How to Get an ADHD Diagnosis in the UK
People with ADHD are often confronted with a network of gatekeepers when seeking referral or assessment and support. It is clear that a few of these gatekeepers from NHS CCGs aren't adhering to national clinical guidelines or their legal obligation to prevent discrimination and health inequality.
Anecdotal evidence also suggests that some private ADHD clinics are not sufficiently controlled. This could lead to inconsistent diagnostic thresholds, and assessment reporting, which can create problems when trying to transfer to the NHS.
How do I obtain an appointment for a diagnosis?
ADHD is a mental health issue, meaning it can only be diagnosed by a healthcare professional with expertise. This includes psychologists and psychiatrists (who are the only qualified to diagnose ADHD in the UK). People suffering from mental health issues frequently report symptoms of ADHD particularly those who have struggled for a long time. They may feel trapped in their current situation, and in desperate need of assistance. However it is true that the NHS isn't always easy to navigate for those seeking a diagnosis.
You can receive a diagnosis via the NHS by asking your GP to refer you to a specialist. Your GP will take your concerns seriously and should be able refer you for an assessment but you may have to wait until the specialist is in.
When assessing for ADHD healthcare experts will examine the family history of ADHD and any other mental health issues you have had in the past. To determine your behavior, they'll examine you in a variety of settings, such as at school, home or at work. They will ask you to describe your symptoms and how they affect your daily life. They might also inquire about your relationships, social life and any other activities you engage in regularly.
A specialist will examine all the evidence before arriving at an assessment. They will look at criteria like being irritable and fidgety at all times, having a short-term memory, having difficulty staying focused, having difficulty keeping up with school or work, not finishing tasks and being extremely active. The diagnosis is based on the pattern of behaviors that can be seen in a variety of environments and affect your performance.
In the last few months, there has been a rise in the number of prominent people who have spoken out about their experiences of being diagnosed with ADHD. This has resulted in an increase of people seeking an assessment. This can result in long waiting times for healthcare professionals. Some families and patients opt to avoid the NHS by undergoing assessments at private clinics which can be costly. It is important to choose an healthcare provider you can trust and be honest about the symptoms you are experiencing.
What happens during the assessment process?
If you're self-referring or recommended by your GP the process of assessing for ADHD symptoms is essentially the same. The person conducting the test will ask questions about your symptoms and how they affect your daily life. For instance, "What problems do experience at home?" "How does your symptoms impact your work?" "Do you have other symptoms that you believe could be related to ADHD?"
Depending on where you go for your assessment, there may be different forms or questionnaires for you to complete before your appointment. Complete these forms in a timely manner will ensure that you don't have any delays in your appointment. It's also worth familiarising yourself with the traits (symptoms) of ADHD so that you can recognise them and discuss how they affect your life in depth.
The assessment will usually include an interview with psychiatrists, specialist nurses or other appropriately qualified healthcare professional. The therapist will assess both your mental health and ADHD symptoms to determine if they are caused by a different condition or not (NICE guidelines). The therapist will discuss with you the options for treatment that could include medication.
It is important to keep in mind that nurses, GPs and psychologists will not be as knowledgeable about adult ADHD as Psychiatrists with specialization It is therefore essential to prepare and practice your symptoms before you go for an assessment. This will enable you to communicate the impact that your symptoms are having in a way that is easily understood by them. You'll have to provide examples of how your symptoms have impacted your life in all areas including your work, your relationships, and over time.
As part of the evaluation, you could be required to take some tests, such as an allergy test. Your therapist could suggest additional tests to check if you have other medical problems.
You may be self-referring, or making use of the Right to Choose Scheme, however, you'll still have to wait for an appointment funded by the NHS. This can vary from NHS trust to NHS trust and clinician to clinician.
What is the outcome if I fail to get an appointment?
There are several things that can stop you getting diagnosed with ADHD. It is more difficult for certain groups of people to be diagnosed, such as those who are of color or a woman at birth, or if you have other mental health conditions like depression or bipolar disorder.
If you're having difficulty getting an answer, you can talk to your GP about it and asking for an appointment with a psychiatrist. You may also find a private psychiatrist who is specialized in adult ADHD tests. They can often offer a much faster service than the NHS.
The psychiatrist will analyze your symptoms and determine whether they fit the criteria for ADHD using the Nice guidelines as a guideline. They will also try to determine the cause of your problems, such as anxiety, depression or thyroid issues. This can be a thorough procedure, and it's not always easy for adults to provide all the evidence required (for instance, they may have trouble finding old school reports that are in the back of the cupboard).
You might not be diagnosed with ADHD even when your GP agrees. This is because a psychiatrist can only determine that your ADHD symptoms result in significant impairment. If they think that you don't meet the criteria, they will inform you why.
If you have been diagnosed with ADHD it is legal in the UK to seek treatment through the NHS. This applies to England, Wales, and Northern Ireland. You might also be able to get medication through an Individual Funding Request, but this depends on the location you live in. You may be referred to your local specialist to prescribe the medication you prefer. NHS specialists prefer Methylphenidate or Atomoxetine first and don't usually make plans for long titration periods.
Joining a support group, whether in person or on the internet for adults suffering from ADHD can be beneficial. They can be very supportive and reassuring, and it can help to share your story with people who understand.
How can I get treatment?
GPs can recommend adults to specialist ADHD services for assessment and treatment. These services are usually located in NHS hospitals or NHS community health teams. For instance the Maudsley Hospital, London, offers a nationwide ADHD diagnostic service for adults. However, many NHS healthcare providers do not accept these reports, and patients are often blocked from getting care. This is due to long waiting times or rejection of referrals.
Support groups reported at the consensus meeting that many ADHD sufferers seek out private assessments and diagnoses to circumvent the NHS's lack of funding in this area. Private clinics offer a much quicker and more efficient, and generally understanding diagnosis. They are also helpful in the screening of comorbidities like anxiety and depression which are very common in ADHD and can assist with titration to the final dose of the medication. Prices vary from PS500 to PS1,200, although sometimes a diagnosis and titration are charged separately.
The diagnosis and treatment for ADHD is different from person to person. Most people are treated with medication. It could be methylphenidates, such as Ritalin or Concerta or atomoxetine like Strateva. Sometimes, non-drug treatments are beneficial, like training and education for parents and families of individuals with ADHD. Some people with ADHD discover that a change in diet can help, as well as trying to establish a relaxing sleep routine. adhd diagnoses find that hypnotherapy and psychotherapy can help their symptoms. However the evidence supporting these treatments is not as extensive.
It is unacceptable that many adults with ADHD are unable to get the treatment and care they require on the NHS. This situation must be addressed urgently by UK governments and clinical and regulatory bodies. Patients with ADHD deserve to have access to treatment without discrimination and in line with their rights under the law. Long-term planning of funding, and a coordinated commissioning of social, health care and judicial services are essential to reduce this unmet need. The current state of affairs cannot be sustained and has a negative effect on the families of individuals and the society. It is now the time to invest in this area.