People ask me quite often for advice about getting an ADHD diagnosis as an adult. Whilst I now know everything to include in the list I end up sending to people like the back of my hand, it's probably easier to just make the information publicly available.
Some background about me, and my ADHD
I was diagnosed with ADHD as a child, which made my experience of getting a diagnosis a lot easier! Due to a combination of familial concern about the medication I was given, and "the CAMHS gap" caused by virtually zero mental health care being available for 16 and 17 year olds, I was untreated and unsupported from my early teens until I was 26. At this point, I was able to get an adulthood diagnosis of ADHD, and I began taking medication again, as well as accessing support from my university (which I may write up at a later date, if there is interest. Let me know if you'd like to see this!)
I see a doctor in a different area to the one I live in, as my local NHS mental health trust didn't employ an ADHD specialist at the time that I was seeking a diagnosis. My consultant has agreed that, once I'm definitely stable with a medication plan, he will keep me on his records as a patient who he sees around once a year, even though usual practice would be to discharge at that point. This is because it took me six months to actually get an adulthood diagnosis, from my first appointment about it with my GP to my first appointment with my consultant - which was quite stressful, and he is in agreement with me that I will be more stable knowing that another appointment is only a phonecall away, if I begin struggling with symptoms again.
The delay in getting an adulthood diagnosis, for me, was largely caused by two things: first, my referral was sent to the wrong place, and instead of being rejected by the incorrect department, it was simply ignored, meaning that I was expecting an appointment letter that never came. Second, as I have mentioned, there was no psychiatrist in my area at the time who specialised in adult ADHD, and as a result, the funding body had to meet to discuss my case before I was allowed to be referred to an ADHD clinic. My hope is that, by reading this guide, others will be able to avoid both of these things happening to them.
- This applies to the NHS in England & Wales. It might be the same in Scotland too, but I don't know. (If you live in Scotland, and successfully get a diagnosis by following these steps, please let me know!)
- I cannot guarantee that following these steps will get you a diagnosis, whether you have ADHD or not! This is just what I did, and it worked for me, but your mileage may vary.
Steps to take
- Make an appointment with your GP. A single 10 minute appointment should be fine, as long as you are well-prepared. These things might be useful to take with you:
- Nice Guideline CG72, Section 1.2.2.
- You might want to highlight the relevant paragraph to you (depending whether you were treated as a child or not) which explicitly states that you should be referred to psychiatric services for assessment.
- This will hopefully avoid the problem of the funding body meeting to discuss whether or not you can be referred, given that unless your local NHS trust has a local policy which says differently - and I'm not aware of any that do - then they pretty much have to agree to funding the assessment, because NICE works on evidence-based policy.
- Evidence supporting your claim that you have symptoms which began in childhood, that still persist, and which impair you in your everyday life. I recommend:
- school/college reports
- a reflective diary of about a fortnight to a month, showing how ADHD affects you at home, in your social life, and at college/university/work.
- You might also want to consider taking letters from people close to you, about their opinion of whether or not you show symptoms of ADHD. They may have noticed things that you haven't!
- The list of symptoms compiled by AADD-UK.
- You might want to annotate these with your own experiences to jog your memory when you're talking to your GP.
- If you annotate it, and they want to take this to write the referral, ask for a photocopy to keep.
- Get someone to ask you the questions on the Self-Referral Screening form, and fill in the boxes for you.
- This is not a diagnostic tool, but it might help your GP to see that you should have a referral.
- It's useful to ask a partner, friend, or relative to tick the boxes for you, as the "right answers" are shaded in on the answer sheet, and if you can legitimately say "I chose not to tick the boxes myself, because of the colour coding" then your GP may take it more seriously.
- You could also go with a blank copy and ask them to run through the questions, so that they know you didn't 'cheat' - it's very short.
- Make a note of who the nearest specialists to you are from the page on AADD-UK.
- Include some in neighbouring areas, just in case - e.g. I live in Greater Manchester, but I was sent to a specialist in Liverpool.
- This will be useful if there is no specialist in your funding area, and your GP doesn't already know which out-of-area doctor(s) the local funding body has approved, as your GP won't need to look it up themselves.
- A week after the appointment, contact your GP to ask how the referral is going.
- If it hasn't been sent yet, keep contacting them on a semi-regular basis, until you actually get the appointment.
- Remember that NICE guidelines say that you should see a specialist, and that it isn't your GP or the funding body's decision whether or not you have ADHD! Remind them of this, if they seem to have forgotten!
- If you are denied an assessment, Q9 on AADD-UK's frequently asked questions page tells you what you can do. Lots of the other questions/answers there are really useful as well!
If this has been useful to you, or if you have any further questions, I'd love to know! You can email me at katie[at]tajasel[dot]org, or tweet me: @tajasel.