I think I have ADHD!

Introduction

Let me guess - you’ve seen a TikTok showing you “5 things that people with ADHD do” and you’ve thought to yourself:

”Hey I do those things…but I don’t have ADHD…wait

…well…shit!”

You’ve gotten by well enough so far, but I bet you’ve often wondered why everyone else seems to cope with life just that tiny bit better than you. Then some TikTok wanker (like me) comes along and makes you question your entire existence.

With the incredible surge of people seeking an ADHD diagnosis, both in the UK and across the world, it can feel like there’s no point in even trying because you’re not going to get seen for 17 years anyway.

Well, my friend, you’re in safe company here because I’ve been there.

As dark, long and utterly oppressive as the tunnel can be - I’m here to tell you that there is a bloody great big shining light at the end of it AND there are a number of ways you can get assessed for ADHD in MUCH less than 12 years.

Before you continue - bookmark this post!

With the current rate of change being as rapid as it is, I’ll be updating this post regularly to keep the info as up-to-date as possible.

Key Takeaways

Recognising ADHD Symptoms: ADHD is a neurodevelopmental disorder that affects behaviour and executive function. Many people realise they might have ADHD after recognizing symptoms in themselves or their children, often sparked by online content or personal reflection.
Steps to Diagnosis: The process for getting an ADHD diagnosis in the UK involves several steps: gathering evidence, contacting a GP, getting a referral, and attending both an initial and a full ADHD assessment. The journey can be straightforward on paper but often involves challenges and persistence.
Gathering Evidence: For adults, evidence includes completing a recognized checklist (like ASRS v1.1) and writing a letter describing how their life experiences relate to ADHD symptoms. For children, evidence from both parents and schools is typically required, often involving a School Support Plan and a “watchful waiting period.”
Navigating Referrals: The referral process can be tricky. GPs may choose whether or not to refer, and individuals have the right to seek a second opinion or choose where their referral is sent, including private providers. The NHS Right to Choose is crucial for avoiding long waiting lists.
Assessment Process: ADHD assessments in the UK are split into an initial screening and a full assessment. The initial assessment determines if further evaluation is needed, while the full assessment confirms the diagnosis. It’s important to attend these appointments prepared and with support if possible.
Private vs. NHS Options: Private assessments can be faster but come with costs. There are funding options, including employer healthcare plans, private insurance, and self-funding. Shared care agreements allow for private assessment with NHS prescriptions, potentially reducing ongoing medication costs.
Post-Diagnosis Journey: Receiving an ADHD diagnosis is just the beginning. The diagnosis can bring about significant life changes, including shifts in identity, coping strategies, and long-term management plans. It’s essential to take time to process this change and seek support as needed.

What is ADHD? - Quick Recap

ADHD is a neurodevelopmental disorder, which affects behaviour and executive function.

Executive function is the term we use to describe decision making abilities in the brain and they can be deeply affected by ADHD.

If you want to learn more about what ADHD is and how it could be affecting you - check out these posts ADHD in Adulthood and ADHD The Basics and when you’re done pop back here to see what to do next.

Steps to Diagnosis

On paper, the steps to getting an ADHD diagnosis in the UK seems quite straightforward. In simple terms, it goes like this:

You gather some evidence to support your concerns about you or your kids having ADHD.
Contact your GP, or your kids’ GP saying that you think you might have ADHD and give them the evidence you’ve just collected.
Your GP will refer you to an ADHD and Autism unit for assessment.
Attend an initial ADHD assessment.
Attend a full ADHD assessment.
Get (or sometimes don’t get) an ADHD diagnosis.

Easy peasy.

While the steps to diagnosis are quite simple, the reality can be a little different. I’ll break down each step for you so you can feel more confident about your journey.

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1. Gathering Evidence

Don’t worry, you don’t have to get your deer stalker, pipe and magnifying glass out - gathering evidence about yourself is probably the second easiest step on the list.

For Yourself

You can evidence your behaviours and symptoms with a recognised checklist - the ASRS v1.1 - and a letter describing your life experience and how it relates to ADHD.

I’m not talking about writing an omnibus - just a side or 2 of A4, detailing the main struggles you’ve had and how you think they relate to the symptoms of ADHD.

You can also include some templated wording to activate your NHS Right to Choose, which allows you to choose where you have your assessment.

To make this process even easier you can download the ASRS 1.1 checklist AND a template evidence letter below - including Right to Choose wording.

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For Your Kids

Broadly speaking, to accept a referral for a children’s ADHD assessment, NHS children’s services in the UK require evidence from both you and your kids’ school.

You can evidence your kids’ behaviours and symptoms in the same way as you would for yourself.

Evidence from your kids’ school comes in the form of a School Support Plan that has been in place for around 10 weeks.

In some cases, your kids’ school might approach you about referring your child for a developmental assessment or an ADHD assessment.

If this is true for you - you’re in luck because the school will likely be champing at the bit to get a support plan in place.

10 weeks later you trundle off to the GP to make your referral, all evidence present and accounted for.

Bloody marvellous!

What is far more likely, however, is that you will have to approach your kids’ school with concerns about your child struggling with ADHD.

This scenario, I’m sorry to say, can be a very different, disheartening and frustrating ball game.

Not bloody marvellous.

When you approach your kids’ school’s SENCO with your concerns that your child might have ADHD they will trigger a “watchful waiting period”.

During this time - typically also lasting about 10 weeks - the school will observe your child and keep a record of their performance, their struggles and their behaviours.

Because you know your child is struggling - the tantrums at home, the difficulties making decisions, the constant noise in their head that’s so loud even you can hear it - you’d think this would be clear to the school who see your kid for 6-8 hours a day and you’ll likely just sit back and wait for 10 weeks to be told “Yes, we’ll put a support plan in place.”

In my humble experience, I’ve heard far too many stories from parents of kids who are clearly struggling with symptoms of ADHD that, after the watchful waiting period, the school “saw no signs” of ADHD.

Very un-bloody marvellous!

While I completely get that if your kids’ school comes back with a bullshit “computer says ‘no’” response it’s going to be very disappointing, keep your chin up as best you can because there are options, which I’ll talk about in the referrals section.

If you could do with some help filling out the ASRS form for yourself or your kids, book a free 30 minute call with me to discuss how I can offer some support.

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2. Contacting Your GP

GP

Once you’ve stared at the checklist and template letter for 23 hours, brought yourself down from Overwhelm Mountain and eventually filled out both documents in a moment of panic-induced hyperfocus - told you I’ve been there - it is now time to book an appointment with your GP.

Most GPs now want you to book appointments through a triage form on their own NHS-styled website. If this is the case for you, just fill out the form with something simple like:

“I think I have ADHD. I have completed an ASRS checklist and I would like to discuss my options, please.”

If your GP still uses the phone for appointment booking, just say the same thing to the Gatekeeper of Health…I mean…the receptionist.

If you’re booking for your kids, the same applies, with the addition of the School Support Plan - if you have one.

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3. Referrals

Here’s where things can get a little tricky.

Referral decisions are made by your doctor and it can feel like you’re at their mercy and you’re giving up all of your power.

You’re not though - you’re still in the driving seat and here’s why.

First Decision

Once you’ve had your appointment and presented your evidence your GP’s first choice is:

Make a referral
Do not make a referral

It’s highly unlikely that they won’t refer you, but nevertheless, knowledge is power and you deserve to know that this is a possibility.

If your GP refuses to refer you it can feel like you’ve lost all your power. In reality it makes no difference to your situation because you are allowed to ask another GP to make a referral, and another and another.

If you find yourself being turned down by a number of GPs, though, it might be worth asking yourself whether this is the right route for you.

While I don’t doubt you’re probably suffering, it might not actually be ADHD you’re suffering from, and it might be something else.

If this happens, ask your GP for more support in working out where your struggles come from.

All that being said, I've yet to encounter an adult who has been in this situation, but that’s not to say it isn’t a possibility.

Second Decision

If your GP has been a lad and decided to make your referral for an ADHD assessment, they then need to decide to whom or where your referral should be made.

While they are likely to have a bewildering number of choices as to whom and where your referral should be made, the only 3 that are relevant to you are:

Your local NHS ADHD and Autism Unit
An NHS ADHD and Autism Unit - chosen by you under your NHS Right to Choose
A private healthcare provider - chosen by you under your civil liberties and human rights, which you have as a human who has rights to choose stuff, both in the UK and the Universe.

See how you still have the power?

While your doctor has to do the paperwork, it really is your decision as to where they send that paperwork.

Why NHS Right to Choose is So Important

ADHD assessment waiting list times vary wildly across the UK at the moment.

In Herefordshire and Worcestershire (where I live) the ADHD and Autism Unit have actually stopped taking referrals for assessing ADHD because their waiting list is 17 years long!

Now, I LOVE hyperbole, but on this occasion, this outrageous statistic is, in fact, true.

I remember when I started my diagnosis journey, I was aggrieved to wait for 17 minutes, let alone 17 fucking years!

This is the most extreme example of ADHD assessment waiting list times, and it’ll no doubt be a comfort to you to hear that this is not the case across the country.

This is where NHS Right to Choose is your best friend.

Let’s say you live in the area that’s covered by Herefordshire and Worcestershire’s ADHD and Autism Unit - you don’t have to wait 17 years. You have the RIGHT to choose another area in which to be assessed. Ideally one with a shorter waiting time.

Options for Kids without a School Support Plan

As incredibly disheartening as it may be to feel like a school may have failed your kids, don’t worry - here are your options:

NHS Right to Choose

Thankfully there are a few NHS children’s services that do NOT require a high level of school involvement.

You might be one of the lucky ones who lives in an area where your local NHS children’s services have a short waiting list AND only require evidence from parents.

If not, the good old NHS Right to Choose is on your side and you should be able to find a service where only your input is required.

Talk to your doctor about your local service and Google the shit out of this concept. You will find one, you just might have to be aware of the waiting list times.

Self-refer to a Private Healthcare Provider

In the vast majority of cases, a private healthcare provider will accept a self referral or a referral from your GP, without the involvement of your kids’ school.

They might want some input from the school for your kids’ assessment, but this won’t delay or hamper your referral.

NHS vs. Private Healthcare Providers

The fastest way to get an ADHD assessment in the UK is to be referred to a private healthcare provider like Bupa or Priory Group.

Depending on the provider you use and your local NHS trust you could even get your assessment privately and have your prescriptions dispensed through the NHS.

Shortest waiting time, lowest cost for medication. BOSH!

We are truly blessed to live in the UK, where our main healthcare system is government funded, making access to doctors free and access to medication hugely affordable.

The trade off, as mentioned above, is time.

Waiting lists for NHS treatment, of any kind, can mean the difference between engaging free services and, if we can, reaching deep into our own pockets to get the help we need.

That’s where the Private Healthcare system comes into play.

Yes, it’s a paid-for service, but:

a) there are a couple of options for funding it that don’t break the bank and

b) depending on your provider, it might not be quite as expensive as you think

More on funding a private ADHD assessment later.

It’s worth saying that, in some circumstances, NHS Right to Choose will allow you to choose a private healthcare provider to conduct your ADHD assessment, under a contract that the NHS has. I.E. at no cost to you. Talk to your doctor about your circumstances to see what can be done.

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4. ADHD Assessments Explained

In the UK, ADHD Assessments are split into 2 separate appointments.

Initial ADHD Assessment
Full ADHD Assessment

Both assessments are carried about by specialist clinicians, like psychiatrists, specialised psychologists and advanced prescribing nurses who specialise in ADHD.

These are by far the easiest steps on this list. All you have to do is turn up to your appointment and be your wonderful self.

Now I think about it, turning up to your appointment might actually be a genuine struggle - so let’s just assume you do turn up and then I’m not lying about these being the easiest steps on the list.

Initial ADHD Assessment

Your initial assessment is usually quite short - between 15 and 30 minutes.

While your assessor will be collecting relevant information about your experience, initial assessments largely act as screening appointments to make sure you’re getting the correct support.

Your assessor will make the decision as to whether you go through to a full ADHD assessment or whether you would benefit from being assessed for something else first.

You won’t receive an official diagnosis at this point, but you are likely to discover which direction you’re going after the initial assessment.

You will usually be asked if you can bring someone who has known you since childhood with you to your next assessment - I took my mum.

For kids, this appointment might look a little different. Some NHS children’s services use computer programmes to make the assessment more engaging for children.

Either way, the outcome will be the same as if it were an adult assessment. Kids may have to wait a day or so for their decision to come back.

Full ADHD assessment

Your full ADHD assessment may last for anything up to an hour and a half.

If it doesn’t last long at all, don’t worry - it’s likely you gave enough relevant information in your initial assessment for your clinician to safely determine that you’re bloody riddled with ADHD - like I am.

My full assessment only lasted about 20 minutes - most of which was my psychiatrist and my mum having a whale of a time talking about how clumsy / spacey / hilarious (obvs) / forgetful / sensitive I was as a kid.

By the end of your full assessment you will know whether or not you’ve joined the dizzying heights of the, one and only, ADHD Club.

Your ADHD Membership Pack is likely to include information about which House you’re in - Hyperactive, Inattentive or Combined (I’m in Combined - it’s hardcore!) - an Access All Areas pass to “I’ve Got ADHD Land” and, if you’ve gone for the Medicated Membership you’ll get a prescription or a little bottle of pills to set you off on your merry way into the rest of your life.

(Note: this is most definitely hyperbole - no such ADHD Membership Packs exist - it absolutely should exist but it doesn’t…not officially anyway.)

What To Do if You Don’t Get Diagnosed

It is so important to say that not everyone who gets assessed for ADHD receives a diagnosis.

If this happens to you, I’m genuinely sorry that you haven’t found the answer to your struggles.

You can, and most definitely should, go back to your GP and have a wide-open, frank conversation with them about your struggles and what your options are.

You’re always welcome to stay around the JD ADHD Coaching club, but if this is goodbye, I wish you all the very best for the future.

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Funding Private Healthcare

If a private ADHD assessment is the way forward for you, there are a number of ways you can fund it.

Employers Private Healthcare: Some employers include a private health care plan for their employees. If yours does, check with your HR department to see if your ADHD assessment can be funded through your employee package.
Private Healthcare Insurance: If you have already got insurance for private healthcare, it’s more than likely that you will be able to claim for your assessment through your insurance. Be careful not to approach your GP before you investigate this though as pre-existing conditions are rarely covered in private healthcare insurance.
I know you won't have a diagnosis from just talking to your GP, but those underwriters at the insurance company will do anything NOT to pay out on a claim - it is kinda their job, after all. Better safe than sorry - insurers first, then GP if no joy.
Self Funding: Private healthcare companies will be more than happy to accept self-referrals and self-funded patients. You’ll probably find that most of the doctors who know you are self-funded will actively try to minimise your cost.

The Cost of A Private ADHD Assessment in the UK

In the UK a private assessment for ADHD can range in costs between £600 and £3500.

What’s the difference between a £600 assessment and a £3500?

It’s difficult to truly quantify what the differences are, you just need to be vigilant when selecting a private healthcare provider.

The biggest consideration you need to make about ANY private healthcare provider, in my opinion, should be:

Can I get assessed by this provider privately and move back to the NHS for ongoing treatment?

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Whatever the answer is to this question should be the main driving force behind your decision.

Shared Care Agreements

This route of private assessment to NHS prescriptions is what’s known as a “Shared Care Agreement”

Not all private healthcare providers are able to enter into shared care agreements with NHS trusts.

There are a great many reasons why a particular private healthcare provider might not be able to enter into shared care agreements, but they’re not really important to you.

What’s most important - if you want to have your prescriptions dispensed through the NHS and not have to pay £200 a month for your meds - is that you find a healthcare provider who CAN enter into a shared care agreement.

It’s very common for the NHS to subcontract to private healthcare providers for all manner of things.

Those providers who already have large subcontracting contracts with the NHS are the most likely candidates who are able to enter into shared care agreements.

Do your own due diligence on this.

I can say for certain that Priory Group can enter shared care agreements, because that’s who I was assessed by and I now get my prescriptions through the NHS.

And for those nosey bods of you who have clocked that I went private for my assessment - mine cost £1300 - not the end of the world, right?

Particularly if I a) I can do my bit to ease the burden on NHS resources and b) not have to wait 17 fucking years for an assessment!

Hidden Costs

Most private healthcare providers will have costs that continue beyond your initial assessment.

When you first receive your diagnosis through a private healthcare provider, you will undoubtedly be asked if you want to try medication.

For that you will need a prescription.

Some private doctors charge to write a prescription - mine didn’t, but I’m reliably informed that the charges for a private prescription to be written are around £50.

Then you will need to buy your medication off that private prescription. No NHS savings for the pink scripts, I’m afraid.

ADHD drugs can be quite expensive - the lucky thing is that at the start of your journey you’ll be on lower doses, which are lower cost.

My first set of meds cost £98 for 30 tablets of 30mg Elvanse Adult.

Initially your medication adventure needs to be closely monitored by your prescribing doctor - they have responsibility over your health and safety.

This initial phase of mediation is called “titration” and it should last about 3 months until you’re stabilised on your medication.

During this time you will need to check in with your doctor - each appointment will cost you until you have stabilised and your private doctor is happy to transfer you to the NHS.

Finally - which is the case for me - because my private doctor was the original prescriber and there isn’t an ADHD specialist at my local GP surgery, for my 6 monthly check-ups and any changes I need to make to my medication, I need to see my private doctor, privately, an appointment for which I pay.

All in all for my assessment and titration period I paid £2130 - which if you break it down monthly is £710 for 3 months.

I’m not moaning about this - I was fully informed by Priory at the start of my journey - I just want you to go into this whole thing with your eyes as wide open as they can possibly be.

I know it’s not for some of you and that is absolutely fine, but if it’s looking like it’s affordable for you I have zero complaints about going private.

In fact, I’m eternally grateful that I was able to do so as I might still be waiting for my assessment, 3 years later.

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“OK - So, I’ve Actually Got ADHD - What Now?”

Kick back, enjoy the drugs and live in peace, man! 😎

…is absolutely NOT what I would say to anyone who has recently been diagnosed.

It may have been a journey to get your diagnosis, but let me tell you, that wasn’t even the pre-game.

The journey through the rest of your life started when you received that diagnosis.

This is a massive change.

A change in life choices.

A change in physiology.

A change in identity.

You will need time to process and understand what your diagnosis means to you or what it means to your kids AND / OR what your kids’ diagnosis means to you as their parent.

As strange as it sounds, you will need time to grieve the life you never had or a life you imagined for your kids that they won’t have.

You need time to breathe.

Don’t fight it.

Cry all the water out of your body if you need to. Then do it again and again and again.

Don’t let anyone rush you on your journey of self-discovery.

You need time to heal.

And…only when you’re ready…I’ll be here for you.

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If you’re looking for coping strategies to help you along on your journey - try this article:

Redefining Success: Personalised ADHD Coping Mechanisms For You

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If you want to see what ADHD Coaching can do you pre and post diagnosis, book a call and we’ll see what we can cook up.

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