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Why are we failing young patients with ADHD?

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6082 (Published 13 October 2014) Cite this as: BMJ 2014;349:g6082

Rapid Response:

Dear Sir,

Simon Bower has very appropriately highlighted the need to restructure the delivery of health care to 'young patients' (I read Children) who may have ADHD.

There has been a service for generations for badly behaved children, who may present to professionals with school refusal, trauncy and lack of engagment, etc. It is those very groups now diagnosed with the more formal Diagnosis of Attention Deficit Hyperactivity Disorder. Thanks to the advances in the understanding of the neural basis and effects of lack of early identification of such issues, we are now in a position to make more evidence-based and much more effective intervention. The NICE guideline has played its role by spelling out what to do.

Surprisingly, implementation of holistic service to cater for the needs of those unfortunate individuals who may initially be identified as having a developmental problem before they show a behavioral problem has lagged behind. Unattended they progress to manifest Psychosocial problems. You guessed it right, these are the children who present with conduct disorders of magnitudes that attract police and criminal justice system involvement, and cost society in the damaged esteem of a child who might have the potential to be something altogether different!

It seems, it is for the professionals to advise and influence the strategic decision makers (Clinical Care Commissioning Group) to look at the bigger landscape as to how the funds are being used to serve the community and how the same can be comprehensibly improved for the children, who are the future of the country.

Neel Kamal
Consultant Community Paediatrician
Convenor, George Still Forum: Neurodevelpmental Disorders
n.kamal@nhs.net

Competing interests: No competing interests

17 November 2014
Neel Kamal
Consultant Paediatrician
CHCP
The Children's Centre, Octagon, Walker Street, Hull HU32RA