How to Get an ADHD Diagnosis in the UK
When seeking advice, assessment or assistance for ADHD Patients often have to deal with the network gatekeepers. It is clear that a number of these gatekeepers, notably in NHS CCGs, do not follow national clinical guidelines and their legal obligations to stop health inequalities and discrimination.
Anecdotal evidence suggests certain private ADHD clinics aren't properly controlled. This could result in inconsistent diagnostic thresholds and assessment reports that could cause problems when trying to transfer back to the NHS.
How do I get a diagnosis?
ADHD is an illness of the mind, meaning it can only be diagnosed by a healthcare professional with specialist knowledge. This includes psychologists and psychiatrists (who are the only professionals qualified to diagnose ADHD here in the UK). People with mental health conditions frequently report symptoms of ADHD especially those who have been struggling for a long time. They may feel trapped in their current situation, and are desperate for help. The NHS can be confusing for those looking for an answer to a medical condition.
It is possible to get a diagnosis through the NHS by asking your GP for a referral to see a specialist. Your GP will take your concerns seriously and should be able recommend you to an assessment but you may have to wait while the specialist is in.
In assessing you for ADHD health professionals will look at your family history of ADHD and any other mental health issues you have had in the past. They will be observing you in various settings, including at home and school or work to evaluate your behavior. You will be asked to describe your symptoms and how they affect your daily life. They may ask you about your social life, your relationships, and other activities you participate in frequently.
A specialist will review all the evidence before arriving at a diagnose. They will apply criteria such as being persistently active and fidgety, possessing an insufficient amount of attention, difficulty keeping up at work or school or work, having difficulty staying focused on work or tasks, not completing them and being a lot of active. The diagnosis is based on a pattern of traits that can be seen in a variety of environments and affect your performance.
In recent months there has been a rise in high-profile people talking about their experiences of being diagnosed with ADHD. This has resulted in an increase of people seeking an assessment. This can lead to long wait times for healthcare professionals. Patients and their families bypass the NHS in order to undergo assessments at private clinics. This is expensive. It is important to locate a healthcare professional you trust and be prepared to answer any questions honestly regarding your symptoms.
What happens during the process of assessment?
The method of the process of assessing ADHD symptoms is the same whether you self-refer or are referred by your GP. The person doing the assessment will ask you questions about how your symptoms affect your daily life, like "What issues do you face at home?", "How do your symptoms impact on work?", and "Do you experience any other symptoms you believe could be related to ADHD?"
You may need to fill out various forms or questionnaires before your appointment, depending on where you are going for your assessment. Filling out these forms as quickly as you can will prevent any delays to your appointment. It is also important to familiarize yourself with the signs of ADHD to be able to recognize the signs and their effects on your life.
The evaluation will usually include an interview with a psychiatrist or specialist nursing staff, or a qualified healthcare professional. The therapist will assess both your mental health and ADHD symptoms to determine if they're caused by another illness or not (NICE guidelines). The therapist will then go over possible treatment options with you which can involve medication.
It is important to keep in mind that GPs, nurses and psychologists will not be as well-versed in adult ADHD as specialist Psychiatrists, so it is important to prepare and practice your symptoms before you go to the test. This will help you describe your symptoms in a manner they can understand. You'll need to provide examples of how your symptoms have had an impact on every aspect of your life, from work to relationships and how they've changed over time.
You may have tests done as part of the assessment like a blood test to check for any allergies. Your therapist may suggest additional tests to check whether you have any other medical problems.
You may be self-referring, or making use of the Right to Choose Scheme, however, you'll still need to wait to get an NHS-funded appointment. This can differ from NHS trust to NHS trust, as well as from clinician to clinician.
What happens if I do not receive an appointment?
There are many factors that can prevent you from getting diagnosed with ADHD. Certain groups might have a difficult time getting diagnosed. For example that they are of color, were assigned female at birth or if they have other mental health conditions like depression or bipolar disorder.
If you're having difficulty getting a diagnosis, consider speaking to your GP about it and asking for an appointment with a psychiatrist. You could also find a private psychiatrist who is skilled in adult ADHD tests. They can provide a more rapid service than the NHS.
The psychiatrist will examine your symptoms to determine if they match the Nice guidelines for ADHD. They will also attempt to eliminate other causes of your issues, such as anxiety, depression or thyroid issues. This can be a very thorough procedure, and it's not always easy for adults to give all the evidence needed (for instance, they may have trouble finding old school reports in the back of the cupboard).
It's also possible that you will not be diagnosed with ADHD, even when your GP agrees to refer you. A psychiatrist can only diagnose ADHD in the event that they believe your ADHD symptoms are causing significant impairment. If they believe you don't meet the criteria, they will tell you the reason.
If you have been diagnosed with ADHD, it is legal in the UK to access treatment via the NHS. This is applicable to England, Wales, and Northern Ireland. You might also be able to access medication through an Individual Funding Request but this will depend on the area you live in. You could be referred by your physician to prescribe the medication of your choice. NHS specialists will recommend Methylphenidate and Atomoxetine first and don't usually make plans for long titration periods.
It is helpful to join an adult support group with ADHD in person and online. They can be very supportive and reassuring, and it can help to talk through your experience with people who understand.
What can I do to get treatment?
Adults can be directed to ADHD specialist services to be assessed and treated. Most often, these services are located in NHS hospitals and NHS community health teams, for example, the Maudsley Hospital in London offers a national ADHD adult diagnostic service. However there are many NHS health providers aren't able to accept these reports, and patients are often blocked from accessing care. I Am Psychiatry is due to lengthy waiting times or the rejection of referrals.
Support groups reported at the meeting of consensus that a lot of ADHD sufferers are seeking private assessments and diagnosis to overcome the NHS's inability to invest in this area. Private clinics can provide an accurate, professional and faster diagnosis. They are also helpful in identifying comorbidities like anxiety and depression which are very common in ADHD and can assist with titration to the final dose of the medication. Prices range from PS500 to 1,200 however, sometimes a diagnosis and titration are priced separately.
The treatment and diagnosis for ADHD is different from one person to another. The most common treatment is medication, which can be in the form of methylphenidates (Ritalin, Concerta) or atomoxetine (Strateva). Sometimes, non-drug interventions are useful, such as training and education for parents and families of people with ADHD. Certain people with ADHD have found that changing their diet and developing an appropriate schedule for sleep can help. Some people find that hypnotherapy or psychotherapy can ease their symptoms, but the evidence for these therapies is not as extensive.
It is inexcusable that so many adults with ADHD are not receiving the medical and treatment they require through the NHS. This situation must be addressed immediately by UK government officials and regulatory and clinical bodies. People suffering from ADHD need access to treatment that is free of discrimination and consistent with their legal rights. Long-term planning of funding, and a coordinated commissioning of social, health care and judicial services are vital to reduce this unmet need. The current situation is not sustainable and the effect on families, individuals and society is hugely damaging. It is time to invest in this area.