How to Get an ADHD Diagnosis in the UK
When seeking referral, assessment or support for ADHD, people often encounter an array of gatekeepers in the network. It is clear that some of these gatekeepers within NHS CCGs aren't adhering to the national guidelines for clinical practice or their legal duty to stop discrimination and health inequalities.
Certain private ADHD clinics might not be properly regulated according to reports from anecdotal sources. This can result in inconsistent diagnostic thresholds, and assessment reporting that could create problems 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 healthcare provider who has specialist expertise. This includes psychologists and psychiatrists (who are only qualified to diagnose ADHD in the UK). People suffering from mental health issues frequently experience symptoms of ADHD especially those who have struggled for a long time. They may feel stuck in their current situation and desperate for assistance. The NHS can be difficult for those trying to find a diagnosis.
You can receive an assessment through the NHS when you ask your GP to refer you to an expert. Your GP should be attentive to your concerns and should be able recommend you to an assessment, but you may need to wait while 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 evaluate your behavior, they will examine you in a variety of situations, like at home, school, or work. 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 participate in regularly.
A specialist will review all the evidence before deciding on a diagnose. They will look at criteria like being unrestful and fidgety at all times and having a short-term memory or difficulty focusing or keeping up in school or at work, not completing tasks and being overly energetic. The diagnosis will be based on the presence of these characteristics in a variety of settings that affect your functioning and if there's a distinct pattern that has persisted for at least six years.
In recent months there has been an increase 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 result in long waiting times for healthcare professionals. Some patients and their families bypass the NHS in order to be assessed at private clinics. This is costly. undiagnosed adhd in adults is essential to choose the right healthcare provider who you can trust and be honest about your symptoms.
What happens during the assessment process?
The method of conducting an assessment of ADHD symptoms is the same regardless of whether you self-refer or are referred by your GP. The person who is conducting the assessment will ask questions about your symptoms and how they affect your life. For instance, "What problems do experience at home?" "How does your symptoms affect your work?" "Do you have other symptoms you think could be related to ADHD?"
You may be required to fill out different questionnaires or forms prior to your appointment, depending on the location you're going to for your examination. Making sure you complete these forms as quickly as you can will ensure that you don't have any delays to your appointment. It is also important to familiarize yourself with the signs (symptoms) of ADHD to be able to recognize them and discuss how they impact your life in detail.
The test will usually involve an interview with a psychiatrist or specialist nursing staff, or another appropriately qualified healthcare professional. The therapist will evaluate your overall mental health and the symptoms of ADHD to see whether they are caused by any other condition or are not related to any other medical condition (NICE guidelines). The therapist will go over with you the options for treatment, which may include medications.
Be aware that nurses and GPs are not as well-versed in adult ADHD as psychiatrists. It is therefore crucial to plan your symptoms and practice them before you take part in the evaluation. This will allow you to explain the impact your symptoms are having in a way that they can understand. You will have to give examples of how your symptoms affect your life in all aspects from your work to your relationships, and then over time.
There may be tests taken in the course of your examination, such as a blood test to check for any allergies. If you are suffering from any other medical problems your therapist could suggest additional tests to look for these issues, too.
You may be self-referring, or using the Right to Choose Scheme, however, you'll have to wait for an appointment funded by the NHS. This varies from NHS trust to NHS trust, and from clinician to clinician.
What happens if I don't get a diagnosis?
There are many factors that can prevent you from getting diagnosed with ADHD. It is more difficult for certain categories of people to be diagnosed, for example, if you are a person of colour or assigned female at birth, or if you have other mental health conditions like bipolar disorder or depression.
If you're having trouble getting a diagnosis, talk to your GP and request a referral. It is also a good idea to locate a private psychiatric clinic that specializes in adult ADHD assessments. They can often offer an earlier service than the NHS.
The psychiatrist will evaluate your symptoms to determine if they are in line with the Nice guidelines for ADHD. They will also look for other possible causes of your problem, such as depression, anxiety, or thyroid problems. This is a thorough procedure, and it's not always easy for adults to give all the evidence required (for example they might struggle to locate old school reports that are in the back of the cupboard).
It's also possible that you will not be diagnosed with ADHD, even if your GP will agree to refer you to a psychiatrist. A psychiatrist can only diagnose ADHD in the event that they believe your ADHD symptoms cause significant impairment. If they believe that you do not meet the criteria, they will tell you why.
In the UK it is legal to access treatment through the NHS in England, Wales and Northern Ireland in the event that you have been diagnosed with ADHD. You could also access medication through an Individual Funding Request but this depends on your local area. You may be referred to an expert in your local area who will prescribe the medicine you prefer. NHS specialists prefer Methylphenidate or Atomoxetine first and don't usually think of long titration cycles.
It is helpful to join an adult support group with ADHD, both in person and on the internet. They can be very helpful and comforting and can assist to talk through your experience with other people who can relate to your experience.
What can I do to get treatment?
Doctors can refer adults to specialist ADHD services for assessment and medication. These services are usually found in NHS hospitals or NHS community health teams. For instance, the Maudsley Hospital, London, provides a national ADHD diagnostic service for adults. However there are many NHS healthcare providers don't accept these reports and patients are often blocked from getting care. This is due to lengthy waiting periods or rejection of referrals.
Support groups at the meeting revealed that many ADHD patients seek out private assessments and diagnosis to avoid the absence of NHS investment in this area. Private clinics offer a much speedier and more professional, and generally understanding diagnosis. They can also be helpful in the screening of comorbidities like anxiety and depression which are very common in ADHD and can assist with titration to the final dosage of the medication. Prices range from PS500 to 1,200 however, often a diagnosis and titration are priced separately.
The diagnosis and treatment for ADHD is different from individual to individual. The most commonly used treatment is medication, which can be in the form of methylphenidates (Ritalin, Concerta) or atomoxetine (Strateva). Sometimes, non-drug interventions can be beneficial, like 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 appropriate schedule for sleep can help. Others find that hypnotherapy or psychotherapy can help with their symptoms, although the evidence on these isn't as strong.
It is unacceptable that many adults with ADHD cannot get the medical and treatment they require through the NHS. This issue must be addressed immediately by UK governments and clinical and regulatory bodies. Patients with ADHD should have access to treatment without discrimination and in line with their rights under the law. Long-term planning of funding, and joined up commissioning of social, health 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 families, individuals and society is incredibly damaging. It is time to invest in this area.