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How to Get an ADHD Diagnosis in the UK People with ADHD often face a network of gatekeepers when seeking referral or assessment and support. It is clear that many of these gatekeepers, particularly in NHS CCGs, do not follow the national guidelines for clinical practice and their legal obligation to prevent health inequality and discrimination. Some private ADHD clinics might not be properly controlled as per reports from anecdotal sources. This can lead to inconsistent diagnostic thresholds, and assessment reporting that could create problems when trying to transfer to the NHS. How can I get an official medical diagnosis? ADHD is a mental health condition which means it can only be diagnosed by a healthcare professional who has expertise. This includes psychiatrists and psychologists (who are the only professionals qualified to diagnose ADHD in the UK). Mentally ill people frequently report ADHD symptoms, especially those who have struggled for a long period of time. They may feel stuck in their current situation and in desperate need of help. The NHS can be confusing for those who are looking for a diagnosis. You can get an appointment with the NHS if you ask your GP to refer you to an expert. Your GP will be attentive to your concerns and might refer you to specialists for an evaluation. However, you may be required to wait until a specialist is available. When assessing for ADHD healthcare specialists will review your family history of ADHD and any other mental health issues that you've had in the past. They will be observing you in various environments, such as your home, at school or at work to evaluate your behavior. They will ask you to describe your symptoms and how they impact your daily life. They may ask you about your social life, your relationships, and other activities you engage in often. A specialist will look at all the evidence prior to making an appropriate diagnosis. They will apply criteria for example, being perpetually restless and fidgety, having a short attention span or difficulty focusing at work or school and having difficulty staying focused on tasks that are not completed, and being extremely active. The diagnosis will be by examining the presence of these traits in multiple settings, affecting your functioning and if there's a clear pattern that has remained for at minimum six years. In recent months, there has been an increase in the number of celebrities talking about their experiences of being diagnosed with ADHD. This has led to an increase in people seeking a diagnosis. This can lead to long waiting times for healthcare professionals. Some patients and their families bypass the NHS in order to be assessed at private clinics. This can be expensive. It is crucial to select an healthcare provider you trust and be honest about the symptoms you are experiencing. What happens during the assessment? The procedure of the process of assessing ADHD symptoms is the same regardless of whether you self-refer or are referred by your GP. The person doing the assessment will ask you questions about how your symptoms affect 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 you believe could be related to ADHD?” Depending on where you go to get your assessment, there may be various forms or questionnaires for you to complete before your appointment. It is essential to complete these as quickly as possible so that your appointment won't be delayed. It is also important to familiarize yourself with the symptoms of ADHD to be able to recognise them and talk about their impact on your life. The assessment will usually include an interview with a psychiatrist, specialist nurse or other appropriately qualified healthcare professional. The therapist will examine your mental health and ADHD symptoms to determine if they're caused by a different condition or not (NICE guidelines). The therapist will then go over the treatment options with you, which could include medication. Be aware that nurses and GPs aren't 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 your symptoms in a manner they can comprehend. You will need to give examples of how your symptoms have had an impact on all aspects of your life from work to relationships, and how they have changed in time. As part of the assessment you could be required to take certain tests, for instance an allergy test. Your therapist could suggest additional tests to determine whether you have any other medical issues. If you are self-referring, or going through the Right to Choose scheme, it is important to understand that although you pay for your private assessment however, you must wait for NHS scheduled appointments – and this can vary between NHS trusts and from one physician to another. What happens if I don't get an appointment? There are many factors that can prevent you from getting diagnosed with ADHD. It is more difficult for some groups of people to be diagnosed, for example, if you are a person of colour or assigned female at birth or if you suffer from other mental health diagnoses like bipolar disorder or depression. If you're having difficulty getting an assessment, speak to your GP and request an appointment. It's also worth trying to find a private psychiatric provider who specializes in adult ADHD evaluations. They can often offer a much faster service than the NHS. The psychiatrist will examine your symptoms and decide whether 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, such as depression, anxiety or thyroid issues. It's a lengthy process, and adults may not have all the information they need. It's also possible that you will not be diagnosed with ADHD even if your GP is willing to refer you. A psychiatrist can only diagnose ADHD in the event that they believe your ADHD symptoms are causing significant impairment. If they think that you do not meet the criteria, they will inform you the reason. 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 could also access medication through an Individual Funding Request, but this will depend on the location you live in. You may be referred to your physician to prescribe the medication you want. NHS specialists recommend Methylphenidate or Atomoxetine first, and don't always make plans for long titration periods. Participating in a support group, whether in person or online, for adults with ADHD can be beneficial. They can be supportive and comforting. www.iampsychiatry.uk can also help to share your experience with other people who understand. How do I receive treatment? Adults are directed to ADHD specialist services to be assessed and treated. These services are usually found in NHS hospitals or NHS community health teams. For example, the Maudsley Hospital, London, offers a national ADHD diagnostic service for adults. However, many NHS healthcare providers don't accept these reports and patients are often denied receiving treatment. This is due to long waiting periods or rejection of referrals. Support groups at the consensus meeting reported that many ADHD patients seek out private assessments and diagnosis to overcome the lack of NHS investment in this area. Private clinics can provide an accurate, professional and speedier diagnosis. They can also help screen for comorbidities like depression and anxiousness, which are common in ADHD. They can assist with titration of the final dosage. Prices vary from PS500 to PS1,200 however, often a diagnosis and titration are priced separately. The diagnosis and treatment for ADHD differs from person to person. Most people are treated with medications. It could be methylphenidates, such as Ritalin or Concerta or atomoxetine like Strateva. Non-drug interventions can be helpful like education and training for parents and families of those with ADHD. Some people suffering from ADHD have found that a change in their diet can help, as does developing a sleep-friendly routine. Others find that hypnotherapy or psychotherapy can help ease their symptoms, but the evidence on these isn't as strong. It is inexcusable that many adults with ADHD aren't able to receive the treatment and care they require from the NHS. The UK government, the clinical and regulatory authorities need to act urgently to rectify this issue. People with ADHD should have access to treatment that is devoid of discrimination and in accordance with their rights under the law. Long-term planning of funding, and joined up commissioning of social, health care and judicial services are essential to reduce this unmet need. The current situation isn't sustainable and the impact on families, individuals and the entire society is devastating. It is now the time to invest in this area.