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How to Get an ADHD Diagnosis in the UK

People suffering from ADHD are often confronted with a network of gatekeepers when seeking referral, assessment and support. It is clear that some of these gatekeepers from NHS CCGs are not following national guidelines for treating patients or their legal obligations to avoid discrimination and health inequalities.

Anecdotal evidence suggests some private ADHD clinics are not sufficiently monitored. This can lead to different thresholds for diagnosis, and assessment reporting, which can create problems when trying to transfer to the NHS.

How do I obtain a medical diagnosis?

ADHD is an illness of the mind that can only by diagnosed by a medical professional who has specialist knowledge. This includes psychiatrists and psychology (who are the only ones qualified to diagnose ADHD here in the UK). Patients with mental health issues frequently report symptoms of ADHD particularly those who have struggled for a long time. This means they may feel stuck in their current situation and are desperate for assistance to improve their lives. The NHS can be confusing for those trying to find a diagnosis.

It is possible to get a diagnosis through the NHS by asking your GP for a referral to see a specialist. Your GP will be attentive to your concerns and be able to refer you for an assessment, but you may need to wait until the specialist is in.

general-medical-council-logo.pngIn order to assess your ADHD, healthcare experts will look into any mental health issues you might have had in the past, as well as your family history. They will also observe you in different situations, such as at home and school or work to evaluate your behavior. They will ask you to explain your symptoms and how to get adhd diagnosis in Adults they affect your daily life. They might inquire about your social life, your relationships, and other activities you engage in regularly.

A doctor will take into consideration all the evidence prior to making an assessment. They will use criteria such as being restless and fidgety all the time and having a short-term memory or difficulty focusing or keeping up with school or work, not finishing tasks, and being extremely energetic. The diagnosis will be made based on the presence of these traits in multiple settings, affecting your functioning, and if there is an identifiable pattern that has been evident for at least six years.

In recent months there has been a rise in the number of celebrities talking about their experiences of being diagnosed with ADHD. This has resulted in an increase in people seeking an assessment. This can lead to long waiting times for healthcare professionals. Some patients and families choose to bypass the NHS by having their health checked at private clinics which can be costly. It is crucial to select the right healthcare provider who can diagnose adhd in adults you can trust and be honest about your health issues.

What happens during the process of assessment?

The process of assessing ADHD symptoms is the same 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 daily life, for example "What difficulties do you encounter at home?", "How do your symptoms impact on work?", and "Do you experience other symptoms that you think might be related to ADHD?"

Depending on the location you visit to get your assessment there could be different forms or questionnaires for you to fill out prior to your appointment. Making sure you complete these forms in a timely manner will ensure that you don't have any delays in your appointment. It is also important to familiarize yourself with the characteristics (symptoms) of ADHD to ensure that you recognise the signs and the ways they affect your life in depth.

The evaluation will typically include an interview with a psychiatrist, specialist nurse or other appropriately qualified healthcare professional. The therapist will evaluate your mental health and ADHD symptoms to determine if they are caused by another condition or not (NICE guidelines). The clinician will discuss with you the options for treatment, which may include medication.

It is important to keep in mind that nurses, GPs and psychologists will not be as well-versed in adult ADHD as specialist Psychiatrists, so it is important to practice and prepare your symptoms prior to going for the assessment. This will enable you to communicate the impact your symptoms are having in a manner that is easily understood by them. You will have to give examples on how your symptoms affect your life in all areas, from your work to your relationships, and over time.

There may be tests taken as part of the assessment for example, a blood test to check for any allergies. Your therapist might suggest additional tests to determine whether you have any other medical problems.

If you self-refer, or enrolled in the Right to Choose scheme, it is important to understand that even though you pay for your private evaluation however, you must wait for NHS approved appointments. And this can differ between NHS trusts and also from one doctor to another.

What happens if I do not get a diagnosis?

There are several things that can stop you getting diagnosed with ADHD. It can be more difficult for certain categories of people to be diagnosed, for instance if you are a person of color or assigned a female at birth or if you have other mental health diagnoses like depression or bipolar disorder.

If you are having a hard time getting an answer, you can talk to your GP about it and request a referral to a psychiatrist. It is also a good idea to locate a private psychiatric service who specializes in adult ADHD assessments. 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 rule out other possible causes for your issue like depression, anxiety, or thyroid issues. This is a extensive procedure, and it's not always easy for adults to provide all the evidence needed (for example they might struggle to locate old school reports in the back of the cupboard).

You may not be diagnosed with ADHD even when your GP agrees. A psychiatrist is able to diagnose ADHD if they believe that your ADHD symptoms are causing significant impairment. If they believe you do not meet the requirements, they will inform 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 a diagnosis of ADHD. You might also be able to get medication through an Individual Funding Request but this depends on the area you live in. You could be referred by your doctor to prescribe the medication of your choice. NHS specialists usually prefer Methylphenidate, Atomoxetine or Straterra first. They do not usually plan for long intervals of titration.

Joining a support group, whether in person or on the internet, for adults with ADHD can be beneficial. They can be helpful and calm. It is also helpful to share your story with other people who understand.

What can I do to get treatment?

Adults may be referred to ADHD specialist services for assessment and treatment. These services are typically located in NHS hospitals or NHS community health teams. For example the Maudsley Hospital, London, provides a national ADHD diagnostic service for adults. However there are many NHS healthcare providers do not accept these reports and patients are often blocked from receiving treatment. This is due to long waiting times or the rejection of referrals.

Support groups at the consensus meeting noted that a lot of ADHD patients seek out private assessments and diagnosis to circumvent the insufficient NHS investment in this area. Private clinics provide a faster and more professional, and generally understanding diagnosis. They can also be helpful in screening for comorbidities, such as depression and anxiety that are prevalent in ADHD and can assist with titration to the final dosage of the medication. The cost is ranging from PS500 to PS1,200. Sometimes, a diagnosis and dosage are separately priced.

The diagnosis and treatment for ADHD is different from one person to another. Most people are treated with medications. This may be methylphenidates, like Ritalin or Concerta or atomoxetine like Strateva. Other interventions that are not drugs can be beneficial like education and training for parents and families of people with ADHD. Some people with ADHD have found that altering their diet and creating an appropriate schedule for sleep can help. Others have found that hypnotherapy and psychotherapy can help ease their symptoms, but the evidence on these is not as extensive.

It is unacceptable that many adults suffering from ADHD cannot access the medical and treatment they require through the NHS. The UK government, clinical and regulatory authorities need to act urgently to rectify this issue. People with ADHD need access to treatment that is devoid of discrimination and in line with their rights under the law. Long-term planning of funding and a coordinated commissioning of health, social care and judicial services are vital to reduce this unmet need. The current situation cannot be sustained and has a negative impact on individuals, their families and society. It's time to invest.

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