ADHD: Writing to my MP (Robert Courts)
Dear Robert Courts,
I'm writing to you about mental health again, because I have to say - I've been digging deep into the subject, and I'm actually getting really angry about how big a problem this is.
I have always thought that one of the major benefits of a national healthcare systems is economic - it's able to offer efficient interventions, rather than profitable ones, that keep a productive and healthy workforce available to support business and growth.
Quality of life is irrelevant to this argument - the concept justifies itself on economic basis alone. Healthy citizens are productive taxpayers, enabling innovative businesses to thrive with an engaged workforce.
On this basis - I'm a very productive taxpayer. I'm well above the line of 'net contributor' to the treasury, and have been almost every year of my working life.
So with that in mind I come back to Mental Health services - in the grand scheme of things, mental health support and therapy is actually really cheap. Whilst it requires medical skills and training, it _doesn't_ need expensive hospital infrastructure, emergency response services, or indeed even much in the way of subsidised medication.
And that's why I am angry here, because on economics alone, having effective well funded mental health support is trivially justified. Anyone who's off work for a week, has already 'cost' the economy as much as a program of treatment prior to that would have cost.
But I know so many direct examples of people who were missed as children for their diagnosis of ADHD, ASD, and a smaller number of other underlying conditions - things that are neurogenetic in origin, and cause brain development problems from a very young age.
A child that is spotted, can be very easily supported - these conditions are well understood, and not hard to diagnose. A child that is spotted early? The very vast majority of them can, and negligible cost, become productive taxpayers in their own right.
A child that is not spotted? Is incredibly likely to become a net drain on the treasury. Almost all fail to live up to their potential. A very large proportion end up with significantly problematic life circumstances:
- Any woman with ASD has a 90% chance of having been sexually assaulted.
- The prison population of people with ADHD is around 10x that in the normal population.
- The chance of a failing out of an inaccessible education is much higher, but even from an early stage 'failing to live up to potential' is still life altering in a negative way.
- The frequency of depression and suicide is also vastly magnified.
- The probability of risky sexual behaviour, leading to unplanned, early life parenthood is also substantially increased.
All these things cost the taxpayer _FAR_ more than the mental health screening and treatment that would have prevented almost all of it.
As a 'productive taxpayer' myself, I feel I should let you know that I came very close to suicide last year. It might seem inconceivable, because on the surface I do have all the trappings of a successful life.
But depression just doesn't work like that. It's a slow insidious killer, that works by destroying all the things that make you want to live in the first place. Depression destroys your sense of self worth, and demolishes your self confidence. It suppresses your emotions, and turns the world grey and dreary. It makes you cruel. And most of all, it makes it hard to reach out and seek the help and treatment that is necessary to change course.
Because that course? That's nihilistic desire to cease existing. To remove yourself from the lives of everyone around you. To become reckless and to push people away, so they don't hurt as much when you 'disappear'. So you get to a point where you've nothing left, and suicide seems a very simple and rational final step.
I hope you've not experienced or encountered this - because I truly wouldn't wish it on anyone. But in my case? It was brought on as a direct result of ADHD. Slowly, over time - I've been depressed for 20 years probably, and it's just slowly been getting worse. The turmoil of COVID almost certainly didn't help either of course, and I think this is why were seen a very large increase in demand for mental health services. Because people have 'moved forward' on their depression journey faster for a couple of years.
I was cheap to 'fix' - I think I paid around £900 for some therapy, and around £1000 for ADHD diagnosis and treatment. I did it privately, because if I hadn't I'd still have been waiting. Only I probably wouldn't, because I'd have taken my own life.
That's less tax than I pay in a month, and I do that every month, and have done for a LONG time.
If I'd have been spotted as a child? None of this would have happened at all. It'd have been even cheaper. And likely I'd have flourished and 'lived up to my potential' and who knows what benefits that might have brought?
My story though, is not any sort of unusual one. I can probably introduce you to 10 people I know who have similar stories to tell. ADHD alone is approximately 3-8% depending on what metrics you use, and that's one - or more - child in every classroom. Many of those are missed, because they're not quite the squeakiest wheels. Because our teachers too, are stretched, and not any sort of mental health experts either. ADHD and ASD goes unnoticed.
Not all of those people end up suicidal - but plenty will, eventually. But all of those people fail to live up to their potential. They fall into unfavourable lifestyles - cycles of abuse, criminality, or just sustained depression and alienation.
So please Mr Courts - could you take on this cause?
I'd be more than happy to come and see you to discuss it, because I earnestly believe that doing this is justified in so many different ways. The quality of life impact is huge, but so is the economic impact. The costs of screening and treatment and additional training resources are downright trivial - even on an entire cohort - compared to the future economic impacts.
Yours sincerely,
Ed Rolison