A senior health expert has questioned whether ADHD could be overdiagnosed in Jersey, leading some individuals to receive powerful medication unnecessarily when they should instead be treated for anxiety or stress.
Jersey’s Government is grappling with how to manage a spiralling waiting list of nearly 1,000 adults hoping to be assessed for ADHD – around one in 50 of the island’s population.
Concerns about the “high” number of diagnoses in Jersey compared to other regions were raised by Dame Clare Gerada, a non-executive director on the Health Advisory Board, which oversees the Health Department, at a meeting this morning.
There is already an ongoing review in England regarding the rise in ADHD diagnoses and potential misidentification with other mental health conditions.
“Jersey is at risk of becoming the drugs capital of Europe”
Questioning whether it was possible that ADHD was sometimes being confused with anxiety and stress in Jersey, Dame Clare suggested that there should be a “deep dive” external review into Jersey’s high number of adult ADHD diagnoses and warned against expanding prescribing powers to GPs without closer scrutiny.
“Jersey is at risk of becoming the drugs capital of Europe,” she told the health board this morning. “We need a deep dive by an external person or do it ourselves.”
“I think it’s about understanding the demographics of who’s on the list. It’s about understanding the reasons for referrals.
“With an almost indefinite waiting list and a 600% increase of people on these being diagnosed with this condition, we have to do something rather than just say it’s going to go away. It’s not going to go away.
“I’m not sure it wouldn’t take a staggering amount of resources [to do a review], and it’s about getting public confidence in this so they understand what’s going on, rather than just hide behind the figures.”
However, Mental Health Director Andy Weir told the board meeting that it was “not the right time to do an external review”, adding that the best time would be in three months.
“We need to do a bit more work before we ask someone to come in and look at where we are.
“We’re concerned that if we pay to get someone in, we will end up just telling ourselves what we already know.
“Because we do so much work on the ADHD waiting list month in, month out – utilising a load of clinical time [by doing an internal review] to get us nowhere further.
“I’m not sure if we’re clear enough what we’re trying to do,” he added. “I could write a paper now about the changes we’ve made over the past two years and all the different initiatives. You don’t need to bring someone in to do that.”
The chair of the meeting requested Mr Weir deliver an explanation at the next health board meeting.
“Then we can get to the nub of exactly what it is that we want to want to look into,” Carolyn Downs said.
An “unusual” conversion rate?
The service currently screens people before they get a full ADHD assessment – which helps make sure only those who are likely to have the condition are referred. This process includes a self-assessment form and a review by a clinician.
Papers published in advance of this morning’s board meeting recorded how Dame Clare had previously highlighted Jersey’s “unusual” 98% conversion rate from referral to diagnosis for ADHD, and suggested it could reflect people identifying with ADHD themselves, rather than all cases being clear clinical diagnoses.
Currently, just one consultant psychiatrist and one junior doctor are responsible for handling hundreds of cases – a situation described as “unmanageable” by officials.
Priority for prisoners and young people proposed
Health leaders are now considering closing the list to new referrals altogether, and introducing a triage model that would prioritise those most in need – such as individuals in the criminal justice system, young people or those struggling with substance misuse.
Officials say discussions are still ongoing and that closing the waiting list would be a “complex and sensitive” move that would require political sign-off.
When contacted by Express for an update, a Health spokesperson said: “There are no immediate plans to close the waiting list.”
Meanwhile, the idea of shared prescribing – allowing GPs to issue repeat ADHD medication – has been suggested as a way to free up specialist time, but local doctors have so far resisted due to safety concerns and recent national shortages.
The approach would mirror changes made in parts of the UK, where services have also come under pressure amid rising awareness and referrals.
The proposal follows a recent critical prison inspection which found that there was weak staff awareness and minimal support for neurodivergent prisoners at HMP La Moye, despite 23 inmates being identified as having additional needs.
Campaigners have long called for more support in the justice system, pointing to figures that suggest a quarter of UK prisoners may have ADHD, compared to just 2–4% of adults in the general population.
One former prisoner opened up to Express about how learning she had ADHD led to a “massive turning point” in her life.
Rachel Tippet, founder of ADHD Jersey, said the findings showed a “clear need” for earlier diagnosis and support, particularly for people at risk of reoffending.
“All prisoners should be screened for ADHD and supported to reduce reoffending and increase well-being and self-worth,” she said.
Former Jersey prison governor Susie Richardson also previously told Express that La Moye had added neurodiversity as a resettlement pathway and was trialling ADHD clinics – but that more support was needed.
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