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 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.
Private ADHD clinics may not be properly controlled as per reports from anecdotal sources. This can lead to different thresholds for diagnosis, and assessment reporting that can cause problems when trying to transfer to the NHS.
How do I get an official medical diagnosis?
ADHD is a mental health issue, meaning it can only be diagnosed by a healthcare professional with specialist knowledge. This includes psychiatrists and psychologists (who are the only professionals qualified to diagnose ADHD in the UK). Patients with mental health issues often report symptoms of ADHD particularly those who have been struggling for a long time. They may feel stuck in their current circumstances, and in desperate need of help. The NHS can be confusing for those who are seeking a diagnosis.
You can get an assessment through the NHS when you ask your GP to refer you to an expert. Your GP will be attentive to your concerns and be able to send you to a specialist for an examination however, you may have to wait until the specialist is available.
When assessing for ADHD healthcare experts will examine your family history of ADHD and any other mental health issues that you have had in the past. To assess your behavior, they will examine you in a variety of settings, such as at home, school or at work. They will ask you to explain your symptoms and how they impact your daily life. They might ask you questions about your social life, your relationships and other activities that you do regularly.
A specialist will consider all the evidence prior to making an appropriate diagnosis. They will look at criteria such as being restless and fidgety at all times and having a short-term memory and having trouble staying focused, having difficulty keeping up at school or at work, failing to complete tasks, and being extremely energetic. The diagnosis will be made by examining the presence of these traits in a variety of settings, which affects your functioning and if there is an identifiable pattern that has been evident for at minimum six years.
In recent months there has been a rise in high-profile people speaking 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. Some patients and families choose to avoid the NHS by undergoing assessments at private clinics that can be expensive. It is important to locate a healthcare professional you trust and be prepared to answer any questions honestly regarding your health issues.
What happens during the assessment?
The process of assessing ADHD symptoms is the same whether you self-refer or get referred by your GP. The person who is conducting the assessment will ask you questions about how your symptoms impact your daily life, for example "What problems do you experience at home?", "How do your symptoms affect your work?", and "Do you experience any other symptoms that you think might be related to ADHD?"
You may be required to fill out a variety of forms or questionnaires before your appointment, depending on the location you're taking for your evaluation. Filling out these forms in a timely manner will prevent any delays in your appointment. It's also important to become familiar with the characteristics (symptoms) of ADHD to be able to recognise the signs and how they affect your life in depth.
The assessment will typically include an interview with either a psychiatrist or specialist nursing staff, or another appropriately qualified healthcare professional. The therapist will evaluate your mental health and ADHD symptoms to determine if they're caused by another illness or not (NICE guidelines). The therapist will go over with you the options for treatment that may include medication.
Remember that GPs and nurses will not be as well-versed in adult ADHD as psychiatrists. Therefore, it is important to identify your symptoms and practice them before you go to the assessment. adhd in adults undiagnosed will allow you to explain the impact that your symptoms are having in a manner that they can understand. You'll need to provide examples on how your symptoms have affected your life in all areas, from your work to your relationships, and then over time.
You may have tests taken as part of your assessment, such as a blood test to check for any allergies. If you have any other medical issues, your therapist might suggest additional tests to look for these, too.
You may be self-referring or making use of the Right to Choose Scheme, however, you'll need to wait until you can get an NHS-funded appointment. This varies from NHS trust to NHS trust and clinician to clinician.
What happens if I do not receive a diagnosis?
There are several things that can prevent you from getting diagnosed with ADHD. Certain groups might be more difficult to get diagnosed. For example that they are of color or were born female or if they suffer from other mental health conditions like depression or bipolar disorder.
If you're having difficulty getting an assessment, speak to your GP and request an appointment. You can also try to locate a private psychiatrist who specializes in adult ADHD tests. They usually provide an earlier service than the NHS.
The psychiatrist will look at your symptoms and decide whether they fit the criteria for ADHD, using the Nice guidelines as a guideline. They will also attempt to determine the cause of your symptoms like anxiety, depression or thyroid issues. It can be a lengthy procedure and adults might not have all the information they require.
It's also possible that you won't be diagnosed with ADHD, even when your GP will agree to refer you to a psychiatrist. This is because a psychiatrist can only be able to diagnose you if they believe that your ADHD symptoms cause significant impairment. If they think you do not meet the criteria, they'll inform you the reason.
In the UK, it is legal to access treatment through the NHS in England, Wales and Northern Ireland when you have been diagnosed with ADHD. You may be able to get medication through an Individual funding request, however it will depend on the location you reside in. You may be referred to a specialist in your local area who will prescribe the medicine you prefer. NHS specialists prefer Methylphenidate or Atomoxetine first, and don't always make plans for long titration periods.
Joining a support group, whether in person or online, for adults with ADHD can be beneficial. They can be very helpful and comforting and can be a great way to share your story with people who understand.
How can I receive treatment?
Doctors can recommend adults to specialist ADHD services for assessment and treatment. These services are typically located in NHS hospitals or NHS community health teams. For example, the Maudsley Hospital, London, provides a national ADHD diagnostic service for adults. However, many NHS healthcare providers do not accept these reports and patients are frequently denied accessing care. This is due to long waiting periods or rejection of referrals.
Support groups reported at the meeting of consensus that a lot of ADHD sufferers seek out private assessments and diagnoses to circumvent NHS's lack of investment in this area. Private clinics offer a more accurate, professional and speedier diagnosis. They can also assist in screening for comorbidities, like anxiety and depression that are prevalent in ADHD, and in helping with titration to the final dosage of the medication. Costs vary from PS500-PS1,200, although the diagnosis and titration are priced separately.
The treatment and diagnosis for ADHD will differ from one person to another. The majority of people are treated using medication. This may be methylphenidates such as Ritalin or Concerta, or atomoxetine, like Strateva. Sometimes, non-drug interventions can be beneficial, like education and training for parents and the families of those with ADHD. Certain people with ADHD have found that changing their diet and developing an effective sleep schedule can help. Some people find that hypnotherapy and psychotherapy can alleviate their symptoms. However, the evidence for these therapies is less extensive.
It is unacceptable that many adults suffering from ADHD cannot access the medical and treatment they require through the NHS. The UK government, clinical and regulatory authorities must take action urgently to correct this situation. People with ADHD must have 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 state of affairs cannot be sustained and has a negative impact on individuals, their families and the society. It is now the time to invest in this area.