ADHD Scotland does NOT currently provide any clinical services or assessments to people with suspected / confirmed ADHD.
Why get assessed and diagnosed?
There are many benefits to being assessed for ADHD and other neurodevelopmental conditions. A formal diagnosis can:
- help you understand your experiences, challenges and strengths
- provide access to treatment and support
- support requests for reasonable adjustments at work, college or school
- strengthen applications for benefits or other support where appropriate
- reduce feelings of self-blame by providing an explanation for lifelong difficulties
- connect you with ADHD communities and resources
Can ADHD medication help?
A formal diagnosis of ADHD can provide access to medication that can help people better control their attention, focus and ability to complete tasks. ADHD medications can also be helpful for the executive function, impulsivity and hyperactive aspects of ADHD. Medication can help people to achieve their education, work, or personal goals more easily. It doesn’t “cure” ADHD but it can reduce its impact and make it easier for us to cope and thrive.
For some people, access to medication is the main purpose and benefit of being formally diagnosed. For others, medication is either not suitable or not a priority.
Medication for ADHD can only be prescribed by someone medically trained and with relevant qualifications. This is usually by a psychiatrist or a specialist nurse.
What other treatments and support are available?
Other forms of treatment and support for ADHD are focussed around learning how to live well with ADHD. This is often referred to as “psychoeducation”. This helps people understand ADHD and learn practical strategies for managing everyday challenges, building on strengths, and improving wellbeing.
Psychoeducation can be provided by health professionals such as psychologists, nurse practitioners, and occupational therapists who have training in caring for people with ADHD. It can also be provided by suitably trained and qualified ADHD and neurodiversity coaches. This can be on a 1:1 basis or in group settings.
Other treatments and therapies can be used to help people with ADHD such as Cognitive Behavioural Therapy, and various forms of counselling. This can be to help people with ADHD manage the mental health, emotional, and relational difficulties that often accompany ADHD. Therapies of this sort tend to be more helpful if they are adapted to neurodivergent people and their needs. Therapists should be trained in working with neurodivergent people effectively.
What support is offered to parents of children with ADHD?
Parenting a child with ADHD or other neurodevelopmental conditions can be challenging. Parenting techniques that are commonly used with neurotypical children can be ineffective or even harmful towards children with ADHD. Psychoeducation offered to parents is not because of poor parenting. It’s intended to equip parents with insights, skills, and strategies that help them parent the needs of their child.
Can ADHD coaches treat ADHD?
Specialist ADHD or neurodiversity “coaches” also work with adults with ADHD to help them learn how to manage their condition, harness their strengths, to live well, and to achieve their goals. ADHD coaches are not health professionals. They are however very knowledgeable about ADHD, often have ADHD themselves, and have been trained in techniques and methods that can help people with ADHD thrive.
Who can diagnose ADHD?
ADHD is usually assessed and formally diagnosed by specific health professionals who have specialist training in ADHD. These include psychiatrists, specialists ADHD nurses, and psychologists.
How can I access an assessments, diagnosis and treatment in Scotland?
Assessments for ADHD are carried out within NHS clinics and hospital services in Scotland. Your GP cannot assess you / your child for ADHD.
For children, this usually means by Child and Adolescent Mental Health Services, or via a paediatric service. Some health boards separate children’s mental health services from neurodevelopmental disorder assessments – mainly ADHD and autism. Referrals to CAMHS / similar services are usually made by or with the child’s GP. The diagnostic criteria for ADHD state that the difficulties the patient is experiencing should be evident in two or more environments. For children this is usually school and home. Therefore, referrals for assessments and assessment processes typically also involve or may be led by the child’s school.
For adults, a referral to adult mental health services or a specialist ADHD clinic is made by their GP.
Many people report difficulties accessing referrals because ADHD may not always be recognised consistently across education and health settings.
Growing awareness of ADHD has led to a significant increase in demand for assessments, placing considerable pressure on NHS services and contributing to long waiting times. Some health boards have now closed their waiting lists to adults, except those with the most severe co-occurring mental health difficulties showing signs of possible ADHD.
There are currently around 65,000 people on waiting lists in Scotland for neurodevelopmental assessments that include ADHD and autism.
People who have been diagnosed with and treated for ADHD in other parts of Scotland, elsewhere in the UK, or from abroad may experience significant difficulties with having their ongoing care transferred into a Scottish NHS service. They may find themselves placed at the back of long waiting lists along with others with no diagnosis or active treatment.
Private Assessments and Care
While access to assessment, diagnosis and care for ADHD within NHS services is so scarce and restricted, many people are opting for private assessments if they can afford it, particularly in times of crisis. There are many pros and cons to private care.
Pros
Cons
Quicker access to assessment and diagnosis.
Potential for quicker access to treatment
Quicker access to understanding, validation, and support for any diagnosed condition within the clinical service, and beyond – into education or workplace settings.
Greater choice over provider, clinician, and services accessed.
Potential for neurodevelopmental conditions AND mental health difficulties to be considered together instead of in separate services, queues, and in isolation from one another.
Potential for detailed report of clinical findings as well as recommended treatments and accommodations to be provided to be shared with other clinical services, schools, workplaces, etc.
More choice over location and timing of appointments including virtual (online) appointments.
Assessment MAY be paid for by private medical insurance if this is available to you.
Some providers are excellent and deliver the highest quality services.
Private services are usually very expensive, ranging in price from £700 – over £2,000 just for the ADHD assessment.
If diagnosed with ADHD and you want to try medication, appointments to start and monitor you on medication are a continued cost.
Unless you have a NHS GP who is willing to enter into a shared care arrangement for ADHD medication with a private provider, you face ongoing private prescription fees.
Private assessments are often viewed with suspicion by NHS clinicians, schools, and others and interpreted as lower quality regardless of the actual skills, experience, and clinical practice on offer.
NHS services very often disregard private diagnoses as evidence of need of care. If you’re on a waiting list for an NHS assessment, a private diagnosis is unlikely to give you quicker access to treatment.
NHS services may still insist on assessing you themselves using different or higher threshold measures of diagnosis and determine that you do not meet their criteria for diagnosis.
Only services led by psychiatrists or specialist nurse-prescribers are able to prescribe medication for ADHD. Psychologist-only services may diagnose but cannot directly prescribe.
Tips for Selecting a Private Provider
- Make sure you’re aware of ALL the costs involved in assessment for and the ongoing treatment of ADHD and that these are sustainable for you in the longer term.
- If acceptance of a diagnosis by your GP or local NHS service, now or in the future, is important to you, find out which, if any providers, they will accept a diagnosis from and under what conditions. E.g. a psychiatrist-led clinic, or a service that follows a particular assessment methodology. Note, it is not always possible to get this information from your local NHS and guidance is changeable. The answer may be that they do not accept ANY private diagnoses.
- Check the qualifications and accreditations of the clinicians you will see. Psychiatrists should be registered with the Royal College of Psychiatrists. Psychologists should be registered with the British Psychological Society and the HCPC. Specialist nurses should be registered with the Nursing and Midwifery Council and be registered to prescribe if that’s a service they say they offer.
- Ask the provider about any written reports and correspondence they will provide you with following assessment and if these can be shared with your GP or other parties.
- Ask about any additional services that the provider supplies such as autism assessments, occupational health assessments, attendance at Team Around the Child (TAC) meetings, assessment and treatment for co-occurring mental health conditions or other neurodevelopmental conditions such as dyslexia, dyspraxia, or dyscalculia.
- If you are accessing an assessment via private medical insurance, check the terms and limitations of your cover.
Tell us About Your Diagnostic Journey!
We do our best to keep our guidance up to date and relevant but things can change. If you’d like to share a story about your diagnostic journey – private or NHS, good or bad, please email it to diagnosis@adhdscotland.org.uk. We may share anonymous quotes, snippets or summaries of your story in our communications but all messages will be treated in confidence and no identifying information will be shared.