Diagnosis pathways for Adult ADHD
Go to your GP and have an open and frank conversation about why you think you have ADHD. Talk about any and all mental health concerns you might have. The goal is to help you with your issues. It is not an “ADHD or not” conversation it should be much wider than that.
Following that conversation you and your GP may decide to refer for an NHS ADHD Assessment. You should ask how long the waiting list is likely to be to allow you to consider alternative options if needed.
If your GP refuses to provide a referral you can consider:
(i) Getting a second GP opinion. You can do this formally or informally. Formally by putting in a request to your GP practice. Informally by booking a new GP appointment and requesting a different doctor. If you choose the informal route it is imperative that you tell your second GP of your previous discussion.
(ii) If you have very few options with your own GP service, for instance it is a single GP or very small practice, then you may consider changing GP. The NHS find a GP service is here. There is now an option for an predominately online based NHS GP service. You can learn about that here.
(iii) You can contact us to provide you with advice. We’re happy to talk to you to see if we can help. Our contact us page is here.
(iv) If you have the funds you can get a private assessment. We are unable to provide recommendations for individual clinicians; however, we do recommend that you ensure your clinician is a recognised member of the General Medical Council You can search the register here.
If your GP says there is no ADHD service in your area:
England, Wales and Northern Ireland follow the NICE guidelines on ADHD, which gives a right to the provision of an ADHD service. That means if there is no local provision then your local NHS has an obligation to fund you to receive the service elsewhere. You can access that funding through the Individual Funding Request process and can learn more about that here.
Scotland has a different guidance system (SIGN). You can learn more about that here.
Step 3 (Option 1) – NHS Assessment
Have a specialist assessment with the NHS. This should cover your overall mental health, an assessment of if you have ADHD, and an assessment if you might have any other related or unrelated mental health conditions. This usually, but not always, involves a 45 to 90 minute discussion, that may include a number of checklists, with a specialist psychiatrist, specialist nurse, or “other appropriately qualified healthcare professional” [Nice Guidelines]. Pychologists can assess ADHD but are are unable to prescribe medication.
Following your assessment your clinician will let you know what the next stage is. One option is a diagnosis of ADHD, with a discussion on whether you want to consider medication options, and a referral back to your GP for shared management.
Step 3 (Option 2) – Right to Choose (NHS England)
If you are based in England under the NHS you now have a legal right to choose your mental healthcare provider and your choice of mental healthcare team. This important right means that, for instance, should you decide the waiting time for your ADHD assessment is too long, then you can choose alternative providers.
You can learn more about right to choose on our Right To Choose page
If you are in England and you want to know more or your GP refuses to allow Right to Choose
We have created a specific page on Right to Choose and have a support letter you can download. To access it please click here.
Step 3 (Option 3) – Private Assessment
Long waiting lists and lack of accessibility of Right to Choose throughout the UK means private diagnosis and treatment is a serious consideration for many, despite the financial cost often being a significant sacrifice. As a charity we are lobbying for the NHS ADHD provision to be properly resourced so it can be timely and effective and that people then don’t feel private is necessary for them.
For our guide to private diagnosis please click here.
Step 4 – Shared care or GP Care
In Step 3 you and your clinician will discuss on going care. This could be continued care with the specialist mental health centre, it could be shared care between the specialist centre and your GP, or it could be discharged to the sole care of your GP. Shared care and GP care are the most common. You will then discuss your ongoing treatment with your psychiatrist, specialist nurse or GP as appropriate.
Step 5 – Next
Being diagnosed is the first step in helping yourself with ADHD and may unravel complex emotions. Many report that a diagnosis can both be a relief to know what has been challenging them but as well they feel upset to know that they have a mental health condition. It is important to remember that nothing has changed because of a diagnosis – except that you are now empowered with the knowledge of it. What you now do with that insight into yourself is then up to you.
We recommend you learn about ADHD, learn and look out for its nuances for you. To help you do that we provide support groups and recommend you join our newsletter. Above all we’re here to help.