How to Get an ADHD Diagnosis in the UK
When seeking referral, assessment or support for ADHD Patients often have to deal with the network gatekeepers. It is clear that a lot of these gatekeepers, especially in NHS CCGs, are disregarding the national guidelines for treating patients and their legal obligations to avoid health inequality and discrimination.
Anecdotal evidence also suggests that some private ADHD clinics are not sufficiently monitored. This can lead to different thresholds for diagnosis, and assessment reporting that could cause problems when trying to transfer to the NHS.
How do I find out if I have a diagnosis?
ADHD is a mental illness, which means it can only be diagnosed by a medical professional who has specialist knowledge. This includes psychologists and psychiatrists (who are the only ones certified to diagnose ADHD in the UK). Mentally ill people often report ADHD symptoms, particularly those who have been struggling for a long period of time. They may feel stuck in their current situation, and desperate for assistance. However it is true that the NHS isn't always easy to navigate for people seeking a diagnosis.
You can receive an appointment with the NHS if you ask your GP to refer you to an expert. Your GP should be attentive to your concerns and should be able send you to a specialist for an examination, but you may need to wait while the specialist is in.
To assess your ADHD, healthcare professionals look at any mental health issues that you may have had in the past and your family history. They will also observe you in various environments, such as your home and school or work, to assess your behaviour. They will ask you to write about your symptoms and how they impact your daily life. They might also inquire about your social life, relationships and any other activities you engage in regularly.
A specialist will review all the evidence before making a diagnose. They will look at criteria like being unrestful and fidgety all the time, having an insufficient memory for short-term events or difficulty focusing and unable to keep up at school or at work, failing to complete tasks and being extremely active. The diagnosis will be upon the presence of these characteristics in a variety of settings, which affects your functioning and if there is a clear pattern that has remained for at minimum six years.
In recent months, there has been an increase in high-profile people talking about their experiences of being diagnosed with ADHD. This has resulted in an increase in people seeking an assessment. This can result in long wait for healthcare professionals. Some patients and their families avoid the NHS in order to have their medical examinations at private clinics. This is costly. It is essential to choose a healthcare provider that you can trust and be honest about the symptoms you are experiencing.
What happens during the assessment?
Whether you self-refer or are referred by your GP the process of assessing ADHD symptoms is essentially the same. The person doing the assessment will ask you questions about how your symptoms affect your daily life, like "What problems do you experience at home?", "How do your symptoms impact on work?", and "Do you have any other symptoms that you think could be related to ADHD?"
You may be required to fill out a variety of questionnaires or forms prior your appointment, based on the location you're going to for your evaluation. It is essential to complete these in the shortest time possible to ensure that your appointment doesn't get delayed. You should also familiarise yourself with the signs of ADHD to be able to recognise them and talk about their impact on your life.
The assessment will typically include an interview with either a psychiatrist, specialist nursing staff or a healthcare professional. The therapist will assess your mental health overall and the specific signs of ADHD to see whether they are caused by any other condition or are not related to any other conditions (NICE guidelines). The therapist will then discuss treatment options with you, which may involve medication.
It is important to remember that GPs, nurses and psychologists will not be as knowledgeable about adult ADHD as Psychiatrists with specialization It is therefore essential to prepare and practice your symptoms prior to going to the test. This will enable you to communicate the impact that your symptoms are having in a way that is understandable to them. You'll need to provide 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 may have to undergo certain tests, like a test for allergies. If you suffer from any other medical conditions your therapist could suggest additional tests to look for these, too.
If you self-refer or enrolled in the Right to Choose scheme, it is important to remember that although you pay for your private evaluation however, you must wait for NHS funded appointments - and this can vary between NHS trusts and also from one doctor to another.
What happens if I don't get a diagnosis?
There are several things that could prevent you from being diagnosed with ADHD. Certain groups might be more difficult to get diagnosed. For instance when they are of color, were born female or if they suffer from other mental health diagnoses such as bipolar disorder or depression.
If you are struggling to get a diagnosis, try speaking to your GP about it and request an appointment with a psychiatrist. adult adhd diagnosis uk is also a good idea to locate a private psychiatric clinic that specialises in adult ADHD tests. They can offer a faster service than the NHS.
The psychiatrist will look at your symptoms and decide if they meet the criteria for ADHD, using the Nice guidelines as a guideline. They will also look for other possible reasons for your symptoms like anxiety, depression or thyroid problems. It's a lengthy procedure and adults might not have all the information they need.
You may not be diagnosed with ADHD even when your GP agrees. This is because a psychiatrist can only be able to diagnose you if they believe that your ADHD symptoms cause significant impairment. If they think that you don't meet the criteria, they will tell you why.
In the UK it is legal to seek treatment through the NHS in England, Wales and Northern Ireland when you have a diagnosis of ADHD. You might be able to receive medication through an individual funding request, however it will depend on where you live. You may be referred by your doctor to prescribe the medication of your choice. NHS specialists are more likely to prescribe Methylphenidate, Atomoxetine or Straterra first, and they do not usually plan for long titration periods.
Joining a support group, either in person or online for adults suffering from ADHD can be beneficial. They can be extremely supportive and reassuring and can be a great way to discuss your experiences with others who understand.
How can I receive treatment?
Adults may be sent to ADHD specialist services to be assessed and treated. These services are usually located 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 do not accept these reports and patients are frequently denied receiving treatment. This is due to long waiting times or rejection of referrals.
Support groups at the consensus meeting revealed that many ADHD patients seek out private assessments and diagnosis to circumvent the lack of NHS funding in this area. Private clinics can provide a speedier and more professional and a more generalized diagnosis. They are also helpful in screening for comorbidities, such as depression and anxiety that are prevalent in ADHD and can assist with titration until the final dose of the medication. Costs vary from PS500-PS1,200, although sometimes a diagnosis and titration are charged separately.
The treatment and diagnosis for ADHD will differ from person to person. The most commonly used treatment is medication, and this may be in the form of methylphenidates (Ritalin, Concerta) or atomoxetine (Strateva). Other interventions that are not drugs can be beneficial for education and training for families and parents of children with ADHD. Some people suffering from ADHD find that a change in their diet helps, as well as developing a sleep-friendly routine. Some people have found that psychotherapy and hypnotherapy may help their symptoms. However, the evidence for these therapies is less extensive.
It is inexcusable that many people suffering from ADHD aren't able to receive the treatment and care they need on the NHS. The UK government, the clinical and regulatory authorities must act urgently to address this situation. Patients with 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 meet this unmet need. The current state of affairs is not sustainable and the effect on families, individuals and society is incredibly damaging. It is now the time to invest in this area.