NHS data essay
A Channel 4 documentary, The Great ADHD Myth?, asks whether ADHD is a real condition or a fashionable explanation, and whether Britain is handing out the diagnosis too freely. Fair questions. But the NHS publishes its own numbers on who is asking for an assessment, who gets one, and who is left waiting, and those numbers describe a different problem from the one on television.
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Everyone agrees on one fact: ADHD diagnoses and prescriptions have risen sharply. The documentary reads the rise as an epidemic of labelling, phones, processed food and inflexible schools. Before choosing an explanation, it is worth asking a narrower question. Who, exactly, is arriving?
Between 2019/20 and 2022/23, the number of people in England prescribed ADHD medication rose from about 158,000 to 237,000, an increase of 50% in three years.
Split that growth by age and the "medicated generation of children" story gets awkward. Prescriptions for ages 5 to 9 barely moved (+0.6%). The under-15 bands grew slowest of all. The growth lives with adults, and it peaks at ages 30 to 34: up 146%.
Now split that peak group by sex. Men aged 30 to 34: +117%. Women aged 30 to 34: from 2,602 patients to 7,713, +196%. The fastest-growing ADHD patients in England are women in their early thirties, the group the diagnostic checklists of the 1990s were never written for.
A contagion spread by phones and TikTok should show up first in the people who use them most: teenagers. Instead the sharpest growth is among adults old enough to have been overlooked at school, and among women more than men. That pattern looks less like fashion and more like a backlog of missed cases being worked through, two decades late.
The documentary's central worry is that too many people end up with the label. The NHS's management information lets us follow the journey from "probably has ADHD" to "actually being treated", stage by stage. At every stage, the numbers shrink.
Start at the top. Applying prevalence rates to GP registers, NHS England estimates 2,492,000 people in England have ADHD, diagnosed or not: roughly 741,000 children and young people, the rest adults.
Of those 2.5 million, 803,659 had an open referral that may be for an ADHD assessment in March 2026: 626,415 in mental health services plus an estimated 177,244 children in community paediatrics. Note the wording: these are "up to" figures, and some referrals will turn out to be for something else. Even so, at most 1 in 3 of the estimated total is in the queue at all.
The queue barely moves. Of the mental health service referrals, 88% had been open longer than the 13 weeks NICE considers a reasonable wait for a first assessment appointment, and 231,455 had been open for more than two years. Two thirds, 408,690 people, had not yet had any first contact. Add the children's list and over 260,000 people have been waiting more than two years.
Now the bottom of the funnel. The Independent ADHD Taskforce estimates that only 15 to 25% of people with ADHD in England obtain medication, against trial evidence that 70 to 90% would benefit from it. Whatever one thinks of pills, the system is not dispensing them freely; it is not even managing to see the queue.
The gap has a price. The taskforce puts the cost of untreated ADHD in the UK, in lost work, extra NHS use, education failure and criminal justice, at around £17 billion a year.
If the adult surge is a backlog of missed cases, someone must have been doing the missing. The taskforce's own figures show who: compare the share of each group with an ADHD diagnosis in their health records against the share research suggests actually has the condition.
The shaded band is what research prevalence studies find: 3 to 5% of children and 2 to 3% of adults, and the condition is not dramatically rarer in one sex than the other.
Now the diagnoses on the books. Among children: 2.55% of boys have a recorded ADHD diagnosis, and 0.67% of girls. A nearly four-fold gap, built on checklists that described fidgeting boys rather than daydreaming girls.
Among adults the records thin out for everyone: 0.74% of men, 0.20% of women. Both sit far below the 2 to 3% the research expects. Undiagnosed adults are the rule, and undiagnosed women especially.
Which is exactly who is knocking now. In the current referral queue, women (315,245) outnumber men (292,010). The women driving the prescription surge in their thirties are this missing group arriving late, not a new condition spreading.
ADHD rarely queues alone. Autism and ADHD co-occur so often that the overlap has its own shorthand, AuDHD, and many late-diagnosed women are assessed for both. The autism waiting list is measured separately, and it is in worse shape.
In March 2026 there were 270,701 open referrals for suspected autism in England. Each square here is one hundredth of that queue.
89.7% of those referrals had been open for more than 13 weeks, the point by which NICE says a first assessment appointment should have happened.
And of the people past that mark, the share who had actually had a first appointment in time was 3.7%. On this chart, that is the small blue corner.
For an AuDHD adult, these are two separate multi-year queues, run by different services, and being in one does not advance you in the other. The person the system missed as a child gets to wait twice.
The Great ADHD Myth? asks whether Britain hands out the diagnosis too easily. The NHS's own ledger answers a plainer question: easy is not a word anyone in this queue would recognise.