How to Get an ADHD Diagnosis in the UK
Patients with ADHD are often confronted with a network of gatekeepers when seeking referrals assessment, support and referral. It is clear that some of these gatekeepers in NHS CCGs aren't adhering to the national guidelines for clinical practice or their legal obligations to avoid discrimination and health inequalities.
Anecdotal evidence suggests certain private ADHD clinics aren't properly controlled. This may result in uncoordinated diagnostic thresholds and assessment reporting which could create difficulties when trying to transfer to the NHS.
How can I get a medical diagnosis?
ADHD is an illness of the mind and can only be diagnosed by a medical professional who has specialist expertise. This includes psychologists and psychiatrists (who are the only ones qualified to diagnose ADHD in the UK). People with mental illnesses often have ADHD symptoms, especially those who have struggled for a lengthy period of time. They may feel trapped in their current situation and are desperate for help. However the NHS isn't always easy to navigate for those seeking diagnosis.
You can receive an assessment through the NHS by asking your GP to refer you to a specialist. Your GP will consider your concerns seriously, and might refer you to an expert for an assessment. However, you may have to wait until the specialist is available.
When assessing for ADHD healthcare experts will examine the family history of ADHD and any other mental health issues that you have had in the past. To determine your behavior, they'll examine you in a variety of situations, like at school, home or at work. You will be asked to write about your symptoms, and how they affect your daily life. They may also ask about your relationships with friends, social life and other activities you do on a regular basis.
A specialist will consider all the evidence prior to making an appropriate diagnosis. They will apply criteria like being constantly distracted and fidgety, having a short attention span, difficulty keeping up at work or at school, having trouble staying focused on work, not finishing things and being extremely active. The diagnosis will be made based on the presence of these traits in a variety of settings, which affects your functioning and if there's a distinct pattern that has persisted for at least six years.
In recent months there has been a rise in celebrities talking about their experiences of being diagnosed with ADHD. This has resulted in an increase in people seeking a diagnosis. This can lead to long wait times for healthcare professionals. Some patients and families choose to bypass the NHS by undergoing assessments at private clinics, which can be expensive. It is important to choose a doctor you trust and be prepared to answer any questions honestly regarding your symptoms.
What happens during the test?
Whether you're self-referring or getting referred by your GP, the process of assessing ADHD symptoms is similar. The person who is conducting the assessment will ask you questions about how your symptoms impact your life, such as "What issues do you face at home?", "How do your symptoms impact on work?", and "Do you have any other symptoms that you think could be related to ADHD?"
Depending on where you go for your assessment, there may be various forms or questionnaires for you to complete before your appointment. It is crucial to complete these forms as quickly as you can so that your appointment doesn't get delayed. It's also important to become familiar with the characteristics (symptoms) of ADHD to be able to recognize the signs and how they affect your life in detail.
The assessment will typically include an interview with either a psychiatrist, specialist nursing staff or a healthcare professional. The therapist will evaluate your mental health and ADHD symptoms to determine if they are caused by another illness or not (NICE guidelines). The clinician will discuss with you the treatment options, which may include medication.
It's worth remembering that GPs, nurses and psychologists may not be as familiar with adult ADHD as Psychiatrists with specialization It is therefore essential to prepare and practice your symptoms prior to going to the test. This will help you explain the impact your symptoms are having in a way that is easily understood by them. You will need to give examples of how your symptoms have affected on every aspect of your life, from work to relationships and how they've changed over time.
As part of the assessment you might be required to take certain tests, for instance an allergy test. Your therapist might suggest additional tests to check for any medical issues.
If you are self-referring, or enrolled in the Right to Choose scheme, it is important to understand that, even if you pay for your private assessment however, you must wait for NHS funded appointments - and this can differ between NHS trusts and from one physician to another.
What happens if I don't receive an appointment?
There are many factors that could prevent you from being diagnosed with ADHD. Certain groups could have a harder time getting diagnosed. For instance when they are of color, were assigned female at birth or if they have any other mental health conditions like depression or bipolar disorder.
If you are having difficulty getting a diagnosis, consider speaking to your GP about it and request an appointment with a psychiatrist. It is also a good idea to locate a private psychiatric service who specializes in adult ADHD evaluations. They often provide more rapid service than the NHS.
The psychiatrist will look at your symptoms to determine if they fit the Nice guidelines for ADHD. They will also look for other possible reasons for your symptoms, such as depression, anxiety or thyroid problems. This can be a extensive process, and it's not always easy for adults to present all the evidence needed (for instance, they may be unable to locate old school reports in the back of the cupboard).
It's also possible that you will not be diagnosed with ADHD, even the GP will agree to refer you to a psychiatrist. diagnosing adult adhd ADHD Diagnosis is able to diagnose ADHD when they believe your ADHD symptoms are causing significant impairment. If they believe you don't meet the criteria, they'll tell you the reason.
In the UK it is legal to seek treatment through the NHS in England, Wales and Northern Ireland if you have been diagnosed with ADHD. You may be able to obtain medication through an individual funding request, however it will depend on where you live. You could be referred by your doctor to prescribe the medication you prefer. NHS specialists usually prefer Methylphenidate Atomoxetine or Straterra first and they don't always plan for lengthy intervals of titration.
Joining a support group, whether in person or online for adults suffering from ADHD can be beneficial. They can be very positive and reassuring and can assist to talk through your experience with people who understand.
How can I receive treatment?
GPs can recommend adults to specialist ADHD services for assessment and treatment. 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, a significant number of NHS healthcare providers do not recognize these reports as valid and patients often encounter blockages in their access to treatment such as long waiting times and rejection of referrals (see below for more details).).
Support groups reported at the consensus meeting that many 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 help screen for comorbidities, such as anxiety and depression, which are common in ADHD. They can assist with titration of the final dose. Prices range from PS500 to 1,200, although the diagnosis and titration are charged separately.
The treatment and diagnosis for ADHD can vary from person to person. The most common treatment is medication, and it can be in the form of methylphenidates (Ritalin, Concerta) or atomoxetine (Strateva). Sometimes, non-drug interventions are useful, such as training and education for parents and families of people with ADHD. Some people suffering from ADHD discover that a change in their diet can help, as does trying to develop a sleep-friendly routine. Some people have found that psychotherapy and hypnotherapy may aid in reducing symptoms. However the evidence behind these therapies isn't as strong.
It is unacceptable that so many adults with ADHD cannot get the medical and treatment they require through the NHS. This issue needs to be addressed urgently by UK government officials and regulatory and clinical bodies. Patients with ADHD need access to treatment, free from discrimination and in line with their legal rights. To address this unmet need, it is vital to plan for long-term funding and to provide health, social care and judicial services together. The current situation isn't sustainable and the effect on families, individuals and society is incredibly damaging. It's time to invest.