Today’s Herald article: ‘Medication Generation’ – a response

Today’s Herald front page ‘Medication Generation’ highlights the increase in prescribing of ADHD medication which has taken place over the past 5 years in Scotland – based on data published a year ago.

We see this increase as a positive sign that Child and Adolescent Mental Health Services are recognising that ADHD is a serious condition with implications across the life course which needs to be appropriately diagnosed and addressed – in part stimulated by the ADHD Services over Scotland final report which was published in 2012. While there are many more children in Scotland being treated with medication for ADHD now than five years ago, the number remains below 1 in 100 children, suggesting that many more still go undiagnosed.

Where we agree with the Herald coverage, though, that ‘parking’ children with ADHD on medication is not enough. That’s why we are calling for a national strategy for ADHD. In particular:

• Teachers need training on how best to teach and support children with ADHD at school. Far too many are currently excluded, formally or informally.
• Children with ADHD need to be identified and diagnosed at an early stage through joined up pathways between education and CAMHS services. Current waiting times for assessment are too long in many places, and referrals to CAMHS may be rejected without clear reasons.
• Health Boards need to adhere to SIGN guidelines and treat ADHD appropriately, not only with medication (where appropriate) but also through structured parent training programmes such as Parents InC – currently available in some health boards but not others
• ADHD should be part of the national schools census dataset so that diagnosis rates, attainment and long term outcomes can be systematically tracked. Currently, there is no data on the number of children diagnosed with ADHD other than prescribing statistics.
• Pathways for children transitioning into adult services need to be strengthened, and adequate provision made to assess and treat previously undiagnosed adults with ADHD. The new Scottish Royal College of Psychiatrists guidelines explain what is required.

One of our Trustees, Alison Clink, contributed to the discussion with a reflection on how difficult the decision to medicate a child is, but how much it can help – something previously highlighted by a survey of parents of children with ADHD around Scotland.

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