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Our Response: Panorama Private ADHD Clinics Exposed

Panorama has positively benefited people with ADHD by uncovering some poor practices. But by broadcasting in the way they have, they’ve done serious damage to our community and real harm to individuals with ADHD. Our research, from over 1,500 people, evidences that the Panorama show’s presentation was misleading and harmful to people with a disability. We will be complaining to the BBC and ask as many people as possible to join in that complaint.

Henry Shelford

CEO and Co-Founder, ADHD UK

Update : Complaint Process

September 2023: The BBC ECU Unit has met and has not upheld our complaint (read their response here). The conclusion of the BBC process then enables us to escalate to ofcom. We have done so. You can read our complaint here. The process gives 90 days to conclude so we should hear before Dec 10th 2023.

Henry Shelford

CEO and Co-Founder, ADHD UK

2,203 people with ADHD answered our survey about the Panorama Show

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People with ADHD think ADHD Stigma has Increased due to Panorama's show

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People with ADHD think Panorama's show wasn't fair in how it represented ADHD

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People with ADHD think Panorama's show lacked balance in its representation of private clinics

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People with ADHD think Panorama's show will stop people with symptoms seeking an ADHD Assessment

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People with ADHD think Panorama's show will negatively impact them personally (1350 left comments - see below)

The most complained about Panorama ever - 1639 complaints

Data from the BBC fornightly complaints report show that the “Panorama: Private ADHD Clinics Exposed” is now their most complained about show. Data shows 1,639 complaints. This compares to 1,479 for “Panorama: Vaccines The Disinformation War” and 793 for “Panorama – Has The Government Failed The NHS?”. The significance is further highlighted by knowing that in the last decade Panorama has only 7 shows with over 100 complaints.

Panorama's most complained about show - 1639 complaints

Summary

We wrote to Panorama before their broadcast outlining our concerns that overly sweeping negativity for the private ADHD Assessment sector would risk serious harm to individuals with ADHD.

In particular, the risk of adding stigma and increased discrimination for individuals with solely an ADHD private diagnosis. This is a group usually only joined out of necessity and as a consequence of failures of service within the NHS. We also pointed out the value of equally investigating the NHS. Notably, the failure in many areas to provide adequate ADHD services that have resulted in long waiting lists, improper screening, and a lack of after-care.

Panorama changed their title, but otherwise, to all apparent evidence, ignored us (and others like us).

We specifically raised the issue of increasing stigma for people with ADHD and despite that we were told there wasn’t an issue by both the Editor, “By reporting these serious matters of concern, please be assured that it is not our intention to stigmatise people with ADHD and we are confident that we have not done so“, and the Producer, “We hope that you will watch the programme and agree that it doesn’t stigmatise people with ADHD“.

Our evidence clearly shows that stigma has increased for individuals with ADHD. This is a travesty – it didn’t need to happen. If Panorama had been balanced we could have had a positive impact without the bad.

An opportunity, that could have simply and importantly changed the world of people with ADHD for the better, has instead been forever tarnished by the unnecessary damage it has wrought. Damage that individuals now have to deal with.

Panorama knew better, because we and others told them. They have an important position and have done incredible work in bringing people to account for their failures. They now have to hold themselves to account.

If you have been impacted by the programme please join us in complaining to the BBC. We need your voice to add volume and weight to the complaint. Click here to put in your complaint.

The show had been told it would stigmatise people with ADHD and went ahead anyway. We now know that 89% of people with ADHD, myself included, who watched the show believe that stigma has been increased. 75% of all respondents felt that there would be a personal negative impact on them. This is completely unacceptable, irresponsible programme making that we will be formally complaining about.

Henry Shelford

CEO and Co-Founder, ADHD UK

Original Title: False Diagnosis: The ADHD ScandalAmended Title: Private ADHD Clinics Exposed

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Panorama changed their title between announcing and broadcasting. They reacted to complaints and concerns and acknowledged they were wrong, but they should have gone further. They should have responded by re-editing it. Instead, they ignored the facts they’d been given and have caused real damage to people with ADHD.

Henry Shelford

CEO and Co-Founder, ADHD UK

Our Pre-broadcast Letter to Panorama

Prior to broadcast, we wrote Panorama a detailed letter outlining our concerns and worries.

Panorama knowingly went forward despite alarms being raised by us and others. You can read our entire letter here or by clicking the image,

Panorama Letter First Page

Panorama's Response

Response from Panorama’s Editor:

Your letters to the Director General, Tim Davie and the Head of Current Affairs, Joanna Carr (12/5/23) have been forwarded to me. We have noted all that you have said.

As my colleague Hannah O’Grady has already explained, we have taken on board concerns raised by you and others about the title and short summary of the programme, and we have acted promptly to make changes.

The Panorama investigation began because of concerns that vulnerable people are being failed by some private clinics. As we have already said, serious concerns were raised with us by former staff members, patients, and their families as well as clinicians in the field. One clinician told us, “Thousands of these assessments are taking place and when you think about the number of people who may have received an incorrect diagnosis and may have been started on medications inappropriately, the scale is massive.”

It is our belief that it is clearly in the public interest to report these concerns and to highlight the way in which some clinics are failing in their obligations to provide good quality care.

The programme is clear that ADHD is a recognised condition affecting many people and that some may face long waits for assessment and treatment on the NHS. The programme also makes clear that if someone has received an assessment from a private clinic, including one where poor practice has been identified, that does not mean they do not have ADHD.

By reporting these serious matters of concern, please be assured that it is not our intention to stigmatise people with ADHD and we are confident that we have not done so.

Once again, thank you for contacting the BBC. We appreciate the feedback that you have provided.

Response from Panorama’s Producer:

Thank you for your letter about next week’s Panorama on private clinics who offer ADHD diagnostic assessments and treatment.

I appreciate the concerns you have raised on behalf of the people that you support.

I am afraid I can’t go into a lot of detail about the programme prior to broadcast, but I can say that the billing is a very short summary and the final programme will contain a lot more factual information and context about ADHD.

I can also assure you that the programme will make clear that ADHD is a recognised condition affecting many adults and it will highlight the long waits for assessment and treatment on the NHS in some areas.

The focus of the programme is not to query the nature of ADHD, but is an investigation into the way that some private clinics diagnose and prescribe medication for the condition following online assessments.

Panorama’s research has uncovered serious failings by some private clinics and we think there is a clear public interest in broadcasting the findings. We will be reflecting serious concerns that have been raised by clinicians specialising in this field as well as individuals who have been diagnosed with ADHD. The programme is likely to criticise specific clinics, but we will not be arguing that assessments should only be made on the NHS.

We have, however, listened carefully to the concerns that you and others have raised and we have decided to change the title and billing to more accurately reflect the content of the programme. We can tell you that the new title is Private ADHD Clinics Exposed and that a new billing has been issued.

We hope that you will watch the programme and agree that it doesn’t stigmatise people who have ADHD.

Yours sincerely,

The Resulting Damage

2,203 people, all with ADHD, answered our survey about the impact of Panorama’s show. The results are a devasting indictment of Panorama’s failure to heed our warnings before broadcast. This damage was unnecessary – solely because of how Panorama presented, not because of what it presented.

1,585 (75%) thought they’d be personally negatively impacted. 1,350 of those left a comment letting us know how they’d personally be negatively impacted. Scroll down to the bottom of the page to read them. In stark contrast, just 50 (2%) thought they’d be personally positively impacted. This highlights the disproportionate emphasis of Panorama’s storyline.

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People with ADHD think ADHD Stigma has Increased due to Panorama's Show

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People with ADHD think Panorama's Show wasn't fair in how it represented ADHD

%

People with ADHD think Panorama's Show lacked balance in its representation of private clinics

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People with ADHD think Panorama's Show will stop people with symptoms seeking an ADHD Assessment

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People with ADHD think Panorama's Show will negatively impact them personally (1350 left comments - see below)

The NHS Assessment Length Norm is not 3+ Hours

The Panorama show indicated that an ADHD Assessment on the NHS was 3+ hours. The length of ADHD Assessment was repeatedly used as an indicator of quality and referenced against the 3+ hour NHS expectation. We’ve surveyed individuals (774 contributors, all with ADHD) about their ADHD Assessments and found just 1 in 5 to be over 3+ hours. This indicates strongly that Panorama was factually incorrect in both its information and the inference it took from it.

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Of NHS ADHD Assessments reported to be 3+ hours. Despite Panorama's presentation that was the NHS norm.

The NHS also does ADHD Assessments over video

The Panorama show inferred that an ADHD Assessment should be done in-person and not online. That the NHS norm as a 3+ hour in-person Assessment. Our survey (774 respondents) indicated that the NHS do use virtual appointments with a ratio of 1:2. One third virtual and two thirds in-person.

Confidence in Assessment

Confidence in Assessment is startlingly similar across ADHD Assessment Sectors: NHS Local, NHS Right to Choose, Private.

The Panorama show inferred significant issues with the entire private sector of the ADHD Assessment market. They stated that their investigation started due to individual complaints from people who didn’t trust their diagnosis. They did uncover poor practice; however, if poor practice was endemic, this graph would look different for each sector. It doesn’t. Every sector has complaints; however, this is a strong indication that Panorama’s anti-private slant in the show was not based in truth.

The NHS is has very marginally the worst confidence results.

 

Positive Confidence in Assessment Negative Confidence in Assessment
NHS – My Local Service 88% 8%
NHS – RIght to Choose 89% 5%
Private 90% 7%
Confidence in ADHD Assessment

Opinion on quality of ADHD Asssessment Service

Service Quality Opinion is similar across all sectors: NHS Local, NHS Right to Choose, and Private.

However, it is notable that the NHS scores the worst of all sectors with a 13% having a negative view of the service vs 4% and 7% for NHS Right to Choose (run by private companies for the NHS) and Private Services. Based on these numbers the Panorama show should have focused its attention on the NHS rather than Private Services.

 

Positive View of Service Negative View of Service
NHS My Local Service 74% 13%
NHS Right to Choose 85% 4%
Private 87% 7%
Confidence in ADHD Assessment

Nothing about us - without us

There should have been people with ADHD on the programme.

A common programming guideline is “Nothing about us – without us”.  When discussing any group, particularly groups that suffer from discrimination, then people directly impacted should be part of the programme. No screen time was given to anyone who identified as having had a positive ADHD diagnosis. This was a programme about us but without us.

We would challenge Panorama to identify another instance where they would do that.

– In the episode “Mental Health: Young lives in crisis” Panorama extensively featured young people talking about their situation.
– In the episode “Is the church racist”. Panorama featured people of colour talking about their situation.
– In the episode “Road Rage: Cars vs Bikes”. Panorama gave screen time to both cyclists and drivers.

It is a great sadness that a condition that is as undermined and challenged as ADHD is didn’t have individuals in the show to represent the perspective of someone with ADHD

We warned that negative "troll" attacks would result

This is one example of the negative debilitating articles and comments that the Panorama show has invigorated.

Confidence in ADHD Assessment

Below are the top comments the article generated. (over 2.9k at the time of writing)

1,585 (75%) indicated a negative personal impact. 1,350 left us a comment.

75% of people with ADHD think the programme will impact them negatively personally. Compared to just 2% thinking it will have a positive personal impact.

Of the 1,585 who indicated a personal negative impact, an extraordinary 1350 left a comment telling us more.

The vast majority of comments are below. We have removed comments with personally identifiable information or those containing expletives. If you see a comment of concern please get in touch with us.

75% of people with ADHD think the show will Impact them personally

I haven’t informed anyone other than my partner of my own diagnosis for fear of how it will be perceived, this means I will likely never do this

I believe that it will completely undermine my very real diagnosis. ADHD has impacted my entire life and the NHS is simply not funded well enough to deal with diagnosing mental health conditions. For over 10 years I was told by GPs that yes, I very likely did have ADHD but there was no point in getting a diagnosis as the waiting lists were years long and I didn’t know for certain if I wanted to be medicated. Instead I spent over a decade being treated for anxiety when that wasn’t what I was suffering with at all. Now all these years later, I have finally been able to afford to pay for a private, professional diagnosis by a reputable psychiatrist who sits on NHS boards. This misrepresentation of the process with it’s sweeping generalisations undermines that. I will now face the stigma of having my diagnosis dismissed by people who will be led to believe that I paid for a guaranteed result.

It further invalidates an already invalidated community.

I believe it will call into question my diagnosis of ADHD. People will believe I faked it.

I feel extremely angry after watching that programme. Too wound up/over stimulated to sleep tonight.Since diagnosis,I have discovered how little ADHD is seen as a serious condition.Too many people already think ADHD is over diagnosed, Panarama has just helped re-enforce that opinion even more.

As someone who got a private diagnosis, I fear this may impact other people’s view of the validity of my diagnosis. I was diagnosed in my first year of university and if I had to wait for an NHS assessment, I would almost definitely have dropped out of university and been unable to continue. If in future my private diagnosis is disregarded or doubted, I fear that I will have the supports and accommodations for my ADHD withdrawn. If that were to happen, the waiting list for an NHS diagnosis could leave me stranded without any support for years and unable to continue my academic career.

Many of my friends, family members and colleagues doubt ADHD exists as a condition. This programme has already been cited in 4 messages to me this evening as evidence that my condition is imaginary and I should just “try harder”.

ADHD is already misunderstood and this biased and leading journalism leads to further stigma. Some of the private diagnoses in the programme showed flaws, but unless the NHS is funded better in this area, it is often the only place to turn. The programme inaccurately showed the reality of what the NHS are willing or able to provide in most parts of the country.

I’m already having to justify my diagnosis to a couple of my family and friends who doubted my original diagnosis because they believe ADHD is a “made up” condition.
My boss watched it and talked about it today, and seemed to suggest it was far too easy to get a diagnosis.
I was able to talk about it with him, and explain how complicated and lengthly the process is, but I am concerned that this will effect his opinion, and the few adjustments I have at work.

There is already a stigma behind ADHD, I was lucky enough to be able to get a diagnosis through Right to Choose, through a PRIVATE company because I was told I would be waiting four to five years to be assessed through the NHS service. I was suicidal, I couldn’t wait that long. This diagnosis has saved my life.

It’s stigmatised adhd. As someone who is newly diagnosed, it was worrying telling people anyway. It’s now been made worse. My diagnosis was only 3 days ago and I am scared, even though I was seen by the nhs.

My daughter (14) had a very thorough private assessment resulting in a diagnosis but I am worried that if we wish to use the assessment in the future to gain additional educational support or medication the diagnosis will be questioned because it was done privately

Even more people are likely to tell me that I’m simply lazy and disorganised because I don’t really have ADHD.

A friend has already suggested that my ADHD diagnosis from the NHS might be incorrect. I’m concerned that this is going to happen more often, and that my university or employers might also start doubting my diagnosis.

I got my private diagnosis a week ago and was about to start telling people but I don’t think i will now because I don’t think they will believe me, because they will doubt my diagnosis is reliable.

It allows others to dismiss my diagnosis because a lot of my struggles are internal and I’ve masked all my life. Just when I was starting to feel more able to be my true self, even if only in my corner, my now feel I have to mask again. This is untold damage to those who are already vulnerable and have likely been through a lot already such as depression (inc. suicidal thoughts) as I have….when the reason for that was unmanaged adhd

The programme was triggering – having being diagnosed as an adult after suicidal ideation and major depressive disorder in my 40s, the world needs to sit up and understand that ADHD is a real struggle – and sometimes a fatal one. This is not about simply losing your keys and getting a label – a diagnosis is life-saving for some people

As someone who had no choice to turn to the private sector for an ADHD assessment, I anticipate that this documentary will contribute to a bias I have already encountered during the course of my life. When seeking an assessment my local NHS trust informed me that despite a screening assessment indicating that a full assessment would be in my interest, they were unable to refer me for an assessment unless I was an existing secondary-care patient or was actively suicidal. It took me a further three years to raise the money for the assessment I went on to have.

The bias in question states that private sector diagnosis for neurodivergent conditions is a “pay for a diagnosis” system. As someone with an ADHD diagnosis from the private sector I am concerned that the legitimacy of my diagnosis will be seen as dubious by some people.

As a counseling psychologist with many years of work behind me in the mental health treatment sector, I have heard examples of GPs refusing to prescribe medication for the treatment of ADHD symptoms to presenting patients with private assessments and diagnoses.

As a practicing therapist with clients who have ADHD diagnoses and others who strongly suspect that they would meet the diagnostic criteria for ADHD, I am very conscious of how common shame and doubt is as part of the ADHD experience in British society. I know this from my own experience as well. ADHD has become a topic of controversy and its legitimacy as a condition that can even be said to exist is often questioned in contemporary discourse. This documentary has only contributed to the view of ADHD being lacking in legitimacy since it presents the idea that the source of assessment and diagnosis that thousands of people have left open to them is itself illegitimate.

ADHD has majorly affected me my whole life, physically, mentally with money, school, work, relationships, literally every part of my life for 38 years. I tried to speak to a dr when I was 20 but was unable to advocate for myself and both he and I didn’t have the ADHD knowledge that I do now. Finding out about ADHD, and then gaining private diagnosis and treatment, was a life line that has been positively changing my life since. Unfortunately one of the difficult aspects of knowing you have ADHD is that not many people really understand it, so it can be hard to talk about with people and I tend not to. I feel this episode with it’s unbalanced view and poor scientific method will only further misinform and mischaracterise our community as people trying to somehow pay for a disability diagnosis. I am also about to ask for a shared care and terrified of approaching my GP. Will they have watched this episode, do they know that my Psychiatrist is an NHS one just working extra or do they think they are all the same. I imagine this will affect many people’s ability to get the care they need including myself. I feel like this show has given me PTSD. It feels like a death or breakup. 38 years of trauma living undiagnosed, to be given a life line, only for the BBC to take it way in a 30 min episode! How can I get the help I need at work if everyone just thinks I have a fake diagnosis. Anyway, I think I need to go mourn for a bit. Happy mental health week BBC.

Below are hundreds of the comments sent in. Please read below to get a further impression of the negative impact the show has had.

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