This article was written by Professor Nancy Doyle, and originally appeared on GeniusWithin.org. Genius Within is a social enterprise that works to support neurominorities.
(Recently) a British newspaper published a yet another piece bemoaning the increased rise in neurominority diagnoses, and this time Attention Deficit and Hyperactivity Disorder (ADHD) is in the firing line. Their complaint is two-fold. Firstly, that “we all suffer from attention deficit sometimes” and secondly that if we increase awareness then services won’t be able to cope with demand. This affects businesses as well as public life – there are limited resources for making adjustments and it certainly seems like more and more people are asking for them. Where will it end? Okay, let’s unpack this.
The Actual Numbers
Firstly, adult women are the fastest rising category for ADHD in the past twenty years, however this is widely thought to be a correction for under diagnosis, from when our view of ADHD was limited to stereotypically male behaviour and it was thought that people grew out of ADHD. The NHS reported in 2022 that 2.86% of the population were in treatment for ADHD in 2020/2021, compared with 1.93 in 2014/2015. This is hardly everyone. And, critically, it is fewer than the estimated 3-4% of the UK population who have ADHD.
The critique is starting to sound a bit like that research where men were asked to rate what proportion of the airtime women took in meetings and consistently rated the women as taking way more than they actually did. Remember that?
When a marginalised population finds its “voice”, backlash is to be expected. A whisper sounds loud when you are expecting silence. But the facts, in this case, tell a different story from the opinions.
Faking It?
Secondly, we do not all “suffer from attention deficit sometimes”. That is like telling a Deaf person that we all “struggle to hear sometimes” or a wheelchair user that we all “struggle to walk sometimes”. We do not. ADHD diagnosis is governed by NICE guidelines and strict criteria using the Diagnostic Statistical Manual.
As someone who has conducted and whose business continues to conduct 100s of assessments a year, I can reliably share that we do not “just diagnose anyone”. In fact, we have to provide evidence of ADHD symptoms throughout early development and childhood, not just recently. Additionally, those symptoms have to have led to serious issues in a person’s education, workplace, relationships and/or health. People who’ve been staring at screens through the pandemic and have got a bit scatty are unlikely to pass our threshold. However, undiagnosed ADHDers who’ve been staring at screens are more likely to have lost all their coping mechanisms and might well now be presenting for diagnosis.
If you started the pandemic with a lower baseline for coping with cognitive overload, then it probably tipped you over the edge. That is not the same as jumping on a bandwagon or making things up.
Scarcity Of Resources
Thirdly, disability support isn’t a zero sum game in which we decide who is “worthy” and “not worthy” of support. If there is a rise in mental ill health that exceeds our ability to provide individual interventions and adjustments, it is time to ask a systemic question – why are so many people unable to cope?
Let’s think about this in a business context. Perhaps you are providing an increasing number of distraction-free working hours, or remote working days, so that your ADHDers can maintain productivity. Maybe it is time to stop reacting to one person at a time, and consider providing “email free Friday afternoons.” You could also consider turning off that Slack channel until lunchtime on Tuesdays and Thursdays, teaching people to use “send later” to ensure no traffic during non-work hours and/or implementing flexible working hours across the business.
Your ADHDers might be the group with a potentially legally protected condition, but few people benefit from the “Always On” culture and it is widely thought of as destructive to performance for all. Consider the ADHDers your proverbial canaries the coal mine, showing you where you need to make changes for all, rather than a group of demanding whingers. It could be an opportunity to map out organisational change, rather than a drain on resources.
ADHD Is Not New
And very lastly, the paper in question mentioned that ADHD is a “new” disorder, insinuating that it is made up. In fact, medical reports of ADHD began in the late 1700s, way before diabetes, multiple scleroris and more. In summary, when opinion based news reports start undermining the lived experience of disabled people, it is time for employers to act protectively of their staff.
You don’t need to diagnose, or question diagnoses, you need to accept that performance or stress is more often cognitive than attitude or motivation. People are rarely trying to cause difficulties. Questioning the existence of a regulated diagnosis is not going to get you anywhere with your company culture or your legal counsel for that matter.
Instead, consider what adjustments and flexibilities a person needs to their workflow and environment to work at their best. Perhaps they need coaching to work that out, if the solutions aren’t obvious. These responses are psychologically safe, legally compliant and simple good practice. Good management is always the most disability inclusive response. And, if addressing a particular need is becoming a regular event, strategic managers start to plan a structural alternative.
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Prof. Nancy Doyle, C. Psychol. led Genius Within as CEO for over 10 years, before moving to Chief Research Officer in September 2021. As a proud neurominority herself, she is passionate about improving the way neurodiversity is treated in the workplace. She is also the founding member of a British Psychological Society Working Group, providing guidance to other Psychologists in the field. Nancy wrote a definitive guide to neurodiversity at work for the BPS and has contributed to many other publications and expert reference groups with organisations such as ACAS, ERSA and the DWP.