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How to Get an ADHD Diagnosis in the UK People with ADHD are often confronted with a network of gatekeepers when seeking referrals or assessment and support. It is evident that a number of these gatekeepers, notably in NHS CCGs, are not following national clinical guidelines and their legal duty to prevent health inequality and discrimination. Anecdotal evidence also suggests that some private ADHD clinics are not sufficiently regulated. This can result in inconsistent diagnostic thresholds, and assessment reporting, which can cause issues when trying to transfer to the NHS. How do I obtain a medical diagnosis? ADHD is a mental health condition which means 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 struggled for a long time. They may feel trapped in their current circumstances, and desperate for help. The NHS can be confusing for those seeking the diagnosis. It is possible to obtain an diagnosis through the NHS by asking your GP for an appointment with an expert. Your GP will take your concerns seriously and might refer you to an expert for an assessment. However, you might be required to wait until a specialist is available. To assess your ADHD medical professionals look at any mental health issues you may have faced in the past and your family history. They will be observing you in various environments, such as your home, at school or at work, to assess your behaviour. You will be asked to describe your symptoms and how they affect your daily life. They may also ask about your relationships with friends, social life and any other activities that you do on a regular basis. A specialist will review all the evidence before making an assessment. They will use criteria for example, being perpetually distracted and fidgety, having a short attention span or difficulty focusing at work or at school and having difficulty staying focused on work that are not completed, and being overly active. The diagnosis is dependent on the pattern of behaviors that can be observed in different settings and affect your functioning. In recent months, there has been an increase in the number of well-known individuals 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 lead to long wait times for healthcare professionals. www.iampsychiatry.uk and their families opt to bypass the NHS in order to undergo assessments at private clinics. This is expensive. It is essential to choose an healthcare provider you can trust and be honest about your health issues. What happens during the assessment process? If you're self-referring or referred by your GP the process of assessing ADHD symptoms is very similar. The person doing the assessment will ask you questions about how your symptoms affect your daily life, for example “What problems do you experience at home?”, “How do your symptoms impact on work?”, and “Do you experience other symptoms you believe could be related to ADHD?” Depending on the location you visit for your evaluation There may be various forms or questionnaires for you to fill out prior to your appointment. It is important to complete these forms in the shortest time possible to ensure that your appointment doesn't get delayed. It is also essential to be familiar with the signs of ADHD to be able to recognise them and talk about their impact on your life. The test will usually involve an interview with psychiatrists, specialist nurses or other appropriately qualified healthcare professional. The therapist will assess your overall mental health, and the specific symptoms of ADHD to determine whether they are caused by any other condition or are not related to any other medical condition (NICE guidelines). The therapist will go over with you the options for treatment that could include medications. Be aware that nurses and GPs are not as well-versed in adult ADHD as psychiatrists. It is therefore important to plan your symptoms and practice them before you take part in the examination. This will enable you to communicate the impact that your symptoms are having in a manner that they can understand. You'll have to provide examples of how your symptoms have impacted your life in all areas, from your work to your relationships, and then over time. You may have tests performed in the course of your examination like an examination of your blood to look for any allergies. If you have any other medical conditions your therapist could suggest additional tests to test for these, too. If you self-refer or going through the Right to Choose scheme, it is important to understand that, even if you pay for your private examination but you will still need to wait for NHS funded appointments – and this can differ between NHS trusts and from one physician to another. What happens if I don't get a diagnosis? You can be diagnosed with ADHD if you have several factors that favor you. Certain groups might have a harder time getting diagnosed. For instance when they are of color, were born female or if they suffer from other mental health diagnoses such as bipolar disorder or depression. If you're having trouble getting a diagnosis, talk to your GP and ask for a referral. It is also a good idea to locate a private psychiatric clinic who specializes in adult ADHD evaluations. They can often offer an earlier service than the NHS. The psychiatrist will evaluate your symptoms to determine if they match the Nice guidelines for ADHD. They will also attempt to determine the cause of your problems, such as anxiety, depression, or thyroid issues. This is 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's also possible that you won't be diagnosed with ADHD, even the GP is willing to refer you to a psychiatrist. This is because a psychiatrist can only determine that your ADHD symptoms cause significant impairment. If they believe that you do not meet the criteria, they will inform you the reason. In the UK, it is legal in the UK to get treatment through the NHS in England, Wales and Northern Ireland if you have a diagnosis of ADHD. You might be able to receive medication through an individual funding request, but it is contingent on where you live. You may be referred to your doctor to prescribe the medication you prefer. NHS specialists will recommend Methylphenidate and Atomoxetine first and don't usually think of long titration cycles. Joining a support group whether in person or on the internet, for adults with ADHD can be beneficial. They can be a source of support and calm. It can also help to share your story with others who understand. What can I do to get treatment? Adults are referred to ADHD specialist services to be assessed and treated. These services are usually located in NHS hospitals or NHS community health teams. For example the Maudsley Hospital, London, offers a national ADHD diagnostic service for adults. However, a majority of NHS healthcare providers do not recognise these reports as valid and patients frequently face obstacles in their access to treatment, notably long waiting times and rejection of referrals (see below). Support groups reported at the consensus meeting that many ADHD sufferers seek private assessment and diagnosis to avoid the NHS's inability to invest in this area. Private clinics provide a more precise, professional and quicker diagnosis. They can also assist in screening for comorbidities, like anxiety and depression that are prevalent in ADHD, and in helping with titration until the final dose of the medication. The cost can vary from PS500 to PS1,200. Sometimes, a diagnosis and dosage are priced separately. The treatment and diagnosis for ADHD can vary from person to person. The majority of people are treated using medications. It could be methylphenidates, like Ritalin or Concerta or atomoxetine like Strateva. Other interventions that are not drugs can be beneficial for education and training for families and parents of people with ADHD. Certain people with ADHD discover that a change in diet helps, as well as developing a sleep-friendly routine. Some people have found that psychotherapy and hypnotherapy may alleviate their symptoms. However, the evidence for these therapies is less extensive. It is inexcusable that many adults suffering from ADHD are unable to get the care and treatment they require from the NHS. The UK government, the clinical and regulatory authorities must act urgently to correct this situation. People with ADHD deserve to have access to treatment without discrimination and in accordance with their legal rights. To reduce this unmet demand it is crucial to create long-term plans for funding and commission health, social care, and judicial services together. The current state of affairs is not sustainable and the impact on individuals, families and the entire society is devastating. It's time to invest.