Psychiatrists in Channel 4 documentary argue it is more a ‘social construct' than a medical condition

As they note, in the documentary Pemberton will apparently question whether ADHD should be understood primarily as a medical disorder at all.

Instead, Pemberton argues that ADHD is a social construct and asks whether schools and society should accommodate a wider range of human behaviour rather than medicate people to fit an imposed norm.

I think Pemberton is indicating a worrying lack of understanding in making this argument, if that is what he does. As a matter of fact, ADHD is, of course, a social construct in the sense that the term itself does not exist in nature. It is a human creation. It is therefore, by definition, a human construct, and no one can disagree with him if he claims that is the case.

The problem is that neither he nor others that I have seen commenting on this issue also point out that cancer, and other diseases, are also human constructs. The term cancer is, for example, used to cover a wide variety of diseases with many different tissues of origin, genetic changes, causal pathways, prognoses, and appropriate responses to treatment. In fact, two cancers carrying the same anatomical label may differ considerably, whilst cells within a single tumour can differ from one another. The label is therefore broad, socially constructed, and a medical convenience that is not necessarily useful in every circumstance, and it is deeply misunderstood as a result.

I make the point very deliberately because, without providing this comparison between ADHD and cancer, or any other human disease, the labels for which are all human constructs, a note of prejudice is introduced into Pemberton's argument which, so far, I have not seen refuted.

Let me go one stage further. That is to note that medicine itself is a human construct. Medicine is not a naturally occurring human phenomenon. A profession has created it over centuries, with the primary goal of protecting the interests of those who practise within the discipline, as is true of all professions everywhere, and what is deemed within or outside its orbit has always been a matter of judgement that has changed over time.

What Pemberton might, at my generous best, be doing is asking whether the condition described as ADHD is one that needs treatment, usually with amphetamines, or is instead something that is misunderstood by a society which needs to better accommodate it.

What I would stress is that there is nothing odd about asking this question, but I would suggest that the framing of the Channel 4 documentary is problematic. So, too is the decision to broadcast it at this moment, in the light of Jason Arday's recent death.

Again, a simple comparison makes my point. If I drill down into what I think Pemberton might be saying, I think his argument is that many people can live with ADHD, except that society does not wish to tolerate their difference. I might be generous in my interpretation at present, and will revise that opinion after I have seen the programme, but let me use that as a hypothesis for now.

In the same way that this suggests that the problem for those with ADHD is created by society, so too are the problems for many of those with type 2 diabetes, many forms of cancer, and a great deal of heart disease also created by a society that has created a toxic and hostile environment for human life, to which we know our bodies can, and do, react in some cases.

In other words, what Pemberton is saying is nothing that is surprising, except for the fact that this is being discussed in the case of ADHD, and politicians are jumping on that bandwagon to try to deny help to those who need it because of the hostility towards them within society, whilst those same politicians appear to be seeking to do nothing at all about the physical assaults that the neoliberal industrial complex creates for us all when it comes to toxic products that are harmful to health.

The questions that arise around Pemberton's documentary are, in that case, not so much about what it might say, but why it chooses to say it and the way in which it chooses to present its arguments, particularly if contextual framing of the sort that I have just noted is not provided.

There is nothing wrong with saying that ADHD is a social construct. It is, but so is all of medicine, and so is all of disease.

There is nothing wrong with saying that not all ADHD needs to be treated, but that can be true of other diseases as well. We are all well aware of self-limiting viral illnesses, but perhaps too little aware that, in some, and maybe many, cases, what are considered serious physical illnesses can be reversed without conventional medical intervention, which is a fact that the medical industrial complex is not too keen to highlight because it would harm their interests to do so.

It is, then, the framing that I will be looking at when I view this documentary. My concern, based upon the prior publicity and informed comment that I have read and listened to, is that it appears to be yet another deeply politically motivated attack on people who might be vulnerable within our society. If that's the case, I will say so.

If, instead, it recognises that ADHD is real, distinct from neurotypicality, and needs to be accommodated within a society where so many do not seem to want to care, then it will be worth applauding.

There are, of course, a range of other possibilities between these two outcomes. I will reserve my judgement for now.