Suffering is not inevitable: a thematic analysis of a roundtable on ADHD and mental health

Briefing 67

Alice Brockway

Summary

In January 2026, Centre for Mental Health in collaboration with James’ Place convened an online roundtable around Attention Deficit Hyperactivity Disorder (ADHD) and how it intersects with mental health, with a particular focus on suicidality and suicide prevention. Participants included experts by experience, medical doctors, representatives of third sector organisations, and researchers. This briefing highlights the key themes and insights, gathered through a thematic analysis of the audio transcript and typed chat. The analysis generated four themes: ‘Centring lived and living experience,’ ‘Widespread systemic failures,’ ‘Cost of getting it wrong,’ and ‘Realistically hopeful ways forward.’

Background

People with ADHD are overrepresented in prison populations, have higher rates of mental illness, and increased risk of experiencing suicidality, and death by suicide (Young et al., 2015; French et al., 2024). There has been a significant recent increase in people seeking diagnosis and support for this condition in the UK (Martin et al., 2025), with discussions ongoing up to national level about the causes of this surge, and around the legitimacy of need. This can lead to an apparent inconsistency of approach to mental health and neurodiversity. Some pronouncements seemingly minimise needs, with others, such as the conclusions of NHS England’s independent ADHD taskforce, appearing to support moves towards improvement (NHS England, 2025). The situation is made worse by frequent mis/disinformation that has spread on social media, leading to confusion about prevalence rates, symptoms, and needs arising from both ADHD and mental health challenges, as well as how they intersect (Schiros et al., 2025).

Over several years stakeholders, including representatives of James’s Place and Centre for Mental Health, identified growing concern around the role ADHD-related issues were having in fuelling mental health problems, particularly relating to suicidality and death by suicide. This roundtable was designed to bring together stakeholders to identify key issues and ways forward.

Methodology and limitations

We analysed an automatically generated transcript of the event’s audio along with a copy of the typed chat using a six-stage model of thematic analysis (Willig et al., 2017). We carried out and reviewed initial coding, generating 129 codes that were gathered into four themes: ‘Centring lived and living experience’, ‘Widespread systemic failures’, ‘Cost of getting it wrong’, ‘Realistically hopeful ways forward’.

The nature of the roundtable itself incorporated best practice components. It was framed as a safe, confidential space in which different opinions and perspectives were welcome, as were different communication styles. Participants engaged with each other using kind and supportive language, offering thanks and consideration for sharing, and showing respect for the limits of the meeting itself. Timekeeping was managed carefully and respectfully, with participants also monitoring themselves and showing concern for the need to hear multiple voices.

When considering the need for systemic change it is important to look at how that change is being developed and by whom. The data generated by this event demonstrates tools that could be beneficial to future work.

Limitations

It is important to note that participants were all adults. While there were a number of parents/carers and professionals dealing with the needs and experiences of children and young people, no direct experiences were included. Considering the need for early intervention during childhood and adolescence, this is a significant omission. Additionally, many of the experiences of being diagnosed with ADHD or coming to identify as having ADHD came from adults who had experienced this later in life. There are differences in experience for those who are diagnosed as a child or young person, and those who go for many years without diagnosis that will not be reflected in this data.

Participant quotations may not be exact due to limitations of the transcription. Every effort has been made to represent the speakers’ words as they were said, and to ensure the sense of what people were saying is reflected accurately.

Finally, the analysis was carried out by a person who had participated in the roundtable. This has benefits in the additional information gained during the event but may also have increased bias in the analysis.

Themes

Centring lived and living experience

The event started with three speakers giving testimonies of their lived and living experiences around ADHD and mental health. This foregrounding of lived and living experience emerged as a reflection of participant beliefs and, throughout the entirety of the event, participants came back to the need for progress to be led by the lived experience of people with ADHD and those caring for them.

Participants also identified lived and living experience as crucial for understanding the full impact of ADHD and/or mental distress, as well as unpicking the complexity and wider effects that become visible when these needs are seen in the context of a whole life.

The importance of lived and living experience also led to many professionally focused participants identifying the multiple perspectives they brought to the topic and adding their own lived experiences. This was both a theme in the discussion, and evidence of the difference that including these kind of experiences can make. Along with the experiences of people with ADHD who have faced mental distress, and professional experiences in related areas, participants’ experiences as parents and carers of children and young people emerged as a significant topic.

Perhaps the biggest impact of this theme was to support the need for person-centred care, identified repeatedly as crucial to any improvements. By placing lived and living experience at the centre of the discussion rather than service-led pathways based on a specific diagnosis, the understanding of need moved swiftly to a holistic picture incorporating families, schools, the criminal justice system, and workplaces.

Widespread systemic failures

While participants were able to point to examples of good practice, the dominant discussion within this theme was around systems repeatedly letting people down, often with severe and lasting effects on people’s lives. This was not simply to do with mental health services, but included concerns about educational environments, prisons and workplaces, difficulties coordinating and collaborating between services, and the dissemination of mis/disinformation in national discourse.

Of particular concern were the huge issues around waiting lists: how long they are, that some are being closed, that people are giving up on diagnosis because of them, that there seems to be a total lack of support and information for service users and families/carers during waiting periods. Factors identified as worsening this problem were limits on the capacity of GPs, unnecessary reassessments, and a lack of trust around shared care between NHS and private service providers.

Participants raised a range of underlying issues including lack of clarity and professional agreement regarding the ADHD diagnosis itself, the rapid increase in need for assessments over recent years, evidence that is readily available being omitted all the way up to government level, and significant underfunding. One participant raised that some recent or expected changes, such as privatisation of healthcare in prisons, might pose an increased risk to people with ADHD rather than a route to improved outcomes.

It was noted that these issues foregrounded the significant parity gap between physical and mental health services.

The costs of getting it wrong

Participants were clear at every stage of the discussion that the costs of failing to support people with ADHD appropriately and early can be devastating. Among many issues they identified were severe mental illness, suicidality (including death by suicide), shortened healthy life expectancy, lack of employment, contact with the criminal justice system (including multiple prison sentences), substance misuse, distress for both patients and professionals, additional financial load on services, homelessness, and lowered economic participation.

Building on centring lived and living experiences, much of this theme focused on consequences that started with the individual but then reached out beyond them. Failure to address ADHD early and well was identified as causing challenges for life, many of which simply can’t be repaired.

Realistically hopeful ways forward

In some ways this was the overarching theme of the data. The scale of the work needed was unflinchingly addressed multiple times, with stakeholders repeatedly addressing issues such as the finite nature of resources and the complexity of getting such a wide range of organisations working together. Concerns were raised around current proposals and the possibility of losing what is already working as change takes place, as well as the kind of social and political shifts that would be needed to justify prioritising ADHD over other needs.

However, participants were also able to point towards realistic possibilities for improvement that could work with current plans and resources. Several identified specific organisations or projects working collaboratively with local and national partners, as well as looking further afield for good practice to explore. There was recognition that participants represented a broad range of expertise that already exists, alongside bringing a passionate belief in the need for positive change and progress, and a large and growing evidence base to draw from.

Participants identified three specific shifts needed for effective positive change: separation of diagnosis and need, becoming needs led and person-centred, and focussing on prevention of harm rather than crisis management.

Recalibrating services towards prevention was seen as something that has been successfully achieved, at least to some extent, in other areas of healthcare such as cancer. It was noted that the harms discussed were predictable and preventable, and so similar approaches could be applied at policy level. This could provide an existing model for ADHD provisions to build on.

It was also noted that treatments for ADHD are considered to have a very high rate of success, meaning investment and improved access is likely to have significant positive outcomes both for individuals and society more widely.

Participants identified some routes to improvements that have already been laid out or are underway. The work of the ADHD Taskforce, commissioned by NHS England in 2024, was raised as having made good recommendations that now need to be implemented. Changes to Integrated Care Boards (ICBs) were also identified as bringing potential opportunities for improvement.

Conclusion

The data clearly shows the participants’ beliefs that service provision for ADHD is and has been grossly inadequate, and has led to many people experiencing significant harm over decades. While speakers were adult and referring to experiences going back to childhood, the experiences of parents and carers of children and young people with ADHD suggested that many of the difficulties have not changed as much as might be hoped.

There was consensus among stakeholders about the need for centring lived and living experience, and the subsequent need for holistic person-centred approaches. There was strong indication that lessons are often not being learned, which is concerning. We need to ensure that decision makers base changes on the realities on the ground and not on media messaging or simple cost cutting.

There was also agreement that the route to improve this is through significant systemic reform. While it was recognised that such large-scale changes pose major challenges, participants were readily able to identify positive actions and ways forward. There is a need to mobilise and motivate stakeholders to engage in activities at all levels to support the move towards better services and provision.

Acknowledgements

Centre for Mental Health would like to thank Alice Brockway, a Lived Experience Influencer at the National Suicide Prevention Alliance, for her work producing this briefing.

---