Respected consultant psychiatrist Professor Wendel Abel is predicting that the recent decision by the National Health Fund (NHF) to add attention deficit hyperactivity disorder (ADHD) to its coverage list will result in a surge in diagnoses of the condition.

“I’m sure that diagnosis is going to increase very soon because I noticed the drug that is actually used to treat it, Concerta, is now covered under the National Health Fund,” said Abel, who was the guest speaker at GraceKennedy Foundation’s Annual Lecture last Wednesday.

He, however, cautioned colleague clinicians about being too quick to diagnose individuals because the drug has been made more affordable.

“Please do not overdiagnose this condition when these children come,” Professor Abel pleaded.

Last month the NHF announced that ADHD and cervical cancer would be added to its list, with coverage for ADHD now including the active pharmaceutical ingredient (API) methylphenidate, which is sold under the brand name Concerta for individuals of all ages diagnosed with the disorder. It said the subsidy for the Concerta 18 milligram tablet is $174.38, $261.58 for the 27 milligram tablet, and $348.77 for the 36 milligram capsule.

The announcement was commended as “a positive move” by educator, scientist and award-winning author Dr Karla Hylton who, in 2019, had raised concerns about the “increasing number of students being diagnosed with ADHD”.

Arguing that many “parents cannot afford these medications”, Dr Hylton told the Jamaica Observer, “A lot of times students in the poorer sectors of society are the ones that are excluded from these drugs, which are [more accessible] to the privileged, but by them doing this they are opening it up to more of the population.”

She pointed out that the increased access would be a huge plus for Jamaican educators whose students diagnosed with ADHD might be viewed as “disruptive” in controlled settings.

“The classroom size in Jamaica is so large these days that it’s easy to be overlooked, and if you are already ‘giving trouble’ you are going to be ignored and you will come out with nothing,” she pointed out.

Hylton had also noted that ADHD is one of the most common childhood disorders affecting approximately one in 10 students and said this meant, for example, that of any 40 students in a classroom, four may have the disorder. Pointing out that research has shown that intervention, medically and academically, is beneficial to these students, Hylton said “medication has been shown to be effective in 75 to 90 per cent of students with ADHD”, adding, “it is imperative that parents and medical professionals stress the value of medication to improvement of this condition”.

“I have had students diagnosed with ADHD and who are being medically treated, ‘decide’ to discontinue their meds. If this occurs, intervention must happen as, typically, a marked change in both behaviour and learning is observed,” Hylton said.

She urged parents and caregivers to be measured in administering the available drugs.

“There are side effects, so you still have to be careful; you don’t want it to be misused. Misuse can cause addiction, overdosing, or even death. It has to be carefully monitored, and I don’t want it to be a thing that your child is jumping up and down and you automatically give them [the medication]. Overuse of medication has negative side effects. It’s a balance, but at least it is opening the door for the lower-income persons to be able to acquire the drugs,” she said.

While the cause of ADHD is yet unknown, it has been suggested that it is genetic.

General symptoms of ADHD include lack of attention, impulsive behaviour, and, in some cases, hyperactivity. It is a myth, however, that students diagnosed with ADHD must be hyperactive. Hyperactivity is only seen in few cases.

Teenagers with ADHD face the additional stress of increased expectations, both academically and socially. ADHD is associated with poor grades, poor reading and comprehension, poor maths skills, and behavioural problems in school. Deficits in working memory and recall are notable. These students often have sleep disturbances.

The NHF card helps beneficiaries pay for a select list of prescription drugs, respiratory devices, diabetic supplies, and select diagnostic tests at participating pharmacies, laboratories, or doctors’ offices. The NHF covers a fixed amount of the total cost, with the balance being covered by patients.