How to Get an ADHD Diagnosis in the UK
When seeking assistance, referral or assessment for ADHD Patients often have to deal with a network gatekeepers. It is clear that some of these gatekeepers within NHS CCGs are not following national clinical guidelines or their legal obligations to avoid discrimination and health inequalities.
Some private ADHD clinics may not be properly controlled as per reports from anecdotal sources. This can result in different thresholds for diagnosis, and assessment reporting that can cause issues when trying to transfer to the NHS.
How can I get a medical diagnosis?
ADHD is a mental illness and is only diagnosed by a medical professional with specialist expertise. This includes psychologists and psychiatrists (who are the only professionals qualified to diagnose ADHD in the UK). People suffering from mental health issues frequently experience symptoms of ADHD, especially those who have been struggling for a long time. They may feel stuck in their current circumstances, and are desperate for assistance. However the NHS isn't always easy to navigate for people seeking a diagnosis.
You can receive an assessment through the NHS if you ask your GP to refer you to an expert. Your GP will be attentive to your concerns and should be able to recommend you to an assessment but you may have to wait until the specialist is in.
When evaluating for ADHD healthcare experts will examine the family history of ADHD and any other mental health issues you've had in the past. They will be observing you in various environments, such as your home and school or work to determine your behavior. They will ask you to describe your symptoms and how they impact your daily life. They might also inquire about your relationships, social life and any other activities that you engage in regularly.
A specialist will consider all the evidence prior to making an appropriate diagnosis. They will use criteria like being irritable and fidgety all the time or having a short-term memory and having trouble staying focused and unable to keep up with school or work, not completing tasks, and being extremely energetic. The diagnosis is based on an array of characteristics that can be observed in different environments and affect your performance.
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 waiting times for healthcare professionals. Patients and their families opt to bypass the NHS in order to have their medical examinations at private clinics. This could be expensive. It is crucial to choose a doctor you trust and be prepared to answer honestly about your symptoms.
What happens during the process of assessment?
The procedure of assessing ADHD symptoms is the same regardless of 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 life, such as "What difficulties do you encounter at home?", "How do your symptoms affect your work?", and "Do you have any other symptoms that you think might be related to ADHD?"
You may need to fill out different forms or questionnaires before your appointment, based on where you are going for your assessment. Filling out 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 identify the signs and how they impact your life in depth.
The test will usually involve an interview with either a psychiatrist or specialist nursing staff, or a healthcare professional. The therapist will assess both your mental health and ADHD symptoms to determine if they are caused by another illness or not (NICE guidelines). The therapist will then go over the treatment options with you, which can involve medication.
It is important to remember that GPs, nurses and psychologists aren't as familiar with adult ADHD as Psychiatrists with specialization, so it is important to practice and prepare your symptoms before you go to the test. This will help you explain your symptoms in a way 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 might have some tests done as part of the assessment, such as the blood test to look for any allergies. Your therapist could suggest additional tests to check if you have other medical conditions.
If you self-refer or enrolled in the Right to Choose scheme, it is important to understand that, even if you pay for your private evaluation however, you must wait for NHS scheduled appointments - and this may differ between NHS trusts and from one clinician to another.
What is the outcome if I don't receive a diagnosis?
You could be diagnosed with ADHD if you have a variety of factors in your favor. It can be more difficult for some groups of people to get diagnosed, for instance if you are a person of color or assigned a female at birth or if you have other mental health diagnoses like depression or bipolar disorder.
If you're having a hard time getting a diagnosis, consider speaking to your GP about it and request an appointment with a psychiatrist. It's also worth trying to locate a private psychiatric clinic who specializes in adult ADHD evaluations. They can often offer a much faster 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 reference. They'll also try to rule out other causes of your symptoms including depression, anxiety or thyroid issues. It can be a lengthy process and adults may not have all the information they need.
You may not be diagnosed with ADHD even you and your GP accepts. This is because a psychiatrist can only be able to diagnose you if they believe that your ADHD symptoms cause significant impairment. If they believe that you don't meet the requirements, they will inform you why.
In the UK it is legal in the UK to get treatment through the NHS in England, Wales and Northern Ireland when you have been diagnosed with ADHD. You may be able to obtain medication through an individual funding request, however it will depend on the location you reside in. You could be referred by your local specialist to prescribe the medication you prefer. NHS specialists will recommend Methylphenidate and Atomoxetine first and don't make plans for long titration periods.
Participating in a support group, either 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 discuss your experiences with people who understand.
How can I receive treatment?
Doctors can refer adults to specialists ADHD services for assessment and treatment. These services are usually found 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 health providers aren't able to accept these reports, and patients are often denied getting care. This is due to lengthy waiting times or rejection of referrals.
Support groups informed the consensus meeting that many ADHD sufferers seek private assessment and diagnosis to overcome the NHS's lack of funding in this area. Private clinics can provide an accurate, professional and speedier diagnosis. They also assist in screening for comorbidities, such as depression and anxiousness which are common in ADHD. They assist in titrating the final dosage. Prices range from PS500 to 1,200, although sometimes a diagnosis and titration are charged separately.
The diagnosis and treatment for ADHD can vary from individual to individual. The majority of people are treated with medications. These could be methylphenidates such as Ritalin or Concerta, or atomoxetine, like Strateva. Sometimes, non-drug treatments are beneficial, like education and training for parents and families of individuals with ADHD. Some people with ADHD have discovered that changing their diet and developing a sleep-friendly schedule helps. Some people have found that hypnotherapy and psychotherapy can help their symptoms. However the evidence behind these therapies is less extensive.
It is unacceptable that many people suffering from ADHD are unable to get the care and treatment they require on the NHS. The UK government, the clinical and regulatory authorities must act urgently to address this situation. People suffering from ADHD must have access to treatment that is devoid of 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 vital 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's time to invest.