The misdiagnosis of ADHD in the South African healthcare system

Is the public healthcare system too overloaded and distressed to diagnose children properly?


The Goldilocks and the Bear foundation (gb4adhd) was founded by Cape Town-based Pyschitrist Dr. Renata Schoeman and entrepreneur Nic de Beer. Dr. Schoeman is the recipient of the Young Minds in Psychiatry award from the American Psychiatric Association.

Gb4adhd was developed to alleviate the rising need for proper screening and treatment for Attention Deficit and Hyperactivity Disorder (ADHD) in children. Since its inception in 2017, it has brought mental health services to more than 21 000 children in rural areas.

This came after the growing need to educate parents, especially in rural areas, about the existence of ADHD. Schools are riddled with ‘naughty’ and ‘unruly” kids who are, in fact, suffering from this condition.

According to Dr. Schoeman, “ADHD is the most common psychiatric disorder in children – affecting 2.0% – 16.0% of the school-age population”.

The popularity of ADHD in recent years is either credited to an increased awareness of the condition or a total misdiagnosis of children.

Also read; Understanding and coping with a child who has ADHD

One mother from Lesotho, Mathabo, came to work one day with medication that the Dr. at her local clinic prescribed for her son. It was Ritalin. She wanted to ask her colleagues that can read what this medication is for, and why his son’s personality has taken a 360 turn after using it. The schools asked Mathabo to take her 9-year-old son to the Dr. because his behavior was odd.

Mathabo saw that his son’s mood was dampened and he did not have the same energy anymore since using the medication.

One of her colleagues went back to the clinic with her to inquire about the diagnosis. On arrival, the Dr. became highly defensive and redirected them to a different Dr. The second Dr. took back the Ritalin and stated that the child does not have ADHD.

How many more kids are being misdiagnosed by Drs in the public healthcare system?

Benedict Mhlongo is a Counselling Psychologist registered with the Health Professions Council of South Africa as well as the Board of Healthcare Funders (BHF).

Mhlongo argues that misdiagnosis is a common phenomenon within the Public Health sector.

Mhlongo credits this to the limited sessions Drs have. When you are servicing a large community of patients, you have a few sessions with them, sometimes just a single one. The diagnosis of ADHD requires more than a single session. “Because ADHD occurs on a spectrum, the possibilities of misdiagnoses are prevalent with disorders such as dyslexia, dyspraxia, autism etc”.

This means that more resources have to be given to public healthcare professionals to be able to run the proper assessments first before making a formal ADHD diagnosis.

School teachers only need to be educated regarding the psychological issues children can potentially face and their diagnosis. School teachers are a key part because they offer feedback to parents after observing the children for several hours during the day.

If they can be able to identify certain behaviors correctly, then this could potentially limit the risks of misdiagnosis.

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