How to Get an ADHD Diagnosis in the UK
People with ADHD typically have to deal with a number of gatekeepers when seeking referral or assessment and support. It is evident that some of these gatekeepers from NHS CCGs are not following the national guidelines for clinical practice or their legal duty to avoid discrimination and health inequalities.
Anecdotal evidence also suggests that some private ADHD clinics aren't properly regulated. This may result in an inconsistency in diagnostic thresholds and assessment reporting that could cause problems when trying to transfer to the NHS.
How do I get a diagnosis?
ADHD is a mental health condition that means it must be diagnosed by a healthcare professional with specialist knowledge. This includes psychologists and psychiatrists (who are the only ones qualified to diagnose ADHD here in the UK). Patients with mental health issues often report symptoms of ADHD especially those who have been struggling for a long time. This means they may feel stuck in their current circumstances and need assistance to improve their lives. However, the NHS isn't always easy to navigate for those seeking an assessment.
You can get an assessment through the NHS by asking your GP to refer you to a specialist. Your GP will be attentive to your concerns and be able to refer you for an assessment but you may have to wait while the specialist is in.
When evaluating for ADHD healthcare specialists will review the family history of ADHD and any other mental health issues that you've had in the past. They will be observing you in various settings, including at home, at school or at work, to assess your behaviour. You will be asked to write about your symptoms, and how they impact your daily life. They may also ask about your social life, relationships and other activities you engage in regularly.
A specialist will consider all of the evidence before making a diagnosis. They will use criteria like being unrestful and fidgety all the time and having an insufficient memory for short-term events, having difficulty staying focused or keeping up at school or at work, not completing tasks, and being extremely energetic. The diagnosis is dependent on an array of characteristics that are present in multiple situations and impact your performance.
In recent months, there has been an increase in the number of celebrities sharing their stories of being diagnosed with ADHD. This has resulted in an increase in people seeking a diagnosis. This can lead to long waiting for healthcare professionals. Some patients and their families opt to bypass the NHS in order to be assessed at private clinics. This can be costly. It is essential to choose an healthcare provider you trust and be honest about the symptoms you are experiencing.
What happens during the test?
Whether you're self-referring or getting recommended by your GP, the process of assessing ADHD symptoms is similar. The person conducting the assessment will ask you questions about how your symptoms affect your daily life, for example "What difficulties do you encounter at home?", "How do your symptoms impact on work?", and "Do you have any other symptoms that you think might be related to ADHD?"
You may have to fill out different forms or questionnaires before your appointment, depending on the location you're going to for your assessment. Complete these forms in a timely manner will ensure that you don't have any delays during your appointment. It is also important to familiarize yourself with the signs (symptoms) of ADHD so that you can recognise the signs and the ways they affect your life in detail.
The test will usually involve an interview with a psychiatrist, specialist nurse or any other qualified healthcare professional. The therapist will evaluate your mental health and ADHD symptoms to determine if they're caused by another condition or not (NICE guidelines). The therapist will then discuss possible treatment options with you which can involve medication.
It's worth remembering that nurses, GPs and psychologists aren't as well-versed in adult ADHD as Psychiatrists who specialize in it and therefore it is essential to prepare and practice your symptoms before you go to the test. This will allow you to explain your symptoms in a way they can understand. You'll need to provide examples on how your symptoms have affected your life in all aspects including your work, your relationships, and over time.
You might have some tests taken as part of the assessment, such as a blood test to check for any allergies. Your therapist could suggest additional tests to determine if you have other medical problems.
If you self-refer, or are enrolled in the Right to Choose scheme, it is important to remember that even though you pay for your private evaluation however, you must wait for NHS funded appointments - and this may differ between NHS trusts and from one clinician to another.
What is the outcome if I fail to get an appointment?
There are many factors that could prevent you from being diagnosed with ADHD. Certain groups could have a difficult time getting diagnosed. For instance that they are of color or were assigned female at birth or if they have any other mental health conditions like bipolar disorder or depression.
If how to get an adult adhd diagnosis are struggling to get an answer, you can talk to your GP about it and asking for a referral to a psychiatrist. You may also find a private psychiatrist who specializes in adult ADHD tests. They often provide more rapid service than the NHS.
The psychiatrist will look at your symptoms and determine whether they meet the criteria for ADHD using the Nice guidelines as a reference. They will also look for other possible causes for your issue like anxiety, depression or thyroid problems. This can be a thorough process, and it'sn't always easy for adults to give all the evidence needed (for example they might be unable to locate old school reports in the back of the cupboard).
It is possible that you are not diagnosed with ADHD even if your GP agrees. A psychiatrist is able to diagnose ADHD if they believe that your ADHD symptoms are causing significant impairment. If they think that you don't meet the criteria, they will inform you why.
If you've been diagnosed with ADHD it is legal in the UK to receive 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 will depend on the location you live in. You could be referred to an expert in your local area who will prescribe the medicine you prefer. NHS specialists recommend Methylphenidate or Atomoxetine first and don't usually think of long titration cycles.
It is beneficial to join a support group for adults with ADHD in person and online. They can be helpful and reassuring. It is also helpful to share your experiences with other people who understand.
How can I get treatment?
Adults may be sent to ADHD specialist services to be assessed and treated. They are typically located in NHS hospitals and NHS community health teams. For instance, the Maudsley Hospital in London offers a nationwide ADHD adult diagnostic service. However there are many NHS health providers aren't able to accept these reports and patients are often denied receiving treatment. This is due to long waiting times or the rejection of referrals.
Support groups informed the consensus meeting that many ADHD sufferers seek private assessment and diagnosis to avoid NHS's lack of investment in this area. Private clinics provide a more accurate, professional and speedier 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. Costs vary from PS500-PS1,200, although sometimes a diagnosis and titration is priced separately.
The diagnosis and treatment for ADHD will differ from individual to individual. Most people are treated with medication. This may be methylphenidates, like Ritalin or Concerta, or atomoxetine, like Strateva. Non-drug interventions can be beneficial for education and training for families and parents of people with ADHD. Some people with ADHD have found that altering their diet and creating an effective sleep schedule can help. Some people have found that psychotherapy and hypnotherapy may alleviate their symptoms. However the evidence behind these treatments is not as extensive.
It is unacceptable that many people suffering from ADHD are not receiving the treatment and care they need through the NHS. The UK government, clinical and regulatory authorities need to act urgently to correct this situation. People with ADHD must have access to treatment that is devoid of discrimination and in accordance with their legal rights. Long-term planning of funding and joined up commissioning of health, social care and judicial services are essential to reduce this unmet need. The current state of affairs is not sustainable and the impact on families, individuals and society is hugely damaging. It is time to invest in this area.