End of BUP: Believes too many children are being tested for ADHD

Critical. Psychologist Sindre Skodvin Fidje believes that too many children are being assessed for ADHD, and believes that more should be done to help them in other ways. Photo: Private

Psychologist Sindre Fidje believes that too many children are being assessed and medicated for ADHD when the problems may actually lie in their school, family or community. He also believes that ADHD assessments take up resources that are needed for other serious mental health challenges.

Text: Tarjei Abelsen

When Sindre Fidje started working as a psychologist in the Child and Adolescent Psychiatry Department (BUP) in Bodø, he quickly experienced that ADHD referrals were piling up.

– Eventually, that made up the lion's share of what I was doing, proving or disproving ADHD.

Fidje decided to quit his job. He didn't feel that this was the best way for him to help children and young people.

– As a psychologist, you want to be useful and help people, and I didn't feel like I was doing that through my work with ADHD assessments.

More and more people in Norway are being diagnosed with ADHD, but what is it really? Why are there large geographical differences, and do we risk medicating personality? These are some of the questions that are asked when Lytring invites you to a debate titled "Raise your hand, everyone who doesn't have ADHD", on Tuesday, September 8th at Arbeideren in Kabelvåg.

Hope for help

Many very young children are referred to BUP for ADHD assessment, often because parents and teachers hope that a diagnosis will trigger more help. However, after the assessment, the child may be sent back to the same school, with the same framework and resources.

– If they receive the diagnosis and return to school where there are no more resources to draw from, it will quickly be a short journey to medicine.

Fidje believes this illustrates a larger problem: We are looking for the explanation for the child, when the problems may lie around the child.

– It becomes a kind of individual explanation for what I see as a social problem.

At the same time, he believes that ADHD assessments take up large resources in BUP.

– It takes resources away from trauma and anxiety and other types of serious challenges. An incredible amount of resources go to this.

No simple test

Fidje believes that the ADHD diagnosis should not be understood as a clear medical answer.

– It is a discretionary assessment, no biological markers and no objective tests.

The assessment is based on symptoms and information about how the child functions in different environments. For young children, it can be particularly difficult to distinguish between ADHD and problems that may have other explanations.

– It's difficult when it's a 7-year-old who may have problems at home and 4–5 hours of screen time. It takes a long time to investigate and you're never 100 percent sure.

Fidje also believes that the term ADHD has been expanded over time, and that more people are therefore included.

– The more you dilute the concept, the more difficult it becomes to see those who really have severe ADHD, they disappear.

Concerned about the path to medication

Fidje does not deny that medications can be useful for some, but believes that side effects and alternatives receive too little attention.

– The sunshine stories get too much space. For some, it may be good, but I don't think it's good to medicate children with amphetamines because they don't fit into the environment, and I think we should rather go further to accommodate the child as he is.

To Lytring -debate on Tuesday 8 September will feature a panel with different perspectives on ADHD. In addition to Fidje, Cecilie Haukland, general manager at the ADHD Resource Center, Ottar Bjerkeset, researcher and psychiatrist at Nord University, and Børge M. Larsen, acting department director at the Norwegian Directorate of Health, will participate.