‘Biased’ Channel 4 programme on ADHD misrepresented my views, says expert | Attention deficit hyperactivity disorder

A contributor to a controversial Channel 4 documentary on attention deficit hyperactivity disorder has withdrawn her support for the programme, saying it was biased and could lead to an increased suicide risk by encouraging parents to take their children off medication.

Katya Rubia, a professor of cognitive neuroscience at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, also said The Great ADHD Myth? misrepresented her views.

“I agreed to take part in this documentary because I knew it was aiming to show ADHD was a myth and I wanted to provide an alternative view,” she said. “But they cherrypicked, largely misrepresented, truncated and presented my comments out of context to make them fit into their narrative.

“Biased programmes like this one that push their view of ADHD as a mythical entity are irresponsible and will have detrimental effects, in particular at a time in our society where mental health conditions are escalating and where there is an urgent need for early diagnosis and early treatment to prevent further damage down the line,” she said.

Rubia said ADHD was largely underdiagnosed and undermedicated in the UK. “Parents of children with ADHD may take their children off medication as seen on the programme, which could potentially lead to an increase of the risk of longer-term adverse outcomes of untreated ADHD such as increased anxiety and depression, lower self-esteem, greater risk of substance abuse, suicide, more antisocial behaviour and poorer academic achievement … and reduced employment prospects later in life.”

The Channel 4 programme was presented by the NHS psychiatrist Dr Max Pemberton, who concluded that ADHD was a “social construct” rather than a medical condition, and schools should adapt to better support a wider range of children rather than medicating them into fitting into a restrictive norm.

A Channel 4 spokesperson disputed the claim that it denied the lived experience of those diagnosed with ADHD and instead sought to present the views of a range of senior medical experts who seek to question the conventional understanding of ADHD and if it is a neurodevelopmental condition.

Rubia criticised the documentary for filming the experience of Mason, a 10-year-old boy, while he was taken off ADHD medication.

“This ‘experiment’ provided nothing but anecdotical evidence confounded by a host of factors,” she said. “The child was not only taken off medication, but also off screens, off additives and junk food, subjected to more nature experience and by implication to more interaction with family, friends and parents.

“This can lead to greater happiness and stronger family bonds (for every child, not just ADHD children). There was also the uncontrolled placebo effect of being treated on TV.”

Rubia said research showed most children preferred to be on medication because they had better control over their emotions as a result and consequently more friends and better relationships with others.

“Substantial research on the effects of nutrition, supplements, exercise, neurofeedback, cognitive training and nature exposure shows unfortunately mostly non-significant or very tiny effects in children with ADHD, very inferior to the effects of medications,” she added.

Rubia also criticised the documentary for its negative portrayal of medication for children with ADHD. “There is substantial evidence that long-term use of medication in ADHD is associated with many benefits such as reduced rates of suicide, comorbidities, crime, traffic accidents and substance abuse.

“The side-effects are relatively minor and benefits are very large compared to other drugs in psychiatry. No mention was made about the potential negative consequences of Mason’s dropping school performance on his self-esteem and academic future,” Rubia said.

The Channel 4 spokesperson said: “We are satisfied that Katya Rubia’s contribution has been edited fairly, is an accurate representation of the interview she gave and that her consent was informed.”

They added: “Whilst the film does not seek to provide answers from one family’s experience, their experiences have opened up discussion around whether today’s world is equipped to accommodate ADHD behaviours and the ethics of medicating these, particularly in children and particularly when the long-term effects remain unknown.

“The welfare of the boy and his family were of paramount importance before, during and after the production process. An independent doctor, his GP, and a health and safety company were consulted. Advice was also taken from three independent psychiatrists on the medication break.”

Prof Anita Thapar, a clinician scientist at Cardiff University’s school of medicine, who chaired NHS England’s independent ADHD taskforce, also criticised the documentary.

“It’s not a helpful argument to say ADHD is a ‘social construct’,” she said. “The programme did not use experts in clinical research on ADHD or consider all the risks of ADHD that have been shown. It seemed one-sided and used sensational language, such as likening medication to corporal punishment.”

A Channel 4 spokesperson said the channel had a remit to stimulate public debate and challenge the status quo. They added: “Not everyone will agree with everything included in the programme and we acknowledge the strength of feeling that this subject evokes, however there is considerable public debate in this area and testing conventional thinking and exploring different ideas.”

Prof Subodh Dave, the president of the Royal College of Psychiatrists, also criticised the programme. “Invalidating the condition does a disservice to people with ADHD and professionals involved in their care,” he said.

A survey launched by the charity ADHD UK after the documentary was screened on Tuesday has received more than 4,000 responses.

More than 94% of respondents said the documentary had increased stigma about ADHD. The same proportion said it was not fair in its representation of ADHD as a condition.

More than 85% said the programme “clearly suggested ADHD is not a real condition” and 88% said it did not make clear that the sceptical views featured were minority views within medicine.

The Channel 4 spokesperson said: “This documentary hears from an extensive range of senior medical experts, with a variance of views on the topic, including, but not limited to, psychiatrists, psychologists, psychotherapists and neuroscientists. Many of these experts work or have worked with the NHS or have held presidential roles at professional membership bodies.

“It is undeniable that there is considerable public debate on various aspects of ADHD, including in relation to the prescribing of medication and diagnostic procedures, and it is not misleading to suggest that these views exist. Channel 4 has a remit which includes offering a platform for alternative views, stimulating public debate and challenging the status quo.”