I watched last night's Channel 4 documentary, “The Great ADHD Myth?”. The programme was presented by Dr Max Pemberton, who explained he had been a consultant psychiatrist for around 25 years. He failed to mention that he specialises in geriatric care.  He was supported by a range of psychologists and a GP, every one of whom was sceptical about the existence of ADHD, as was the person interviewed because of her work in scanning brains over a period of 30 years.

The programme appeared to set out to prove three things.

The first was that ADHD does not result in identifiable changes in a person's brain, and as such it cannot exist.

Secondly, and as a result, it suggested that treating what is described as ADHD with drugs is not beneficial. In doing so, it only looked at children. The possibility that ADHD might continue into adulthood and have serious consequences there appeared not to have occurred to those taking part.

The third was to claim that an exploitative industry has developed over the last decade or so, offering ADHD diagnoses to people who do not need them because ADHD is not a neurodevelopmental concern. This was described as neoliberal.

The uncritical viewer might think that the programme achieved its goals. The evidence supporting these hypotheses seemed overwhelming. However, there are very simple explanations for that.

No evidence was presented from anyone who suffered from the condition, except a 10-year-old boy.

Nor was any sought from any psychologist who believes that the condition exists and could explain why.

Nor was evidence offered that shows that, at the population level, evidence for the existence of ADHD does exist, even though it cannot provide a diagnostic test using individual brain scans.

Nor was there any explanation provided for the characteristic traits found amongst ADHD sufferers suggesting differences in how dopamine and noradrenaline systems are regulated and used within their particular brain networks.

In other words, this was an argument won because the counterargument was never presented. It was as if this was a football match that a team was so desperate to win that it inadvertently forgot to invite any opponents. That is how biased the presentation was.

For a regulated public service broadcaster to present such a piece on an issue of significance for so many people, without seeking to offer a balanced view when drawing conclusions, was shocking. This might have been expected of GB News when discussing immigration, but not of Channel 4 when discussing an issue of genuine medical concern. The programme's failure to offer balance may be the best evidence that it did not believe its own arguments.

Some other issues stood out. The first was what I thought to be the abuse of the child on whom an experiment was conducted that required him to go cold turkey on three fronts simultaneously as a result of the withdrawal of his ADHD medication, the denial of access to his electronic devices and a ban on eating sugary stimulants. Could he really have provided informed consent to take part in this way? I question the ethics of that. It is also worth noting that the experiment failed: he ended up back on the drugs the programme wanted to prove he did not need.

The second was the total absence of any discussion on adult ADHD. The issue was totally ignored, except when Max Permerton was diagnosed as having ADHD - evidence for which he inadvertently supplied, in my opinion - but which he denied, and then, unethically, in that case, took the prescribed drugs he had been given for it.

The third was that the possibility of living with ADHD without drugs was not discussed, and yet that is what most people do. The diagnosis is vital to their understanding of their condition, and to their learning how to adapt to it. The value in this was never mentioned. The arrogance in that was staggering. This was an exercise in psychologists granting themselves the power to decide whether other people's lived experiences exist, which they appeared to deny just because they did not have them. I think that was abusive. Just imagine they were deciding instead whether people suffered racism or not, and they were all white. The parallel is obvious, as is the potential for abuse.

But perhaps most staggeringly, the programme did, in reality, and by properly interpreting its proposed closing recommended course of action, conclude that ADHD not only does exist, but requires radical adjustment within society if those with it are to be treated appropriately.

How do I know this? That is because the programme argued that massive reform to the UK education system is required to manage the symptoms that are collectively called ADHD, the existence of which it denied.

It said schools should devote much more time to arts and creativity, to time in nature and on physical activity, and, by implication, reduce the time spent on academic disciplines.

I have sympathy with some of that. I am a critic of the current education system,  because it does not meet the needs of children with autism and ADHD, and of all others as well, as well as the needs of society. But I would not advocate such reform primarily - as this programme did - to manage a condition that I simultaneously claim does not exist. That they did so was quite bizarre.

Conclusions

So, what is there to conclude?

The most obvious thing to say is that this was a massively arrogant and profoundly unbalanced programme, clearly intended to present a biased view on a subject where the opinion presented will cause significant harm to a very large number of people in the UK. That, I think, was unforgivable.

Secondly, we were presented with a range of opinions which were staggeringly ill-considered. The argument that ADHD is just a social construct was presented as if this was an isolated fact, when, as I have noted on this blog, all medical diagnoses are social constructs, as is medicine itself, and as, of course, are both psychiatry and psychology. Those making the claim appeared unaware of this fact. Their lack of awareness shone through their claim and discredited the programme, when much of its argument hung on it.

Third, the programme seemed to argue that ADHD exists to exploit vulnerable people by charging them for diagnosis and drugs, and is, as a result, a neoliberal construct. What no one then mentioned was that the conditions that they suggested create the environment requiring radical reform to our education system, arising as a consequence of people having the characteristics that are described as ADHD, are all caused by neoliberal enterprise. They range from ultra-processed food and electronic devices to social alienation and much more.

The finger of blame was pointed very firmly in the wrong direction in that case. Those who have identified and seek to address issues arising from ADHD were blamed as being neoliberal, when what they have actually identified are faults caused by neoliberalism. A DARVO effect appeared to be in action in that case, which happens when a standard right-wing response of 'denial, attack, and reversing the victim and offender' is in operation.

Fourthly, for reasons I've already noted, drawn from the conclusions that the programme itself reached, ADHD is real, and does require accommodation in society, but not necessarily through the use of drugs on all occasions.

Lastly, neurodivergence needs to be much better treated in the media when those making programmes such as this know that politicians intent on abusing minorities in society will use them as weapons against those they deem to be “others”. In that sense, this programme was deeply ethically and politically irresponsible. Channel 4 should hang its head in shame and make amends by offering an informed programme on the reality of neurodivergence and how we should adapt society to assist those with such conditions.

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