More than 800,000 people in England now carry a formal ADHD diagnosis. One in 44 children has the condition on their medical records, and the numbers keep rising. For many families, that diagnosis is a lifeline. For others, it raises a question that is growing harder to avoid: are we reaching too quickly for a medical label when something far more complex might be going on with ADHD diagnosis in children?

The question has moved well beyond the edges of clinical debate. It now sits at the centre of a government-commissioned review, drawing in some of the world’s most prominent voices on childhood mental health.

A Review That Could Change ADHD Diagnosis in Children

In December 2025, Health Secretary Wes Streeting launched an independent review into rising demand for mental health, ADHD and autism services across England. Professor Peter Fonagy, a clinical psychologist and National Clinical Advisor on Children and Young People’s Mental Health, leads the review. His findings are due in summer 2026.

The scale of what he is examining is stark. Between 2021 and 2025, the number of people with an ADHD diagnosis more than doubled. The review flagged a particularly “unusual” increase among girls and young women. Meanwhile, 13 times more people waited for an autism assessment in September 2025 than in April 2019.

The government paired the review with a £688 million funding package. That money will hire 8,500 additional mental health workers, expand NHS Talking Therapies and bring mental health emergency departments to around 85 nationwide. But funding alone, critics argue, will not reach the root of the problem.

“The Diagnosis Doesn’t Explain the Why”

One of the most prominent voices challenging the current approach to childhood ADHD is Dr Gabor Maté, author of Scattered Minds: The Origins and Healing of Attention Deficit Disorder. He is also one of the world’s leading experts on attention deficit conditions.

Speaking on the Care Visions: Family Talk podcast, Dr Maté did not mince his words. “All they are is a description of certain patterns,” he said of diagnostic labels. “And the question is why? And the diagnosis doesn’t explain anything about the why.”

Dr Maté rejects the dominant framing of ADHD as a purely genetic disorder. He has written extensively about the links between childhood trauma, stress and attention difficulties. “I think that’s total nonsense,” he said of the genetic argument. “It’s a complete misreading of the genetic literature.”

His position is not that ADHD does not exist. He argues that clinicians misread its causes and reduce its treatment too quickly to a prescription. “Genes don’t change in a population over 10, 15, 20 or 30 years,” he pointed out. If rates climb that steeply and that quickly, the environment must be driving it, not the DNA.

Childhood ADHD as Sensitivity, Not Disorder

What many children with ADHD traits may actually inherit, Dr Maté argues, is heightened sensitivity to their environment, not a fixed neurological disorder. He notes that many of the same children also experience asthma or allergies, which he views as further markers of that same hypersensitivity.

“Modern science tells us that genes are turned on and off by the environment,” he said. “What is genetic is the high degree of sensitivity. That means they’re much more affected by the environment.”

Behaviours that clinicians use to support an ADHD diagnosis in children, such as inattention or impulsivity, may sometimes reflect adaptive responses rather than disorder. The brain protects itself under stress. “Let’s take tuning out, the absent-mindedness,” he said. “What is that? Not a disease. It’s actually a coping mechanism.”

The Pressure on Modern Parenting and Childhood ADHD

Dr Maté is careful not to blame parents. The pressures he describes are structural and social, not personal failings.

“It is extraordinarily difficult these days to be a parent, no matter how loving and well-intentioned parents are,” he said. Economic strain, long working hours, insecure housing and rising adult anxiety all filter into family life. Many parents raise children largely alone, without the extended networks of support that previous generations relied on.

“Humans did not evolve to raise children in small, stressed, nuclear households,” he argued, “but in wider communities where care was distributed.”

Research into early brain development supports part of this picture. Stress in infancy and during pregnancy can shape how attention, impulse control and emotional regulation develop. These are the same capacities whose absence underpins a childhood ADHD assessment.

“When the parents are stressed, the child is stressed,” Dr Maté said. “It’s that simple.”

The rise in childhood ADHD does not stand alone. It sits alongside steep increases in youth anxiety, depression, self-harm and addiction. In 1993, 15.5 per cent of adults aged 16 to 64 had a common mental health condition. By 2023 to 2024, that figure had climbed to 22.6 per cent. “Would anyone seriously argue that there is a gene for self-cutting?” Dr Maté asked.

“We’re living in a toxic culture now,” he said. “That affects children by affecting the capacity of parents to be fully present for those kids.”

The Medication Question

None of this means Dr Maté opposes medication entirely. He has taken it himself and prescribed it as a physician. But he is direct about its limits.

“At the very best, they regulate symptoms in the short term,” he said. “The long-term studies indicate that the medications don’t help anybody develop anything.”

He is particularly concerned about how quickly and widely clinicians prescribe drugs, including antipsychotic medication for young children. “It’s a vast experiment,” he said. “Do we know what the effects are going to be 40 years from now on somebody who at age five was given? We don’t.”

His position is measured but firm: medication “should never be the only answer, and rarely should it be the first answer.”

What the Review Must Grapple With

Not everyone shares Dr Maté’s scepticism. Many clinicians argue that ADHD is a well-evidenced neurodevelopmental condition. They say medication can be genuinely transformative for children who need it. Some specialists suggest that rising diagnosis rates reflect better awareness, along with long-overdue recognition of children previously missed, particularly girls.

Professor Fonagy has pledged to test assumptions rigorously and listen closely to those with lived experience. “My aim is to understand, in a grounded way, what is driving rising demand,” he said.

Dr Sarah Hughes, Chief Executive of Mind, pointed to the wider picture. “We also need to be tackling the social and economic factors that are helping to drive increased demand,” she said.

What becomes harder to dispute is that ADHD diagnosis in children, and the systems meant to support them, face pressure from multiple directions. Whether the answer lies in faster assessment, better medication, improved therapy or wider social change is the most consequential question the review must answer.

For now, the children at the centre of this debate are still waiting.

Source: dbrecoveryresources