How to Get an ADHD Diagnosis in the UK
Patients with ADHD often face a network of gatekeepers when seeking referrals, assessment and support. It is clear that a number of these gatekeepers, particularly in NHS CCGs, do not follow the national guidelines for treating patients and their legal duty to stop health inequalities and discrimination.
Some private ADHD clinics might not be properly controlled as per reports from anecdotal sources. This could result in inconsistent diagnostic thresholds and assessment reporting which could create difficulties when trying to transfer back to the NHS.
How do I obtain an appointment for a diagnosis?
ADHD is an illness of the mind which means it can only be diagnosed by a healthcare professional with special expertise. This includes psychiatrists and psychology (who are the only ones certified to diagnose ADHD in the UK). Patients with mental health issues often report symptoms of ADHD especially those who have struggled for a long time. This means that they can feel stuck in their current circumstances and need help to improve their life. The NHS can be confusing for those looking for an answer to a medical condition.
You can receive an assessment through the NHS by asking your GP to refer you to a specialist. Your GP will take your concerns seriously and could refer you to a specialist for an assessment. However, you may be required to wait until a specialist is available.
To determine if you have ADHD, healthcare experts will look into any mental health issues you may have faced in the past, as well as your family history. They will also observe you in different environments, such as your home and school or work to determine your behavior. They will ask you to explain your symptoms and how they affect your daily life. They might ask you questions about your social life, your relationships, and other activities you engage in regularly.
A specialist will review all the evidence before arriving at a diagnose. They will make use of criteria like being constantly distracted and fidgety, having an insufficient amount of attention and having difficulty keeping up with work or at school, having trouble staying focused on tasks, not finishing things and being extremely active. The diagnosis is determined by an array of characteristics that are present in multiple situations and impact your performance.
In recent months, there is a surge in the number of high-profile individuals who have opened up about their experiences with being diagnosed with ADHD. This has led to an increase in people seeking an assessment. This can result in long waiting times for healthcare professionals. Some families and patients opt to bypass the NHS by undergoing assessments at private clinics which can be costly. It is crucial to select the right healthcare provider who you can trust and to be honest about your symptoms.
What happens during the process of assessment?
Whether you're self-referring or getting referred by your GP, the process of assessing for ADHD symptoms is essentially the same. The person who is conducting the assessment will ask you questions about your symptoms and how they impact your life. For instance, "What problems do experience at home?" "How does your symptoms impact your work?" "Do you have other symptoms you think may be related to ADHD?"
You may have to fill out various forms or questionnaires before your appointment, depending on the location you're taking for your assessment. It is essential to complete these in the shortest time possible to ensure that your appointment doesn't get delayed. It's also worth familiarising yourself with the characteristics (symptoms) of ADHD so that you can recognise the signs and how they impact your life in depth.
The test will usually involve an interview with a psychiatrist, specialist nursing staff or a healthcare professional. The therapist will evaluate your mental health and ADHD symptoms to determine if they're caused by a different condition or not (NICE guidelines). The clinician will then discuss treatment options with you, which may involve medication.
It is important to keep in mind that GPs, nurses and psychologists aren't as knowledgeable about adult ADHD as specialist Psychiatrists and therefore it is essential to practice and prepare your symptoms before you go for an assessment. This will help you explain the impact that your symptoms are having in a manner that they can understand. You'll need to provide examples of how your symptoms have impacted on every aspect of your life from work to relationships and how they've changed over time.
As part of the evaluation, you might be required to take certain tests, for instance a get diagnosed adhd test for allergies. Your therapist might suggest additional tests to determine if you have other medical problems.
If you self-refer or are enrolled in the Right to Choose scheme, it is important to remember that even though you pay for your private examination however, you must wait for NHS approved appointments. And this may differ between NHS trusts and from one physician to another.
What happens if I don't get a diagnosis?
There are many factors that could prevent you from being diagnosed with ADHD. It can be harder for certain groups of people to be diagnosed, such as if you are a person of color or a woman at birth, or if you have other mental health issues, such as bipolar disorder or depression.
If you are having a hard time getting an answer, you can talk to your GP about it and request the referral to a psychiatrist. You can also try to find a private psychiatrist who is skilled in adult ADHD evaluations. They can often offer more rapid service than the NHS.
The psychiatrist will examine your symptoms and determine whether they meet the criteria for ADHD, using the Nice guidelines as a reference. They will also look for other possible reasons for your symptoms like anxiety, depression or thyroid problems. This is a extensive process, and it's not always easy for adults to give all the evidence required (for instance, they might struggle to locate old school reports that are in the back of the cupboard).
It's also possible that you won't be diagnosed with ADHD, even if your GP agrees to refer you to a psychiatrist. This is because a psychiatrist can only diagnose you if they consider that your ADHD symptoms are causing significant impairment. If they believe that you are not meeting the criteria, they will inform you why.
If you have been diagnosed with ADHD, it is legal in the UK to receive treatment through the NHS. This applies to England, Wales, and Northern Ireland. You could be able receive medication through an individual funding request, however it will depend on where you live. You could be referred to an expert in your local area who will prescribe the medicine of your choice. NHS specialists usually prefer Methylphenidate, Atomoxetine or Straterra first, and they do not always plan for long intervals of titration.
It is beneficial to join an adult support group with ADHD, both in person and on the internet. They can be supportive and calm. It can also be helpful to share your story with other people who understand.
What can I do to get treatment?
Doctors can refer adults to specialist ADHD services to be assessed and prescribed medication. These services are usually located in NHS hospitals or NHS community health teams. For instance the Maudsley Hospital, London, offers a national ADHD diagnostic service for adults. However, a large number of NHS healthcare providers do not recognize these reports as valid and patients frequently face obstacles in their access to treatment such as long wait times and rejection of referrals (see below for more details).).
Support groups have 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 also assist in screening for comorbidities such as anxiety and depression that are common in ADHD. They can assist in titrating the final dose. The cost ranges from PS500 to PS1,200. Sometimes the diagnosis and dosage are priced separately.
The treatment and diagnosis for ADHD will differ from one person to another. The most popular treatment is medication, and it can be in the form of methylphenidates (Ritalin, Concerta) or atomoxetine (Strateva). Non-drug interventions can be beneficial like education and training for parents and families of children with ADHD. Some people suffering from ADHD have discovered that changing their diet and developing a sleep-friendly schedule helps. 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 many adults with ADHD cannot access the treatment and care they need through the NHS. The UK government, the clinical and regulatory authorities must act urgently to correct this situation. Patients with ADHD need access to treatment without discrimination and in accordance with their rights under the law. To reduce this unmet demand it is crucial to create long-term plans for funding and provide health, social and judicial services together. The current situation can't be sustained and has a negative effect on individuals, their families and society. It is now the time to invest in this area.