In this blog, Dr Abbey Rowe, DECIPHer shares key findings from her doctoral research on how secondary schools shape the mental health of learners with ADHD, along with research‑informed recommendations for actions schools can take to reduce mental health inequalities for these learners and better support them.
With increasing focus on inclusion and well-being in Welsh schools, this is an important moment to reflect on what’s working, and what could work better for learners with ADHD.
For many young people with ADHD, mental health challenges such as anxiety and depression are common and can have consequences that extend well beyond school. Understanding how schools shape the mental health of learners with ADHD is therefore key to identifying how they can be better supported.
Analysis of School Health Research Network (SHRN) survey data from Wales found that mental health outcomes for learners with ADHD-related symptoms varied little between schools. At first glance, this might suggest that schools make little difference to the mental health of learners with ADHD, but interviews with learners and staff across three schools painted a more complex picture.
Participants identified a wide range of school‑based factors they believed influenced the mental health of learners with ADHD, and what stood out was not the similarity betweenschools, but the inconsistency within them.
“We could do something in one lesson and be completely fine, and then do it in another lesson and get into tons of trouble… all teachers need to be on the same wavelength.”
Learner
This suggests that the issue may not lie in individual schools themselves, but in how consistently support is experienced within them.
This matters because improving the mental health of learners with ADHD does not necessarily require a complete structural change. Instead, learners may benefit from more consistent messages of understanding, flexibility and support embedded across everyday school practice.
Where Schools Unintentionally Create Challenges
Across interviews, learners and staff described a mismatch between the expectations and demands of school life, and the characteristics of learners with ADHD, cumulatively contributing to poorer mental health over time.
“[…] it just really puts me down […] it makes me feel that I haven’t tried enough when I have tried my best, and it just makes me feel that my best isn’t good enough for these teachers sometimes.”
Learner
Feeling understood by teachers and peers emerged as particularly important, with ADHD knowledge and empathy seen as supporting engagement and well-being, and misunderstanding being linked to stress, stigma and withdrawal.
Interviews also highlighted how school systems and structures shape inclusion for learners with ADHD, with gaps in staff training, inconsistent flexibility, limited time and resources, and diagnosis‑led processes often restricting effective support.
These challenges are not inevitable , and importantly, many can be addressed through small, everyday changes in practice.
What Schools Can Do Now to Make an Immediate Difference
While structural change depends on funding and national policy, there are things schools can do now, many of them small, but meaningful.
These following suggestions were developed with school partners and people with lived experience of ADHD:
Build a Shared Understanding and Culture of Acceptance of ADHD
Use existing expertise within school communities, ALN teams and evidence‑based resources to develop ongoing, shared understanding of ADHD, neurodiversity and individual variations. This doesn’t have to mean large-scale training programmes , it can start with short conversations in staff meetings, peer learning, assemblies, or tutor time.
“It would be helpful… to have something in place for people to understand what it’s like to have ADHD… so we don’t have to keep explaining ourselves.”
Learner
The focus should be on understanding neurodiversity and recognising individual differences, not just labels or diagnoses. Treat understanding ADHD as a continuing process rather than a single CPD session.
Make Support Needs‑Led, Not Diagnosis‑Led
Where possible, ensure support is available based on a learner’s needs rather than waiting for a formal diagnosis. Normalising adjustments that support regulation, organisation and engagement for all learners can reduce stigma, prevent delays in support, reduce reliance on ALN teams, and ensure no one is left unsupported while assessments are ongoing.
Prioritise Consistency of Everyday Practice
Consistency across classrooms is key. Agree and communicate a small number of inclusive practices available consistently across classrooms, such as predictable routines, flexible learning options, regular regulation breaks, and clearly explained objectives and instructions.
Where learners already have support plans in place, these should be implemented reliably and reviewed collaboratively with the learner to identify and address any challenges.
Put Relationships at the Centre
Embed simple relational practices into daily school life, such as checking in with learners explaining decisions, listening to preferences, and involving learners in conversations about what helps them feel supported and to strengthen trust.
This might be as simple as a brief check-in at the start of a lesson, or recognising when a learner is trying, not just when they succeed.
“When you have a relationship with your teacher… you feel more encouraged to do well.”
Learner
Take a Compassionate Approach to Behaviour
Move towards calmer, more compassionate responses to behaviour by reducing reliance on punitive approaches and prioritising empathy, understanding of ADHD, and appropriate support. Creating spaces for regulation, using strength‑based approaches, and responding to behavioural incidents with respectful language can help all learners feel safer, more understood and better supported across the school community. Importantly, many of these approaches benefit all learners, not just those with ADHD.
“We need to celebrate ADHD… instead of trying to get these kids to conform…”
Teacher
Prioritise Time To Share What Works
This might involve discussing difficulties, exchanging solutions, and gently challenging assumptions about learners’ behaviour and abilities. Importantly, any time created needs to come from rebalancing existing priorities, rather than adding to already stretched workloads.
Small Changes, Bigger Messages
It’s important to recognise that lasting school improvement would benefit greatly from wider support, including sufficient funding, clearer guidance, and more accessible diagnostic pathways. Without these, there’s a risk of placing too much pressure on schools.
However, waiting for system‑level reform should not mean standing still. Small, consistent changes can send a powerful message to learners: ‘You are understood, you are accepted, and support is not conditional.’
When that message is reflected across policies, classrooms, and teachers, schools can reduce daily stress for learners with ADHD. By better supporting these learners, schools can create environments that feel more supportive, inclusive and importantly enjoyable for everyone.
Even small changes can be a catalyst for good. Consistency, compassion and understanding remain among the most powerful tools schools already have. The challenge is not knowing what to do — it’s doing it consistently, every day, in ways that work for all learners.
