse control, and emotional regulation, ADHD affects an estimated 5% of children and 3-4% of adults, according to the National Institute for Health and Care Excellence (NICE). However, a recent study published in The Lancet found that only 1.19% of people in England have received a formal diagnosis, suggesting that millions remain without professional support.
ADHD can severely impact daily life, yet effective treatments are available, including stimulant medications, lifestyle adjustments, and therapy. Many patients describe medication as life-changing and generally well tolerated, though access to diagnosis and treatment is increasingly challenged by systemic obstacles. A notable example comes from Maghull, a town near Liverpool, where the Matthew Lock ADHD Charity operates. The charity was founded by Christine and Richard Lock following the suicide of their son Matthew in 2023, who suffered from untreated ADHD.
Among those navigating treatment struggles is 21-year-old Oliver Cunliffe, diagnosed at 15 but forced to stop medication due to bureaucratic issues. Reinitiating treatment required a new diagnosis, with public health services delaying his care by up to two years. After paying £600 for a private assessment, Cunliffe restarted medication recently, with his family reporting marked improvement. Christine Lock criticized the healthcare system as “broken,” emphasizing the urgency of addressing treatment delays to prevent further harm.
The National Health Service (NHS) offers a “right to choose” policy allowing patients to pursue private ADHD assessments at NHS expense. Yet NHS managers warn of uneven quality in private providers and escalating costs, with some regional health boards reporting a tenfold increase in spending over recent years. Budgetary constraints in certain areas have led to restricted access, exacerbating the treatment gap.
The debate on ADHD has become politically charged. Some commentators dismiss ADHD as overdiagnosed or question its validity as a neurodevelopmental condition. British psychiatrist Sami Timimi has argued that ADHD is a poorly supported hypothesis and expressed concern about overdiagnosis leading to unwarranted lifelong labels. Conversely, most ADHD specialists attribute the rise in diagnoses—nearly two-and-a-half times between 2021 and 2024—to increased awareness, particularly of the condition in females, who represent the fastest-growing group of new diagnoses.
Nonetheless, public discourse includes criticism of what some call “suicidal empathy,” a term popularized by CEO Elon Musk to signify misplaced compassion undermining practical policymaking. Politicians such as Nigel Farage and Robert Jenrick have voiced skepticism about the legitimacy of some ADHD claims and proposed cuts to disability benefits related to mental health conditions, including ADHD.
An analysis by the NHS England ADHD Taskforce, led by Anita Thapar, concludes that ADHD remains under-recognized and insufficiently treated within the healthcare system. The Taskforce recommends expanding diagnosis and care beyond specialists to include schools, general practitioners, and mental health services, coupled with increased funding. An imminent government review, commissioned by Health Secretary Yvette Cooper, aims to address the issue, though experts worry it might lead to tighter restrictions on treatment access.
The tragic case of Matthew Lock, a young Labour councillor whose untreated ADHD and autism contributed to his suicide at age 19, underscores the urgent human cost of the current shortcomings. His parents continue to advocate for “Matthew’s Law,” which would guarantee ADHD screening for all schoolchildren. Meanwhile, bureaucratic hurdles and service delays persist, leaving many individuals with ADHD without appropriate care and support.