Dear Channel 4: ADHD Isn't the Myth. This Documentary Is.

On Tuesday night, Channel 4 broadcast The Great ADHD Myth?, a documentary fronted by NHS psychiatrist Dr Max Pemberton that put a question mark over something the international scientific community settled a long time ago: whether ADHD is a genuine neurodevelopmental condition at all. As a psychiatrist who has spent my career diagnosing and treating ADHD, chairs a national OCD and related disorders network, and sits on the receiving end of the fallout whenever a programme like this airs, I want to set out clearly why the framing of this documentary was not just editorially provocative but actively harmful, and why the "myth" label does not survive contact with the evidence.

What the programme actually asked

Channel 4's own billing for the film asked whether ADHD is a genuine neurodevelopmental disorder or a social construct, and whether phones, ultra-processed food, and rigid schooling might be driving diagnoses rather than any underlying difference in the brain. The press release framed this as new territory, hearing from a growing number of medical experts, several of them formerly senior in the NHS, who question the conventional narrative around ADHD.

That framing matters enormously, because a title ending in a question mark, built around whether a well-evidenced neurodevelopmental disability is genuine, does not simply invite scrutiny of services. As the Global ADHD Advocacy Network put it in their response to the announcement, it takes a question that mainstream science has already answered and reopens it in front of a prime-time audience of hundreds of thousands of worried parents, undiagnosed adults, and vulnerable children

The evidence Channel 4 didn't lead with

I want to be precise here, because "the science is settled" can sound like a rhetorical flourish. It isn't. In 2021, 87 international ADHD researchers and clinicians published the World Federation of ADHD International Consensus Statement, a document built entirely from meta-analyses of at least five studies or 2,000 participants, or single studies exceeding 2,000 participants. The stated purpose of the exercise was explicit: to counter the exact kind of misconception that undermines patients and clinicians alike, on the basis that misconceptions about ADHD stigmatise those affected, erode confidence in the professionals who treat them, and delay people from getting help.

Twin, family and adoption studies consistently put the heritability of ADHD at around 70–80%, on a par with height. Structural and functional imaging studies show consistent, replicated differences in the volume, connectivity and maturation trajectory of frontostriatal and frontoparietal brain networks in people with ADHD compared with those without. Genome-wide association studies have identified specific genetic loci associated with ADHD, and these findings replicate across the UK, the USA, Scandinavia and beyond. None of this is fringe or contested science. It is the same standard of evidence base that underpins diagnosis and treatment for almost any condition in medicine, and it was available to the production team well before broadcast.

"Modern life" is not an alternative explanation

The suggestion that phones, ultra-processed food or overstimulating schooling are driving the rise in diagnoses treats environment and neurobiology as if they were competing explanations. They aren't. Nobody serious in this field argues that environment plays no role in how ADHD presents, how early it's picked up, or how much a child struggles day to day. What the evidence does not support is the idea that a modern, stimulation-heavy environment is manufacturing a disorder out of children who would otherwise be neurotypical. Rising diagnosis rates have several well-documented drivers that have nothing to do with attention spans being eroded by smartphones: better public and clinical awareness, particularly of how ADHD presents in girls and women, who were historically missed; the slow unwinding of decades of underdiagnosis; and, in adults, a first generation who grew up without the language or the pathway to be assessed at all now coming forward. It is also worth noting, as ADHD UK highlighted in their formal challenge to Channel 4 ahead of broadcast, that <cite index="2-1">NHS prescribing data for England shows boys aged 10 to 14 remain the largest single group receiving stimulant medication, a pattern that has held consistently over time</cite> — hardly the profile you'd expect if the recent surge in diagnosis were simply modern life creating a new phenomenon in previously unaffected groups.

The legitimate question buried inside an irresponsible one

There is a serious, overdue conversation to be had about ADHD services in this country: two-year-plus waiting lists in some areas, variable diagnostic quality between private and NHS providers, the pressures on schools trying to support children without adequate resourcing, and the very real question of how we make sure diagnosis is accurate rather than rushed. I would have watched, and welcomed, a documentary that took that on seriously. That is not the documentary Channel 4 made. By packaging legitimate questions about service delivery inside a headline asking whether the underlying condition is real, the programme let the provocative framing do the work that careful journalism should have done instead.

The cost of getting this wrong

This isn't an abstract debate about broadcasting standards. ADHD UK surveyed viewers after transmission and found that one in five people who watched reported the programme caused them severe distress, with a further 38% describing significant distress. Those are not the numbers you get from a documentary that has fairly interrogated a difficult topic. Those are the numbers you get when people who have spent years trying to get taken seriously, sometimes across multiple failed GP appointments and years-long waiting lists, watch a prime-time programme suggest, in effect, that their diagnosis might not be real.

I see the downstream effect of programmes like this in clinic. Patients who have finally reached a diagnosis after a long and often difficult journey come in asking whether they've been wrongly labelled. Parents who have watched their child struggle for years second-guess a decision to pursue assessment. None of that is a reason to place ADHD beyond scrutiny — no diagnosis should be immune from that — but it is a reason to expect broadcasters to distinguish between scrutinising a service and casting doubt on the people who use it.

Where I'd point people instead

If you watched Tuesday's programme and are now unsure what to believe, I'd encourage you to read the World Federation of ADHD's International Consensus Statement summary, or speak to your GP or a specialist clinician about your own situation rather than drawing conclusions from a 47-minute film built around a question mark. ADHD is a real, well-evidenced neurodevelopmental condition. Services supporting people with it in this country are genuinely under strain. Both of those things are true, and only one of them made it into the title.