Audit of ADHD caseload identified an open case prevalence of ADHD as 0.2% and 0.6% in Specialist Tier 2 and 3 CAMHS across 2 metropolitan boroughs of Greater Manchester, as opposed to national prevalence of 1–3%.

We carried out a survey of CAMHS clinicians to identify and address any internal factors that could contribute towards such an under-representation.

A Survey questionnaire was designed to look at staff perceptions, knowledge and training needs in identification and management of ADHD.

Questionnaires were distributed to 50 CAMHS professionals working across these two Specialist CAMHS, which were completed anonymously and returned yielding a response rate of 84%.

1 in 10 CAMHS clinicians did not believe in giving children and young people diagnosis of ADHD and a third believed ADHD was medicalization of behavioural problems rather than neurobiological disorder. Only half of CAMHS clinicians were aware of co-morbidities such as conduct disorder and other developmental disorders.

Although ADHD is a professionally well established condition, scepticism amongst significant number of CAMHS clinicians about the validity of diagnosis, relative risks and benefits of diagnosis continues to exist. This may result in under diagnosis of children who are referred to CAMHS with behavioural difficulties. This has an impact on quality and appropriateness of service provided.

Specific training on ADHD is especially important among CAMHS teams, with clinicians from a multidisciplinary background and differing attitudes towards ADHD.

We anticipate this will help identify missed ADHD cases and improve the quality of care.