Panorama missed the big picture

Raye, ADHD Paris and a weekend breakfast recipe

ADHD and its impact on those unlucky enough to be burdened with it is unique and intensely personal. When I received a diagnosis, I was overwhelmed. Many traumatic memories bubbled in the weeks and months after the diagnosis. It shocked me and took a lot of working out. Without a remarkable ADHD coach, an ability to hyperfocus on reading about the condition, and supportive family members, I would have been floored.

Because it is diagnosed based on a questioning process that rests on the patient's self-awareness of their symptoms and behaviours, it can generate strong emotions for the prospective patient and those around them. I had 40 years of bad memories. The sheer chaos of events, the missed weddings, the suitcases left on trains and those bloody lost school textbooks had weighed heavily below the surface.

Even now, I try to explain a bad ADHD day with excuses. I'm still learning to own the condition. My friend helps me with this. He owns his ADHD. If you judge him, that's your problem. I haven't learnt to think like that yet, but I'm getting there. At least I've been kinder to myself about the failures. That's progress.

Anyone with suspected or diagnosed ADHD is all too familiar with the scepticism and openly dismissive attitudes still harboured by many people towards the disorder. Awareness of the symptoms and impacts of ADHD and its potential scale in the population have become more socially familiar – including through social media platforms like TikTok.

Because of this scepticism, broadcasts by reputable and trusted programmes, like BBC's flagship investigative show Panorama, must get their framing right.

Sadly, Monday's half-hour look at ADHD clinics fell markedly short. Eventually titled "Private ADHD Clinics Exposed" but initially trailed under the headline "False Diagnosis", it could not have been more explicit about its angle: that the main problem facing UK patients is unscrupulous private clinics milking vulnerable patients for cash, leading to an overdiagnosed, overmedicated population.

The programme was a tragic missed opportunity to put the diagnosis and medication of ADHD in its correct context. An objective and nuanced consideration of the condition and its treatment in the UK would have had to lay out the following points:

1) Millions of people in the UK suffer from undiagnosed mental health conditions. These conditions do not just include ADHD but plenty of other conditions like depression, anxiety, PTSD, autism and many others.

2) Those millions of people need help but can't get it. The NHS is arguably its biggest-ever crisis, faces critical staff shortages, and has insufficient funding to provide the parity of esteem between physical and mental health that is now a legal requirement.

3) The ADHD community suffers from a longstanding stigma. People with ADHD do not receive the same parity of esteem as, for example, those with clinical depression or bipolar disorder. Even while those with mental health problems are generally stigmatised, ADHD patients get even shorter shrift.

4) It is near-impossible to get a timely appointment to diagnose ADHD with the NHS. Even children with suspected ADHD often have to wait three years or more to see an NHS psychiatrist; for adults, it can be more like five years. Yet Panorama managed to see an NHS psychiatrist – and their reporter received a consultation lasting 3.5 hours. I do not know anyone who has ever received this amount of time.  

5) You should never judge a medical diagnostic process on its ease or difficulty. When someone asks whether it is 'too easy' to get diagnosed with ADHD, they are admitting a prejudice: they either doubt the disorder's existence or believe that thousands of people are either deluded or mendacious about their symptoms and the impact of ADHD on their lives.

These points should have been made in the Panorama programme. Without their inclusion, any serious examination of ADHD treatment in the UK is impossible.

The impact of the programme on the ADHD community is sadly already clear. A survey run by ADHD UK after the episode aired found that 89% of people with ADHD feel stigma surrounding the condition has increased because of it, and 83% believe it will stop people with symptoms from coming forward to seek an assessment.

Providers are receiving queries from patients about re-diagnosis or reconsidering the medication they are on; other patients are questioning whether to go ahead with costly appointments that they have scrimped and saved for.

Similarly, while it was evident that some clinics exhibit shortcomings in the quality of their service and care for patients, the programme needed to do more to explain why the private psychiatric provision is valuable and vital to relieve the enormous stress on NHS services and GP surgeries.

As Adrian Chiles said in reaction to the programme this week:

“No one wants ADHD, no one wants to hand over a substantial amount of money, no one wants to take medication every day. All we want is clarity, and for everyday life not to be so damn difficult.”

There is a real possibility that because of Panorama's misguided framing, fewer people will have access to vital care and treatment for ADHD. I do not believe that was the intention of the programme's journalism and production team – but an apology is already overdue.

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Healthy food, healthy mind

Although I didn’t realise it at the time, many of the techniques I developed on my health journey helped me overcome some of the negative impacts of ADHD. Exercise has been key not just to maintaining my physical health but my mental health, too.

I created new routines which became habits to help me cope with repetitive domestic tasks, helping to plan my time so I could actually prepare healthy, fresh food from scratch. As someone who used to survive on a diet of takeaways and microwave meals, this was a huge challenge to overcome.

Starting next week, I’m going to be sharing a few more recipes from Lose Weight 4 Life with paid subscribers who generously support this newsletter. To kick things off though, here’s one of my favourites from the book. I make it most weekends.

Weekend Breakfast Eggs

Serves 4 (or 2 if you want more significant portions)

2 punnets of cherry tomatoes, left whole
1 red onion, cut into wedges
1 red pepper, left whole
3 garlic cloves, unpeeled
a pinch of chilli flakes
a squeeze of lemon juice
4 eggs
100g feta cheese
fresh coriander, chopped
salt and pepper

Preheat the oven to 190°C/gas mark 5.

Dry-fry the tomatoes, onion and pepper in an ovenproof frying pan for 10-12 minutes until blackened on the edges. Remove from the heat and leave to cool slightly. Whizz the skinned garlic, tomatoes and onion in a processor until relatively smooth.

Return the mixture to the frying pan and simmer for five minutes to reduce it a little. Cut the pepper into small pieces and add to the mixture to soften a little more. Add the
chilli flakes and season with a bit of salt and pepper.

Add a squeeze of lemon juice and make four wells in the mixture with the back of a spoon. Break an egg into each one.

Pop the pan in the oven for about 8 minutes until the eggs are firm but not opaque. Crumble over the feta and chopped coriander and serve.

If you’d like to receive more recipes from the book, you can upgrade to become a paid subscriber here.

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Fancy a chat?

As a way of connecting more often, I’ve been thinking of starting to hold more regular community discussions here on Substack. If you haven’t used it before, Substack chat is now available on desktop as well as on Apple and Android devices. So you don’t need to have the Substack app to take part.

I thought I’d start things off with an “ask me anything” on Sunday night. I’ll be online from about 8pm UK time. So if you want to come and ask me anything about health, ADHD, music, politics or anything else - you can.

I’ll send a reminder before it starts. If you like it and find it useful, we can do them more regularly. Maybe on different topics? I’ll look forward to hearing what you think.

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Reading

We’re no longer just swimming in shitty seas. Water companies want us to pay for the pleasure, too.

I was lucky enough to spend a couple of days in Paris recently. I was going to write up some recommendations for you, but saw that

Farrah Storr

has saved me a job.

This is an interview that will only improve your view of Ed Davey.

Ultra-processed foods have failed our mental health. Is there an antidote?

Listening

Raye, God bless you. On Thursday, you thoroughly deserved the best contemporary song award for “Escapism” at the Ivor’s.

Raye

Visiting

The Garden Museum, Lambeth. Just next to Lambeth Palace is the quirky and rather wonderful garden museum. It houses a permanent collection of artefacts and tools from gardening throughout history alongside botanical art, photography, and paintings exploring how and why we garden.

16th Century Gardener from Lonicer’s Herbal

Home to the Archive of Garden Design, it preserves and provides access to the working records of leading British garden designers of the 20^th and 21^st centuries. Housed in the deconsecrated church of St Mary-at-Lambeth, the Garden Museum contains the burial place of John Tradescant, an early gardener and plant hunter.

It’s open from Monday - Sunday, closing only for Christmas Day and Boxing Day. More information and opening hours here.