How to Get an ADHD Diagnosis in the UK
When seeking assistance, referral or assessment for ADHD People often come across a network gatekeepers. It is evident that some of these gatekeepers from NHS CCGs aren't adhering to the national guidelines for clinical practice or their legal obligation to avoid discrimination and health inequality.
Anecdotal evidence suggests that some private ADHD clinics are not sufficiently regulated. This can lead to inconsistent diagnostic thresholds, and assessment reporting, which can create problems when trying to transfer to the NHS.
How do I get an official medical diagnosis?
ADHD is a mental health condition which means it can only be diagnosed by a healthcare professional with special expertise. This includes psychologists and psychiatrists (who are the only ones certified to diagnose ADHD here in the UK). People with mental health conditions often report symptoms of ADHD, especially those who have been struggling for a long time. They may feel stuck in their current situation and are desperate for assistance. 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 the referral to see a specialist. Your GP will take your concerns seriously and should be able to send you to a specialist for an examination, but you may need to wait while the specialist is in.
When evaluating for ADHD health professionals will look at your family history of ADHD and any other mental health issues you have experienced in the past. They will also observe you in various environments, such as your home and school or work to evaluate your behavior. They will ask you to describe your symptoms and how they affect your daily life. They might inquire about your social life, your relationships and other activities that you do frequently.
A specialist will review all the evidence before deciding on diagnosis. They will apply criteria, like being constantly distracted and fidgety, having an insufficient attention span and having difficulty keeping up with school or work, having trouble staying focused on tasks, not finishing things and being overly active. The diagnosis will be based on the presence of these traits in a variety of settings, which affects your performance, and if there is a clear pattern that has persisted for at least six years.
In recent months there has been an increase in the number of celebrities sharing their stories of being diagnosed with ADHD. This has led to an increase 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 be assessed at private clinics. This is costly. It is important to choose a healthcare provider that you trust and be honest about your health issues.
What happens during the process of assessment?
Whether you self-refer or are referred by your GP, the process of assessing ADHD symptoms is very similar. The person conducting 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 affect your work?", and "Do you experience any other symptoms you believe might be related to ADHD?"
You may be required to fill out various forms or questionnaires before your appointment, depending on the location you're going to for your assessment. It is crucial to fill these out as quickly as you can so that your appointment doesn't get delayed. It's also worth familiarising yourself with the signs (symptoms) of ADHD to ensure that you recognise them and discuss the ways they affect your life in depth.
The evaluation will usually include an interview with a psychiatrist or specialist nursing staff or a qualified healthcare professional. The therapist will examine your mental health and ADHD symptoms to determine if they are caused by another condition or not (NICE guidelines). The therapist will then discuss the treatment options with you, which can involve medication.
Keep in mind that nurses and doctors will not be as knowledgeable about adult ADHD as psychiatrists. It is therefore important to plan your symptoms and practice them before you go to the assessment. This will allow you to explain your symptoms in a manner they can comprehend. You'll need to provide examples of how your symptoms have affected your life in all aspects including your work, your relationships, and then over time.
As part of the assessment you may have to undergo certain tests, like an allergy test. If you are suffering from any other medical conditions, your therapist might suggest additional tests to test for these issues, too.
If you self-refer, or enrolled in the Right to Choose scheme, it is crucial to know that even though you pay for your private assessment but you will still need to wait for NHS scheduled appointments - and this can vary between NHS trusts and from one clinician to another.
What is the outcome if I fail to receive an appointment?
You may be diagnosed with ADHD when you have several factors that favor you. Certain groups might have a harder time getting diagnosed. For example, if they are of color or were assigned female at birth or if they suffer from other mental health conditions like bipolar disorder or depression.
If you're having difficulty getting an answer, you can talk to your GP about it and request a referral to a psychiatrist. You can also try to find a private psychiatrist who specializes in adult ADHD tests. They may be able to provide a quicker service than the NHS.
The psychiatrist will analyze your symptoms and determine if they meet the criteria for ADHD using the Nice guidelines as a reference. They will also determine if there are other reasons for your symptoms for example, depression, anxiety, or thyroid issues. This can be a very extensive process, and it's not always easy for adults to provide all the evidence required (for example they might have trouble finding old school reports that are in the back of the cupboard).
It's also possible that you won't be diagnosed with ADHD even when your GP agrees to refer you to a psychiatrist. A psychiatrist is able to diagnose ADHD in the event that they believe your ADHD symptoms are causing significant impairment. If they think you do not meet the criteria, they'll inform you why.
In the UK it is legal to seek treatment through the NHS in England, Wales and Northern Ireland in the event that you have been diagnosed with ADHD. You might be able to get medication through an Individual funding request, but it depends on where you live. You may be referred the right specialist in your area who will prescribe the medicine of your choice. NHS specialists are more likely to prescribe Methylphenidate Atomoxetine or Straterra first, and they do not always plan for long time periods of titration.
It is beneficial to join a support group for adults with ADHD, both in person and online. They undiagnosed adult adhd can be extremely positive and reassuring and can assist to talk through your experience with people who understand.
What can I do to get treatment?
GPs may recommend adults to specialists ADHD services to be assessed and prescribed medication. Most often, these services are located in NHS hospitals and NHS community health teams. For instance, the Maudsley Hospital in London offers a nationwide ADHD adult diagnostic service. However, a majority of NHS healthcare providers do not recognize these reports as legitimate and patients often encounter blockages in their access to healthcare such as long wait times and rejection of referrals (see below).
Support groups reported at the meeting of consensus that a lot of ADHD sufferers seek out private assessments and diagnoses to circumvent the NHS's lack of funding in this area. Private clinics provide a more precise, professional and quicker diagnosis. They can also be helpful in the screening of comorbidities such as depression and anxiety which are common in ADHD and can assist with titration to the final dosage of the medication. The cost can vary from PS500 to PS1,200. Sometimes, a diagnosis and dosage are separately priced.
The diagnosis and treatment for ADHD can vary from person to person. The most popular treatment is medication, which can be in the form of methylphenidates (Ritalin, Concerta) or atomoxetine (Strateva). Sometimes, non-drug interventions are useful, such as education and training for parents and families of individuals with ADHD. Some people suffering from ADHD have found that altering their diet and creating an effective sleep schedule can help. Some people have found that psychotherapy and hypnotherapy may aid in reducing symptoms. However the evidence behind these treatments is not as extensive.
It is unacceptable that a lot of adults suffering from ADHD are not able to access the treatment and care they require on the NHS. This issue needs to be addressed urgently by UK governments and clinical and regulatory bodies. Patients with ADHD need access to treatment that is devoid of discrimination and consistent with their legal rights. To meet this demand, it is vital to plan long-term funding and provide health, social care and judicial services in tandem. The current state of affairs cannot be sustained and has a negative impact on the families of individuals and the society. It is now the time to invest in this area.