Why a 2012 paper still reads like today’s headline — and why that’s a problem.
In 2012, a group of leading ADHD researchers published a paper with a blunt title: “ADHD matures: time for practitioners to do the same.”
It was clear, evidence-based, and optimistic: ADHD is real, it persists into adulthood, we know how to treat it, and health systems need to catch up.
Fast-forward to 2025, and here’s the uncomfortable truth — you could reprint that paper today with barely a word changed, and no one would think it was old. That’s not because the science hasn’t moved forward.
It has.
It’s because the system hasn’t.
The science was settled. The services weren’t.
The authors laid out what we still know to be true:
ADHD affects around 3–4% of adults.
It is highly heritable (~76%) and has measurable differences in brain structure and function.
It is not culturally bound.
Untreated, it carries higher risks of unemployment, relationship breakdown, substance use disorders, and criminal justice involvement.
They also pointed to a glaring problem: most adult ADHD cases remain undiagnosed because clinicians aren’t trained to see it, services aren’t structured to deliver care, and professional attitudes often lean toward scepticism or outright dismissal.
It was a call to action. And yet…
The stigma didn’t go away — it just changed shape.
In 2012, the stigma was often about whether ADHD existed in adults at all. In 2025, the script has shifted, but the chorus remains the same. Now, we see a creeping trend of “ADHD minimisation” — public voices claiming the rise in diagnoses is a fad, or worse, a dangerous medicalisation of normal life.
These aren’t just fringe internet takes.
They seep into policy conversations, editorial columns, and sometimes, unfortunately, into consulting rooms. For someone living with late-diagnosed ADHD, the damage is real:
Every dismissal chips away at self-understanding.
Every delay in access prolongs years — sometimes decades — of coping without the right tools.
Late diagnosis isn’t just “the same, but later.”
One of the most misunderstood truths about adult ADHD is that its impact is shaped by when you are diagnosed.
Early diagnosis allows scaffolding — support systems, medication, strategies — to develop alongside you.
Late diagnosis often means a life built on coping mechanisms that worked “just enough” to get by, until they didn’t. Careers stall. Burnout cycles deepen. Self-esteem erodes under decades of “Why can’t I just…?”
The 2012 paper didn’t just point to underdiagnosis — it highlighted the training gap. Most psychiatrists, psychologists, and GPs receive minimal, if any, education on recognising ADHD in adults. In the UK and much of Europe, that gap remains - based on the data - but based on personal experience, South Africa too.
And it’s even more dangerous for late-diagnosed adults, whose symptoms may look different from the textbook childhood version.
What the authors wanted then — and what we still need now.
Back then, Bolea and colleagues called for:
Training mental health professionals to diagnose and treat adult ADHD.
Integrated services — so ADHD sits alongside depression and anxiety in mainstream mental health care.
Transition protocols so young people don’t vanish between child and adult services.
Multi-modal treatment — medication, psychological/occupational support and Coaching.
Criminal justice screening — given the high prevalence of ADHD among offenders.
We could copy and paste that list into a policy briefing today and it would still be a to-do list.
The cost of standing still.
The societal bill for untreated ADHD is staggering — lost productivity, increased healthcare use, higher justice-system involvement. But the human cost is harder to tally:
The gifted student who burns out before 30.
The worker who loses job after job for “underperforming” despite working twice as hard.
The parent who only sees their ADHD after their child is diagnosed — and wonders how different life could have been.
The tragedy isn’t just that we’re failing to act on twelve-year-old recommendations. It’s that every year we don’t act, the gap widens for those still waiting to be seen, heard, and helped.
So, what now?
If ADHD “matured” decades ago, the least our systems can do is grow up with it. That means:
Mandatory ADHD training in all health professional education.
Guaranteed transition services for adolescents into adult care.
Integrated treatment accessible from any mental health entry point.
Routine screening in criminal justice and addiction services.
Public campaigns to dismantle modern stigma and address the minimisation trend.
We don’t need another decade of “emerging evidence.” We need decisive, unapologetic action.
Because the science is clear. The lived experience is clear. And the cost of doing nothing? We’ve already paid it — in wasted potential, preventable suffering, and lives cut short by systems that refused to evolve.
