The One with the ADHD Tax: Part 2 - The Collective ADHD Tax
Alexia Hetzel
Coach and Consultant | Founder of a boutique life design practice | Specialised in ADHD | Neurodiversity Advocate and Speaker | TEDx Speaker
While the individual ADHD tax is burdensome, the collective ADHD tax – the costs borne by society – is also significant. This includes the impact on the healthcare system, the insurance system, businesses that hire individuals with ADHD, and even those that don’t.
The collective ADHD tax also represents a subtle yet demonstrable opportunity cost to society. Let’s dive into what the collective ADHD tax looks like, why you should care, how to minimise it collectively, and how ADHD coaching can help reduce these broader costs.
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The Impact on the Healthcare System
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Increased Healthcare Costs
People with ADHD often require more medical services due to the physical and mental health issues associated with this cognitive profile throughout their entire lifespan. This leads to higher healthcare costs for everyone. ADHD is linked to higher rates of anxiety, depression, and substance abuse, to name a few, all of which require treatment or support. ADHD plays a significant role in many co-occurring conditions as well as an individual’s overall life trajectory.
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Higher Insurance Premiums
Insurance companies often (knowingly or not) charge higher premiums for individuals with ADHD due to the increased risk of accidents (e.g. car accidents) and health issues. This is because the ADHD brain struggles with attention, memory and impulse control, leading to more frequent accidents.
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The Impact on Businesses
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Productivity Loss
ADHD can lead to lower productivity at work. But just how much are we talking? This study tells us ADHD was linked to 35 lost workdays annually in the U.S. in 2005, adding up to 120 million lost workdays, costing $19.5 billion in lost productivity. Just as an example.
Employees with ADHD may struggle to complete tasks on time, keep up with workloads, sustain momentum in projects, and maintain consistent performance. The executive function deficits in ADHD make it challenging to plan, prioritise, and execute tasks efficiently.
ADHD also contributes to higher rates of absenteeism and burnout. The chronic stress and anxiety associated with compensating for or masking ADHD symptoms in the workplace can lead to fluctuations in productivity levels, self-confidence levels, and sociability levels.
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Opportunity Cost
The opportunity cost of not fully utilising the potential of individuals with ADHD is significant. Many people with ADHD are highly creative and innovative, but this advantage may go unnoticed or underutilised due to the challenges they face. This underutilisation is a loss not only for the individuals but for society as a whole. The ADHD brain often excels in divergent thinking and creativity, which are valuable assets across all fields (more on this below).
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Entrepreneurs by Default vs. Entrepreneurs by Intent
ADHDers often leave traditional employment to become entrepreneurs, becoming 'entrepreneurs by default'. This is someone who will try self-employment because they didn’t find a fit in traditional employment. In contrast, an 'entrepreneur by intent' is someone who genuinely has the motivation and an idea to put to market and has or will find the resources to do it. While entrepreneurship creates value for the economy, many companies that cannot retain these profiles miss out on potential innovative talents that could be amazing intrapreneurs.
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The Broader Economic Impact
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Unemployment and Underemployment
Higher rates of unemployment and underemployment among people with ADHD lead to a loss of potential economic contributions. Underemployement is when someone is employed part-time or in a job that is (financially or in substance/content/level of responsibility) below their qualifications or abilities. This means a significant portion of the ADHD workforce is not contributing to their full potential but is also paying less tax, leading to additional strain on social support systems.
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Costs to the Education System
Students with ADHD often require additional support and resources, which can be costly for the education system. ADHD impacts executive function in many aspects of early education, making it harder for students to follow instructions, complete assignments, and stay organised. While the cost of those support structures costs can be considered an investment in the future of ADHD youths, a number of school systems in many parts of the world are not often equipping their staff with the means of detecting, including, or supporting ADHD students.
ADHD can be more or less disabling from a very young age depending on the level of awareness and training of school/university staff – it is not just a matter of financial or staffing resources. I still regularly meet or hear of teachers/educators who ‘do not believe’ in ADHD as a clinical diagnosis, let alone as a unique pattern of thinking to be leveraged.
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ADHD in the Prison System
ADHD prevalence seems to be significantly higher in the prison population compared to the general public. This is in part because the impulsivity and risk-taking behaviours associated with ADHD can lead to antisocial behaviour, and criminal activities and subsequent incarceration.
With ADHD connected with greater unemployement and financial instability, and also being highly hereditary, it is not unreasonable to extrapolate that ADHDers may be more likely to have been born, raised, or educated/schooled in familial or economic contexts that are connected to less opportunities for healthy or socially-accepted life trajectories.
Greater awareness and better management of ADHD in connection with the prevention of criminal activitycould help reduce these prevalence numbers in the carceral population. Providing ADHD coaching and support from an early age could prevent individuals from engaging in illegal activities by teaching them the impulse control and decision-making strategies that their ADHD makes more challenging to learn. This would benefit not only the individuals themselves but also reduce the societal costs associated with the criminal justice system.
It is my professional dream to one day have a pay-it-forward coaching system, through which clients who can afford my rates have the option to pay an additional premium, which would help support me in doing a number of fixed hours of pro-bono coaching in prisons, as part of rehabilitation programs. A virtuous loop of solidarity, while waiting patiently for society to bring collective, systemic solutions to the ADHD ‘problem’. Because let’s not forget: we are not talking about a negligible proportion of the world population. The estimated prevalence of ADHD is 2.8% in adults (or more depending on the studies you read), many studies point towards the finding that it is under-diagnosed.
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Desirable Skills in Today’s Job Market
Another reason why this is so important is that ADHDers possess many of the skills desirable in today’s job market and economy, such as creativity, original thinking, problem-solving and resilience. ADHDers often excel in roles requiring innovation, risk affinity and adaptability, making them valuable assets not only in existing industries, but also future ones.
These skills are critical in an ever-changing work environment, the foundations of which continue to be challenged, not the least by artificial intelligence. Being able to memorise things or accumulating expertise in the form of stacked facts for example, is no longer relevant. With this phenomenon, the nature of what is regarded as expertise will evolve and so will the way of putting a pricetag on someone’s CV.
One recent study showed that the very nature of ADHDers’ diffused attention (elegantly named in the study as “continual environmental scanning”), is precisely what makes them naturally able to see connections and identify gaps in the market and business opportunities. It might be widely considered pathological, but it sure seems pretty handy.
If your ADHD child’s school report card reads “distracted” or “scattered”, please believe that not all is lost - you and your child have plenty of time to reframe and see how to apply this as a positive attribute.
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Lowering the Hurdles: A Collective Responsibility
Lowering the hurdles for people with ADHD to function, and even thrive, is a collective responsibility. Here are some key areas where change is needed:
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Education System
The education system needs to be more aware of and accommodating to ADHD and adapted learning styles. This includes training teachers to recognise and support ADHD students, providing accommodations such as extra time on tests, and incorporating more hands-on and interactive learning and assessment methods.
I know this can sound overwhelming to read for the many teachers out there whose resources are already being stretched very, very thin. My recent trip to Paris for France’s national ADHD day really showed me how cynical some educators and teachers understandably are when it is put to them that they ‘just’ need to be more flexible and accommodating. But once again: if you can’t operate a systemic change all on your own, simply informing yourself and becoming aware of how ADHD can show up in your students, in good and in bad, will go a long way. One person at a time.
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Workplace
Workplaces will want to adapt to provide environments where ADHD employees can thrive. This might include flexible work hours, allowing for movement breaks, and creating quiet spaces free from distractions. What it will most certainly include is a new, more nuanced relationship to some of the traits traditionally associated with productivity (e.g. linear performance) or generally workplace-appropriate behaviours (e.g. obedience, diligence, or reliable social interaction batteries).
Employers should focus on strengths-based approaches, leveraging the unique skills of each individual (including those they may too easily classify as ‘odd’, ‘not easy’, or ‘always interrupting others’) can bring to the table. Not all employers must do this – just those who want to not miss out on true innovation potential.
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Societal Attitudes
Societal attitudes towards ADHD are (s l o w l y) starting to shift towards understanding and acceptance. Continuing to reduce the stigma associated with ADHD will encourage more people to seek information, diagnosis and support. Public awareness campaigns and education can play a significant role in changing perceptions. And I’m not talking about Netflix documentaries that reduce ADHD to pill taking.
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Supporting Entrepreneurship
Providing resources and support for ADHD entrepreneurs can help them succeed. This includes access to funding, mentorship programs, and business training tailored to their needs. By supporting ADHD entrepreneurs, we can harness their creativity and drive to benefit the broader economy.
It is important to note that traditional business/entrepreneurship coaching approaches may not help ADHD entrepreneurs. In fact, traditional methods could very well reinforce the feelings of low self-efficacy that many ADHDers apprehend life with. A differently-wired brain calls for different leverage. Enter ADHD coaching!
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How ADHD Coaching Can Help
ADHD coaching doesn’t just benefit individuals; it also positively impacts society. By helping people with ADHD manage their traits more effectively, coaching can reduce healthcare costs, improve productivity, and help individuals reach their full potential.
Convinced Yet?
The ADHD tax, both individual and collective, is a significant burden. But by understanding its components and implementing strategies to manage it, we can improve financial stability and well-being for individuals and society.
Investing in ADHD coaching can make a meaningful difference, helping to mitigate these costs and create a more supportive environment for those with ADHD. While it is impossible at this stage to quantify the likely benefits of taking the business case of ADHD seriously, I hope this article gave you some idea of the cost of ignoring it.
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