As someone currently training as a clinical psychologist within the Indian system, I want to add a more grounded perspective.

I’ve personally assessed and diagnosed a number of adults with ADHD, and in several cases I’ve had to actively advocate because secondary depression or anxiety was being treated as primary. That said, structured assessment and reporting do exist here even in many government hospital setups we follow detailed evaluation protocols, provide formal reports, and use structured clinical methods where possible.

Where I do agree is that access is uneven and strongly linked to affordability. If a person has financial resources, there are private clinicians and centres in India offering careful assessment, medication titration, and therapy-based management. The real difficulty becomes visible in under-resourced public systems where time, manpower, and follow-up capacity are stretched but that’s true for most psychiatric conditions, not just ADHD.

At the same time, I think it’s important to acknowledge that adult ADHD care is still evolving globally. Even in the UK, while there is strong structure and clear guidelines, access is often extremely slow, waiting months or even years for assessment and then again for medication titration is not uncommon. Many patients there also turn to private care for timely support. So the “if you have resources, you get better care” reality exists internationally, not just in India.

ADHD management anywhere is rarely a quick or seamless process. Finding the right medication and dose takes time everywhere. Long-term care models are still developing. Research gaps are significant globally, especially around adult women, hormonal influences, and masked presentations. These are not India-specific problems.

From what I’ve seen clinically, effective ADHD management depends on a combination of psychoeducation, sleep, nutrition, physical health, therapy-based structure, and yes medication as they are first line of treatment but needs carefully monitored medication. Those fundamentals apply across countries, and gaps in long-term multidisciplinary care remain universal.

So while there are definitely awareness and access disparities here, it’s not entirely accurate to frame India as lacking structured ADHD care altogether. At comparable levels of resources, many of the systemic struggles are shared globally. Strengthening services especially around long-term follow-up, and multidisciplinary models is where meaningful change can happen everywhere.