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Why are we failing young patients with ADHD?

BMJ 2014; 349 doi: (Published 13 October 2014) Cite this as: BMJ 2014;349:g6082
  1. Simon Bowers, general practitioner and clinical vice chair, Liverpool CCG
  1. Simon.Bowers{at}

As new diagnoses rocket and clinicians struggle with demand, Simon Bowers urges a change of approach

Many clinicians will have spent time with a child or adult with a diagnosis of attention deficit hyperactivity disorder (ADHD) and wondered if they were just attention seeking, naughty, or badly parented. Some may have been all three. But it is clear that a definitive diagnosis, early intervention with evidence based treatments, and continued support through important stages of life can hugely improve the quality of life, academic performance, and economic prospects of someone with ADHD.

So why, in 2014, do we continue to fail children and their families and frustrate health professionals and teachers in England? The National Institute for Health and Care Excellence (NICE) says that 3-9% of UK school age children and young adults have ADHD (applying the DSM-IV criteria),1 although a freedom of information request from 2012 suggested that less than 3% of the population had a formal diagnosis.

The NICE guidance is clear: “Drug treatment for children and young people with ADHD should always form part of a comprehensive treatment plan that includes psychological, behavioural …

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