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When BBC journalist Rory Carson sought online consultations for a potential mental health issue, three private clinics diagnosed him with attention deficit hyperactivity disorder (ADHD). They charged between £685 and £1,095 for these consultations, which lasted between 45 and 100 minutes, and all prescribed him medication.

ADHD is a highly controversial disorder which emerged in the US in the late 1950s during the cold war, and quickly became associated with stimulant drugs such as Ritalin. Now diagnosed throughout the world, ADHD is central to many debates about neurodiversity.

While Carson’s Panorama investigation into its treatment attracted plenty of criticism, the fact that this disorder could apparently be diagnosed quite casually online is concerning. When he subsequently had a more rigorous (but free) three-hour, in-person consultation with an NHS psychiatrist, he was told that he did not, in fact, have ADHD.

Society’s increasing awareness of mental health issues and demand for mental health support has been driven, in part, by social media and easier access to information online. While this is no bad thing in many ways, the related increase in self-diagnosis (including among children and adolescents) is clearly open to abuse by some organizations offering costly diagnoses and treatments.

But there is another reason for this rapid growth in private mental healthcare. In England alone, the NHS spends around £2 billion per year on private hospital care for mental health patients – equating to 13.5% of its total mental health spend. Due to the reduction in NHS bed provision, nine out of ten privately-run mental health beds are now filled by NHS patients.

While the UK government says it is committed to spending more money on mental health, private investment companies are reportedly queuing up to “seize the opportunities offered up to them by the NHS crisis”. Private providers say they can do more to help avert a mental health emergency exacerbated by the COVID pandemic. Yet, a dozen of the 80-odd privately-run mental health hospitals in England were rated as “inadequate” in the Care Quality Commission’s latest report, which has warned of possible closures.

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Advert for a universal basic income (UBI) scheme in New York, May 2016. Such schemes could offer significant benefits for recipients’ mental health. Generation Grundeinkommen via Wikimedia, CC BY-SA

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