How to Get an ADHD Diagnosis in the UK
People with ADHD often face a network of gatekeepers when seeking referral, assessment and support. It is clear that many of these gatekeepers, notably in NHS CCGs, are not following the national guidelines for clinical practice and their legal obligation to avoid health inequality and discrimination.
Anecdotal evidence suggests certain private ADHD clinics aren't properly controlled. This can lead to different thresholds for diagnosis, and assessment reporting that could cause issues when trying to transfer to the NHS.
How do I find out if I have a diagnosis?
ADHD is a mental health condition that means it must be diagnosed by a healthcare professional who has expertise. This includes psychiatrists and psychologists (who are the only professionals qualified to diagnose ADHD in the UK). Patients with mental health issues frequently report symptoms of ADHD especially those who have struggled for a long time. They may feel trapped in their current situation and desperate for help. The NHS can be difficult for those looking for the diagnosis.
It is possible to receive an assessment through the NHS by asking your GP for an appointment with an expert. Your GP will be attentive to your concerns and should be able to refer you for an assessment however, you may have to wait while the specialist is in.
When assessing for ADHD healthcare experts will examine your family history of ADHD and any other mental health issues you've had in the past. They will also observe you in different situations, such as at home and school or work to evaluate your behavior. You will be asked to write about your symptoms and how they affect your daily life. They might ask you questions about your social life, your relationships, and other activities you engage in frequently.
A specialist will consider all of the evidence before making a diagnosis. They will make use of criteria, such as being persistently restless and fidgety, having an insufficient attention span and having difficulty keeping up with school or work, having trouble staying focused on work or tasks, not completing them and being overly active. The diagnosis is determined by the pattern of behaviors that can be seen in a variety of settings and affect your functioning.
In the last few months, there has been a rise in the number of well-known individuals who have opened up about their experiences with being diagnosed with ADHD. This has led to a spike in the number of people who are seeking an assessment, which could cause long wait times for healthcare professionals. Patients and their families bypass the NHS in order to have their medical examinations at private clinics. This could be expensive. It is important to choose an healthcare provider you can trust and be honest about the symptoms you are experiencing.
What happens during the test?
If you're self-referring or referred by your GP, the process of assessing for ADHD symptoms is essentially the same. The person who conducts the test will ask questions about your symptoms and how they impact your life. For instance, "What problems do experience at home?" "How does your symptoms affect your work?" "Do you have other symptoms that you believe could be related to ADHD?"
You may have to fill out different questionnaires or forms prior your appointment, based on the location you're taking for your examination. It is important to fill these out in the shortest time possible to ensure that your appointment won't be delayed. You should also familiarise yourself with the signs of ADHD to be able to recognise the signs and their effects on your life.
The assessment will typically include an interview with a psychiatrist, specialist nursing staff or a qualified healthcare professional. The therapist will evaluate your overall mental health and the specific signs of ADHD to see if they are being caused by any other condition, or are unrelated to any other condition (NICE guidelines). The therapist will go over with you the options for treatment that may include medication.
Keep in mind that nurses and doctors will not be as well-versed in adult ADHD as Psychiatrists. It is therefore important to identify your symptoms and practice them before you attend the assessment. This will help you explain the impact that your symptoms are having in a manner that is easily understood by them. You'll need to provide examples of how your symptoms have impacted on every aspect of your life from relationships to work and how they've changed in time.
You may have tests performed in the course of your examination for example, an examination of your blood to look for any allergies. If getting a diagnosis for adhd are suffering from any other medical problems your therapist could suggest additional tests to look for these, too.
You may be self-referring, or using the Right to Choose Scheme, however, you'll still have to wait for an appointment that is funded by the NHS. This can vary from NHS trust to NHS trust, and from clinician to clinician.
What happens if I don't have an answer to my question?
There are many factors that can prevent you from getting diagnosed with ADHD. It can be more difficult for some categories of people to be diagnosed, for example, 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 struggling to get a diagnosis, talk to your GP and ask for a referral. It's also worth trying to locate a private psychiatric service who specializes in adult ADHD tests. They can provide a more rapid service than the NHS.
The psychiatrist will look at your symptoms to determine if they match the Nice guidelines for ADHD. They will also look for other possible causes of your problem, such as depression, anxiety or thyroid problems. It can be a lengthy process and adults may not have all the information they require.
You might not be diagnosed with ADHD even you and your GP is in agreement. A psychiatrist is able to diagnose ADHD if they believe that your ADHD symptoms cause significant impairment. If they think you don't meet the criteria, they'll tell you why.
If you have been diagnosed with ADHD, it is legal in the UK to receive treatment through the NHS. This is applicable to England, Wales, and Northern Ireland. You could also get medication through an Individual Funding Request, but this depends on the location you live in. You may be referred an expert in your local area who will prescribe the medicine of your choice. NHS specialists will recommend Methylphenidate and Atomoxetine first and don't plan long titration phases.
Joining a support group whether in person or on the internet for adults suffering from ADHD can be beneficial. They can be extremely helpful and comforting and can assist to discuss your experiences with people who understand.
How can I get treatment?
Adults can be directed to ADHD specialist services for assessment and treatment. Most often, these services are located in NHS hospitals and NHS community health teams, for example the Maudsley Hospital in London offers an all-encompassing ADHD adult diagnostic service. However, a large number of NHS healthcare providers do not accept these reports as valid and patients frequently face obstacles in their access to treatment including long waiting times and the rejection of referrals (see below).
Support groups informed the consensus meeting that many ADHD sufferers are seeking private assessments and diagnosis to avoid the NHS's lack of funding in this area. Private clinics provide a more accurate, professional and speedier diagnosis. They can also assist in screening for comorbidities, such as depression and anxiousness which are common in ADHD. They can assist with titration of the final dose. The cost ranges from PS500 to PS1,200. Sometimes, a diagnosis and dosage are priced separately.
The diagnosis and treatment for ADHD varies from person to person. The majority of people are treated with medication. This may be methylphenidates, such as Ritalin or Concerta or atomoxetine like Strateva. Other interventions that are not drugs can be beneficial like education and training for parents and families of people with ADHD. Some people suffering from ADHD find that a change in their diet can help, as does trying to develop a sleep-friendly routine. Some people find that psychotherapy and hypnotherapy may alleviate their symptoms. However the evidence behind these therapies is less extensive.
It is unacceptable that so many people suffering from ADHD cannot access the treatment and care they require through the NHS. The UK government, the clinical and regulatory authorities must take action urgently to address this situation. People with ADHD should have access to treatment, free from discrimination and in line with their rights under the law. Long-term planning of funding and joined up commissioning of health, social care and judicial services are crucial to address this need that is not being met. The current situation isn't sustainable and the impact on individuals, families and society is hugely damaging. It is time to invest in this area.