Lucy Foulkes explores the possibility that the rising numbers of young people receiving a diagnosis of mental illness or ADHD are subjects of overdiagnosis (Are we really overdiagnosing mental illness?, 22 February). She posits that changes in terminology, increasing societal awareness and reductions in stigma are all factors in the increase in diagnoses.
However, there is another way of looking at this issue. If we treat ADHD as binary (you have it or you do not), we are missing the possibility that we all lie somewhere on a continuum with diagnosed ADHD towards one end (and perhaps an ability to focus and concentrate at the other). A diagnosis of ADHD then depends on where the line is drawn. I suggest that this line has been moved in recent years, so that a large group of people have been caught up in the positive ADHD group, who would not have been previously.
If we all lie on this continuum many of us may benefit from recognising that, and self-help tools may be useful. Only a minority, as now, may need intervention. The concept of diagnosis may be less useful and we may all, more readily, accept each other’s differences.
Sue Simmons
Bovey Tracey, Devon
• Dr Foulkes is right to suggest we need a more nuanced approach to understanding why more young people are reporting signs of mental illness, including the implications of the complicated shift in the use of language around mental health.
Young people are indeed often growing up in a more challenging era than their parents. However, challenges aren’t a new phenomenon historically. Their 20th-century counterparts lived through two world wars, the Spanish flu pandemic, the Great Depression, deindustrialisation under Margaret Thatcher, and the cold war.
Might the ability to respond to challenges have been reduced by increasingly protective parenting and spoon-feeding school environments – reducing the opportunities to develop resilience enjoyed by previous generations?
Has the UK’s response been one-dimensional and reactive? Medical diagnosis and treatment when symptoms are reported, rather than a more preventive approach? Research suggests that active play in childhood, physical activity, time in nature, and the creative and performing arts are all protective of mental health – unlike sedentary screen time and junk food. Is it time for a more holistic approach to young people’s mental health?
Michael Baber
Director, Health Action Research Group
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