NHS LOTHIAN | STAFF NETWORKS
Disabled Employee Network (DEN)
Around 40% of the workforce have some form of impairment – some lesser and others higher – which can impact on their working and personal lives. The social model of disability sees the person first and argues that the barriers people face, in combination with their impairments, are what disables them.
The Disabled Employee Network (DEN) welcomes any member of NHS Lothian staff who identifies as disabled, neurodivergent, or with a long-term health condition. You don’t need a formal diagnosis, and you don’t need to disclose your condition to your line manager or to other DEN members.
The aim of DEN is to encourage contact, support and friendship among members of staff who self identify as having an impairment or disability, bringing together diverse staff from across NHS Lothian into an environment where issues of disability can be discussed in confidence and where advice and information can be sought. DEN will raise the profile of disability in NHS Lothian in a staff centred way. DEN will research best practice on workplace disability and will gather members’ experiences to better inform NHS Lothian on how best practice can benefit organisational goals and foster good employee relations.
Meetings
All meetings take place in our Teams channel. Contact us if you would like to receive the Teams invitation.
Next meeting:
Our next meeting is Thursday 17 September at 12.30pm. This is a change from our usual evening time!
Future meetings:
- Thursday 22 October at 6pm
- Monday 16 November at 12.30pm (NB: we’re trying a different day of the week!)
- Thursday 10 December at 6pm
DEN Chairs Blog
ADHD Awareness Month 2026
by Jack Hellberg, DEN co-chair
The diagnosis of ADHD has been increasing in recent years. This fact has led to significant media and institutional attention, with strong debate on the causes and appropriate response to this. For example, is the increase in diagnoses due to more awareness or over-medicalisation of individual traits? Should healthcare professionals focus on diagnosis, or prioritise psychological and pharmacological interventions without a diagnosis? To see how we got here, it’s helpful to look at the recent past of ADHD assessment and diagnosis.
There have actually been significant changes to the diagnostic criteria for ADHD in the past 10-15 years. In the UK, there are two benchmarks for psychiatric diagnosis which a professional might reference. One of these is the Diagnostic and Statistical Manual (DSM) 5, which was published in 2013 by the American Psychiatric Association (APA). This was to replace the DSM-IV, which was first published back in 1994 and had its last update in 2000. As one might expect, there are some big changes between the DSM-IV and the DSM-5 (by the way, that is the APA, not me, changing the numbering convention between the two) when it comes to ADHD criteria. For example, the DSM-IV is much more child-focused in its criteria, seeking evidence primarily from a school setting. “Age of onset” was also changed from seven to 12, with a slight reduction in symptom threshold for adults as well.
The International Classification of Diseases (ICD) 11 is the other classification used for psychiatric diagnosis. The ICD-11 was published in 2018 to replace the ICD-10 from 1990. The ICD-11 moved ADHD from a “hyperkinetic disorder” to a “neurodevelopmental disorder” and allowed for a more diverse set of presentations to still fall under diagnostic criteria.
As outlined above, diagnostic criteria for ADHD had a significant period without major updates (although other revisions of each manual were published during this period) up until the 2010s. During this period, ADHD assessment was biased towards children. This isn’t to mention the cultural legacy of earlier ideas around ADHD. For much of its history, ADHD was seen as a “childhood disorder” largely specific to boys. It wasn’t until the later 20th century that adult and/or female diagnosis gained broader recognition in healthcare. Today, evidence overwhelmingly demonstrates that ADHD is a lifelong, measurable neurodevelopmental difference impacting all genders.
Given this, we can reasonably conclude that there is a cohort of people born prior to 2013 who did not previously meet diagnostic criteria for ADHD but now do. Furthermore, we would expect diagnostic rates in children to be higher in the past decade than previously due to a well-founded broadening in diagnostic criteria. But how much have they risen? According to research collated by the UK government, there isn’t actually much evidence for a higher percentage of people with ADHD in the general population (3-5% of adults according to them), although data is admittedly difficult to come by. However, the service demand for ADHD assessment and the number of diagnoses issued has increased. According to UK primary care data, the number of diagnoses increased roughly 2-4 times for women post 2021. Diagnoses increased in men as well, although usually by less than double. In Scotland specifically, waiting lists for adult neurodevelopmental assessment have increased across most healthboards.
So where does this leave us? Overall, there are legitimate reasons that we would be seeing an increased demand for ADHD diagnosis given changes in clinical understanding and access. This is especially true for women and AFAB people, who historically had the least access to assessment. This isn’t to say that other factors aren’t also increasing people’s interest in ADHD assessment, whether that be for people who ordinarily would or would not meet diagnostic criteria. However, we are likely still in a transitional phase of ADHD recognition where public access and infrastructure are still catching up with advancements in clinical understandings. It remains to be seen if diagnostic rates will reduce as gender and other population discrepancies equalise.
Bibliography:
Adam, B. (2025). Neurodevelopmental Pathways and Waiting Times in Scotland. The Scottish Parliament. https://bprcdn.parliament.scot/published/2025/6/24/6f2ae5ab-9a1b-4704-a102-ec570c763ccc/SB%2025-25.pdf
American Psychiatric Association. (2013). Highlights of Changes from DSM-IV-TR to DSM-5. American Psychiatric Association. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf
Department of Health and Social Care. (2026). Independent review into mental health conditions, ADHD and autism: interim report. GOV.UK. https://doi.org/10.13140/RG.2.2.24367.39840
Patryk Malejka. (2026, May 26). ICD-10 vs ICD-11: diagnostic categories, chapters and key changes in the WHO classification. ICD Diagnostica. https://icd-diagnostica.com/en/blog/icd-10-diagnostic-categories
Smith, M. (2024). Narrative Matters: When does the history of ADHD not begin? Child and Adolescent Mental Health, 29(4), 385–387. https://doi.org/10.1111/camh.12727
Tremmery, S., Buitelaar, J. K., Steyaert, J., Molenberghs, G., Feron, F. J. M., Kalff, A. C., Hurks, P. P. M., Hendriksen, J. G. M., Vles, J. S. H., & Jolles, J. (2007). The use of health care services and psychotropic medication in a community sample of 9-year-old schoolchildren with ADHD. European Child & Adolescent Psychiatry, 16(5), 327–336. https://doi.org/10.1007/s00787-007-0604-5
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