ADHD: Private clinics exposed by BBC undercover investigation

A BBC study found that patients were being put on strong medication and told they had attention deficit hyperactivity disorder (ADHD) after an unreliable online assessment.

Three private clinics diagnosed undercover reporters through video calls.

However, a more in-depth in-person evaluation by the NHS revealed that he had no such symptoms.

The clinic says it has conducted a thorough evaluation and is following national guidelines.

Panorama spoke to dozens of patients and whistleblowers after being tipped about hasty and poor evaluations at some private clinics, including Harley Psychiatrist, ADHD Direct and ADHD 360.

Undercover reporter Rory Carson was diagnosed with neurodevelopmental disorders in all three. Neurodevelopmental disorders are recognized medical conditions that affect behavior and may be considered a disability under the Equality Act 2010.

Our investigation revealed the following:

Dr Mike Smith, a consultant psychiatrist with the NHS, commented on Panorama’s findings and was gravely concerned about the number of people who “may have been misdiagnosed and started on medication inappropriately”. said that

In recent years, there has been a significant increase in the number of adults seeking an ADHD diagnosis. This is due to successful treatments and growing awareness of the condition. Advocacy groups claim the disease has long been underdiagnosed.

Discussions about ADHD are ubiquitous on social media, with #ADHD garnering over 20 billion hits on TikTok alone.

In some areas it can take five years or more to get an NHS evaluation, so many patients are willing to pay hundreds of pounds to see a private clinic instead. The NHS is also picking up thousands of these privately assessed bills as part of the government’s effort to eliminate waiting lists.

Having ADHD can be considered a disability. It depends on whether the person’s condition has a “substantial” and “long-term” adverse effect on the ability to perform normal daily activities.

Panorama’s undercover reporter honestly answered questions about his symptoms throughout each assessment. However, he did not tell the real reason why he made an appointment with the private clinic.

His initial assessment was in a face-to-face meeting with Dr Smith, who heads the Adult ADHD Professional Services at the NHS.

Carson and her family filled out questionnaires about Carson’s habits and childhood history ahead of the three-hour appointment. It included a full psychiatric evaluation. His evaluation was performed according to guidelines published by the National Institute for Health and Care Excellence (NICE).

ADHD symptoms include fidgetiness, distraction, and impulsive behavior that many people experience. However, NICE guidelines say that an ADHD diagnosis should only be sought if the symptoms significantly affect one’s life.

Dr. Smith concluded that Carson does not have ADHD.

There are 18 recognized symptoms that could indicate someone has ADHD, and Carson found that one did not meet clinical thresholds.

But when a journalist went undercover at Harley Psychiatric Clinic, he received a score of 15 out of 18 after a 45-minute video call with a psychologist.

He paid £685 for the diagnosis, but was told by a psychologist that ‘there is no expiration date on this, the diagnosis is for life’.

More and more people are turning to private clinics for diagnostics to determine if they have ADHD.Panorama investigates whether some people have unreliable diagnoses

Watch the full investigation on BBC iPlayer and BBC One on Monday 15 May at 20:00 in England and Scotland and 20:30 in Wales and Northern Ireland.

A week later, she had a follow-up visit with her psychiatrist, which took less than 10 minutes, where Carson was prescribed a stimulant called methylphenidate.

This is the standard treatment for ADHD. This drug interacts with chemicals in the brain to help people with this condition improve concentration, reduce impulsivity, and feel calmer.

Although the drug is considered safe and effective for most people with this condition, it can be severe for some, such as those with heart disease or certain mental health problems. Serious side effects may occur.

According to Dr. Smith, exposure to the drug in the absence of ADHD can be a dangerous health risk and may even exacerbate pre-existing mental health conditions. Stimulants used to treat ADHD are Class B drugs, substances regulated under the Substance Abuse Act.

Harley’s psychiatrist did not ask the BBC reporter detailed mental health questions before prescribing the medication, nor was he warned of the potential serious side effects.

Harley Psychiatrist’s attorneys told Panorama clinicians that they also considered information on the pre-assessment form, saying, “It is false to suggest that our clients are at increased risk of misdiagnosing ADHD in adults. And the suggestion that not enough tests have been carried out is also baseless.”

They said that “the diagnosis of ADHD… depends on the patient’s answer” and that “there are many patients who have not been diagnosed with ADHD”.

Lawyers said the clinic has updated the process, acknowledging that Carson “shouldn’t have been able to get a prescription.”

The Harley psychologist’s attorneys who evaluated Carson said that although Carson’s test results “indicated that the patient has ADHD,” such “diagnosis was formally made by a psychiatrist.” will be done,” he said.

Lawyers for the psychiatrist who prescribed the drug said their client supported his diagnosis. He said he “usually takes 30 to 45 minutes” to complete the examination, but in this case “didn’t think it was necessary” because of the psychologist’s report.

Carson was also evaluated by Glasgow-based ADHD Direct.

He was evaluated by a nurse who was new to the clinic and supervised by another nurse. NICE guidelines state that assessments must be performed by a psychiatrist or appropriately qualified clinician.

The assessment took 1 hour and 40 minutes and cost £1,095. Nurses asked more in-depth questions about Carson’s medical history than Harley’s psychiatrist, and Carson and her family were asked to fill out questionnaires ahead of time. But Carson said he felt the assessment was still “like checking a box.”

ADHD was diagnosed again at a follow-up visit, and a prescription for a stimulant was presented.

The journalist revealed to the clinic that he was an undercover reporter before proceeding further.

Attorneys for ADHD Direct said more tests would have been done before Mr. Carson got the drug. They said his evaluation included a “complete developmental and psychiatric history,” and that the clinic “supported the diagnosis.”

“ADHD is underestimated, underdiagnosed, and undertreated,” the lawyers added, adding that the clinic “has no incentive to overdiagnose,” and that an audit found that “10% of patients seen have ADHD.” It turned out not to be,” he said. ADHD”.

The undercover reporter also made an online appointment at ADHD 360, a Lincolnshire-based clinic that sees thousands of NHS-funded patients.

Patients and former staff told the BBC that appointments were short and nearly everyone who came in was diagnosed with ADHD.

One clinician said he saw patients “hourly, hourly” while working on treating ADHD 360, but didn’t feel this was safe. According to ADHD 360, the clinician is required to perform only 2 assessments he does per day.

Carson was evaluated by a pharmacist. He did not take a full psychiatric history, but diagnosed the reporter with ADHD an hour and fifteen minutes later. He once prescribed meth without proper testing.

ADHD 360 says it is regulated as an NHS provider and provides “high standards of assessment, diagnosis, treatment and care” for thousands of patients. The company’s “qualified clinicians” are trained in its own academy and “assessments meet all accepted best practices.”

This time, “Unfortunately, the prescription policy was not followed,” and “Currently, the procedure is being reviewed and strengthened.”

Those interviewed by Panorama also expressed concern about the quality of care provided by private clinics to vulnerable patients who are desperate for services because the NHS’s waiting list is so long.

Casey had to wait three years for an ADHD evaluation by the NHS and instead borrowed nearly £700 to see a Harley psychiatrist.

She said she was diagnosed with ADHD by the same psychologist as the BBC reporter after a video call that lasted about 40 minutes.

Casey has posted many negative reviews online, and the clinic confirmed by Panorama sent a letter to Casey, saying that she wrote a “potentially illegal” review. It said it was handed over to the company’s legal department.

The BBC is aware of many other apparent legal threats made against patients after they left negative reviews about Harley Psychiatrist.

Lawyers for the clinic said the clinic has the right to request that false and defamatory reviews be removed.

ADHD is undoubtedly a large number of people who attend private clinics, but experts say patients may not receive proper treatment if the assessment is not reliable.

“These people were supposed to help me, but they took advantage of me,” Casey told the BBC.

“I wasn’t someone who was struggling with their mental health and needed help. To them I was just money.”