The Cost of an ADHD Assessment in the UK
The national health service will take care of your medication and assessments when you decide to take the NHS route. The NHS is known for its long wait times.
In England You can also get your ADHD evaluation funded privately through the "Right to choose" pathway. The services you select must be relevant to your clinical needs and should not cost more than NHS services.
1. In-person assessment
During the assessment you will work with a senior psychiatrist to fully understand your thoughts, presentations and experiences. You will be asked about your family background as well as any mental issues that you've experienced in the past. The psychiatrist will then gather information from a number of sources such as symptom checklists and scales for assessing behavior, as well as talking to you and your relatives or close friends about how ADHD symptoms affect you in different environments.
Depending on your healthcare professional's judgement, it could be important for them to determine if your symptoms could be more easily explained by medical or psychiatric disorders that mimic or coexist alongside ADHD. Anxiety disorders, for instance may present with symptoms similar to ADHD and have a similar effect on work and relationships. Before deciding on medication or other treatments, it is important to rule out any other disorders that could trigger symptoms of ADHD.
The NHS Route
If you choose to utilize the NHS, your first step is to go to your GP to discuss the reasons you think you may have ADHD symptoms. Your GP should consider this to be a serious matter and send you for an assessment. The NHS assessment waiting times can be long. If you're not able to wait, you may take the private route, which can be more expensive, but has shorter wait times.
During your appointment, you will be asked to complete some questionnaires, and the QbTest (a computerised test that measures the most important ADHD symptoms of activity, attention and impulsivity) will be administered. It is crucial to familiarize yourself with the traits (symptoms) of ADHD prior to your appointment so that you are able to write down instances of how you have experienced them in your life. The psychiatrist will evaluate your answers and discuss the next steps to take including if you'd like to explore medication options.
2. Online assessment
Online assessments can be an efficient alternative to waiting for a NHS appointment. However, it's more expensive. The cost of an ADHD online assessment can range between PS240 and PS2500. This includes the assessment, as well as a complete diagnosis report and the cost of medication.
In the UK children and adults can get ADHD assessments on the NHS through a GP referral. The BBC's investigation shows that there are lengthy waiting times to visit an expert. One woman in Sheffield for instance is waiting for two years. The symptoms she has are suicidal thoughts which could be a sign of undiagnosed ADHD.
The NHS guidelines for ADHD assessments say that patients should be examined by psychiatrists, specialist nurses or "other qualified healthcare professional" (NICE guidelines). In the course of the assessment, a psychiatrist will interview and examine the patient using questionnaires, and observe their behavior. The psychiatrist will determine the severity of ADHD and its impact on daily life.
People suffering from ADHD frequently employ strategies such as diaries, calendars, and post-it note to manage their symptoms. However, these strategies aren't always successful. They can even lead to more stress and confusion, especially for those who are already struggling with mental health conditions. The assessment will include an examination of the body and a review of the medical history.
The NHS has a scheme known as Right to Choose, which allows you to choose the location to which you're referred for an assessment. This is available to everyone who's registered with a GP in England, Wales or Northern Ireland. You can request a private service that is associated with NHS offer an ADHD assessment. As long as the service is accredited by NHS and isn't charging more than NHS, you can request to be referred.
3. Diagnosis
A specialist nurse or psychiatrist typically conducts an ADHD assessment, based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (5th edition). Adults may also be assessed for comorbid disorders like anxiety or depression.
During your appointment, you'll discuss with the doctor your current symptoms as well as any family history. They'll also ask you to fill out questionnaires or rating scales. During this process, an expert will assess the way your behavior affects others in your life, including your spouse or children.
The psychiatrist will review all the evidence to determine if you are in line with the ADHD criteria including subtypes. Your specialist will explain their findings and discuss with you the best course of action.
If your doctor suggests a medication you will be issued the prescription to take to any pharmacy of your choice. Prescription fees are intended for administrative use only and do not cover the cost of medication. You will have to pay separately for the medication. Additional appointments might be required in the event that you require a titration of your medication.
It is essential to share your diagnosis with your GP and anyone else who may need to be aware of it, such as your school or employer. Our specialists can write letters of recommendation for educational accommodations such as additional time during exams or a reduction in deadlines.
For some people, getting an ADHD diagnosis may be a long process, particularly if their GP does not take the diagnosis seriously or doesn't believe that they're suffering from the symptoms. If this is you, you may want to check out our guide on Getting an ADHD Assessment for tips and advice about how to get your GP refer you for an assessment.
4. Medication
In the UK there are a variety of medications that are approved to treat ADHD. These are often stimulants, including the well-known methylphenidate medication (Ritalin) and the newer amphetamine-based medicine, lisdexamfetamine (Elvanse). It is generally recommended that patients start with a small dose of medication, which is gradually increased over a period of appointments until the patient reaches a stable dosage. This is often followed by regular meetings with psychiatrists to discuss side effects and monitor progress.
The medication can help reduce the symptoms of ADHD and ease the burden they impose on families, people and employers. They help by increasing the amount of neurotransmitters which enable brain cells to communicate with one and each other. Finding the right drug is a personal choice and may take some time. Once a person is on the correct medication, it is crucial to adhere to their treatment plan. If websites continue to fail to attend appointments or stop taking your medication, symptoms may return and the medication may not be effective.
A psychiatrist expert is not able to prescribe medication during the assessment session. However, they will refer you to an expert who will go over your options for medication with you and prescribe if necessary. This will require further titration sessions to determine the right dose and regular reviews to ensure that your medication is working. Most of the time you will find that the NHS will not cover your prescription and so it will incur an additional charge from your pharmacy.
Private clinics charge for follow-up consultations. This includes writing and sending recommendation letters to employers or schools, if needed. Brief phone conversations or email (limited to 20 min) can be used to offer advice and guidance on medication or medical questions in between appointments. However, the costs of monitoring and titration are not included in an initial ADHD assessment appointment.
5. Follow-up
The NHS has struggled for years to meet demand for adult ADHD assessment. According to BBC research waiting times in many areas can be as long as 8 years.
The process of assessment is long however it is essential for a thorough diagnostic. The psychiatrist who conducts the assessment will speak to you about your medical history and lifestyle, and also the symptoms that you are experiencing and how they affect your daily life. You might also be asked to fill out questionnaires or rating scales that will help the specialist assess your condition.
Following the clinical interview you will receive the report of your specialist which will include the diagnosis of ADHD and treatment recommendations and ongoing support. They will also talk with you if ADHD is a contributing factor to any health issues or concerns you may have.
There are a variety of types of ADHD and each manifests differently for every person. It is crucial to inform your doctor about the symptoms that you are experiencing, so they can determine the type of ADHD. A thorough ADHD assessment will help you find the best treatment.
Private healthcare providers offer an alternative to the NHS for those who want to avoid waiting and want to accelerate their ADHD assessment. Individuals can make a self-referral directly to an independent mental health practitioner and get quicker access to specialists who have expertise in adult ADHD. The process typically begins with a consultation with a clinical psychologist or psychiatrist who has experience in adult ADHD assessment.