What are some tips to help navigate a psychiatric diagnosis in the UK?

December 23, 2016 11:34 PM

I'm finding it difficult to maintain the significant momentum needed to seek a diagnostic interview for ADHD in the UK (NHS). I'm not looking for medication, just a meeting with a psychiatrist to see if 'ADHD' is even applicable to me. Is there a magic phrase I should be giving my GP? A map? Brief snowflake-y details inside.

Each professional to whom I am referred swiftly passes me to somebody else or directs me back to my GP. You know, the person who initially started me down this rabbit hole and claims not to know a definitive professional that can help me. So far everyone I've spoken to has been introduced with, "you might try ___."

I've now spoken to grand total of seven different contacts, some only vaguely related to general mental health support and others not related to psychiatry at all. At least three have directed me to contacts I've already been in touch with, and when I advise this, they just usher me back to my GP. So far: none of them have been able to help me. None of them seem to know where I can go from here, except back to my GP. None of them can offer me any alternatives, seemingly, at all.

I'm struggling in general. I have been for as long as I can remember. It's been a very long and winding road for me to even get to the point of seeking help and taking a proactive approach to my own mental health. And now I'm starting to realise that the 'seeking' portion is just another added struggle, on top of everything else. I'm starting to falter. I know something is wrong, but I just want to be sure of what it is so I can try to deal with it correctly.

Has anyone been down this road before in the UK*? What did you do that ended in a meeting with a qualified psychiatrist with the ability to determine a diagnosis for ADD/ADHD through the NHS**?

* Specifically, I'm in Scotland.
** To add yet another complication, I definitely can't afford to go private. Looking through previous, similar AskMeFi questions, this seems to be a common suggestion.

posted by Vrai to Health & Fitness (10 answers total)

i'm not in the UK so i don't really know how helpful this will be for you BUT: i had a much easier time getting it done by going through a neurologist and then a specifically pediatric neurologist for my ADHD diagnosis and eventual medication/treatment.
posted by poffin boffin at 12:26 AM on December 24, 2016

Unfortunately it looks like it's a challenging process. Addressing the Balance is a Scottish society for adults with ADHD - if you're in Edinburgh, they do a monthly meetup. There is a lot of information on their site as well.
posted by the agents of KAOS at 2:51 AM on December 24, 2016

It sounds like you've tried lots of things so I hope further suggestions are not further frustration! I don't have any expertise in this area, and I'm not in the UK, but when I've needed info about appropriate professionals in Australia I've contacted the local Adult ADHD group and they've suggested psychiatrists who are particularly knowledgeable for assessing ADHD.

Googling suggests likely groups are Addressing the Balance (which is specifically Scottish - as mentioned by the agents of KAOS above, on preview) and AADD-UK (which is more broadly British). It looks as though you can contact Addressing the Balance by email (contact details here) and AADD-UK has forums where you could probably post a question.

AADD-UK references a clinic in Edinburgh -
Lothian Adult ADHD service
Royal Edinburgh Hospital
Morningside Terrace
Edinburgh EH10 5HF
Tel No. 0131 537 6000

I'm not sure whether it would be possible for you to go there for assessment, but they may be another source of info about other services you can access.

However, it does appear that there aren't a lot of NHS services for ADHD in Scotland outside of Edinburgh. For instance this document (page 14), admittedly reporting a service review from 2012, notes there is no specialised NHS ADHD service for Glasgow, and this list of specialists lists only two NHS specialists in Scotland, and a further one private practitioner. It's quite possible that this info is old and/or incomplete, so it's worth reaching out in different ways, but if it feels like you've knocked on all the doors and are still not getting anywhere, it might be worth considering less ideal options (can you perhaps get assessed by a generalist psychiatrist? Or a psychologist or other kind of mental health worker with experience in the field?)

You mentioned that you're not looking for medication - what is it you are hoping to get out of this assessment? And if you can't get a formal diagnosis, are there other ways you can get some of what you need? I wonder if, for example, reading up on strategies for living successfully with ADHD, or joining a forum or support group, might meet some of those needs.

I hope your search is successful, one way or another. Apologies if my lack of background knowledge about the NHS limits the usefulness of these suggestions.
posted by Cheese Monster at 2:59 AM on December 24, 2016

You can't really bypass a GP altogether, at least not within the NHS - they're the gatekeepers. But you can certainly ask to see a different GP at the same medical practice. There's a surprising amount of mileage in knowing which of your local GPs is clued up about specific areas of medicine, and you may well find that while one partner has nothing to offer you wrt ADHD, another at the same practice may take more of an interest in mental health diagnoses and will be able to help. And you can always move to a different NHS practice if your current one isn't giving you the care you believe you need.
posted by pipeski at 5:01 AM on December 24, 2016

You may not be getting a lot of help because diagnosing ADD is done by having the patient fill out a five-minute questionnaire. There's nothing more to it than that.

Do you need the diagnosis for any specific reason or more to confirm your own suspicions? If it's just confirming you have ADD and nothing else, why not go ahead and take steps to find ways to live with it?

ADD is diagnosed through an incredibly subjective questionnaire -- that's it. A doctor will give someone this questionnaire (or something similar) which takes no more than 5 minutes to complete. Based on the those results alone, a person can be diagnosed. So take an assessment yourself and see!

As far as living as though you have ADD and ways to work with it, I recently asked this question about supporting teens with ADD and got great advice.

Also -- ADD isn't considered a psychiatric disability any more -- in the US it was a health disability but has now been reclassified as a Specific Learning Disability.
posted by yes I said yes I will Yes at 5:17 AM on December 24, 2016

Sorry if this is stating the very obvious, but it took me a while to discover it, so just in case it helps - some GPs can be incredibly passive, which is a disadvantage when you need them to lead you to help, but an advantage when you want to lead them. You say you want a meeting with a psychiatrist - have you literally said to your GP: "Please will you refer me to a psychiatrist?" (or whoever seems to be the right person based on the comments above).

Being able to give examples of how the problem is interfering in your day-to-day life sometimes helps, too.

I sympathise - the NHS is a miraculous and wonderful thing, but sometimes not great at dealing with chronic issues where the answer isn't immediately obvious. It sometimes seems to use attrition as a way of filtering out who is genuinely in need of help. Wishing you the patience and energy you need to get you to the right person.
posted by penguin pie at 5:35 AM on December 24, 2016

For what it's worth, in the US I was tested and diagnosed in an incredibly detailed way that took several hours. It was not a 5-minute checklist. But it's possible that a 5-minute checklist works just as well or is the done thing these days. So sorry you're having difficulties. Best of luck!
posted by Bella Donna at 6:43 AM on December 24, 2016

"Primary Care Mental Health Team" is most likely the magic phrase for the kind of service you want. If not, try "Community Mental Health Team". They will have general psychiatric doctors who can diagnose you and will know what other services might be appropriate. Your GP can refer you to them.
posted by Emma May Smith at 9:36 AM on December 24, 2016

(Just to clarify, I wasn't suggesting bypassing the GP, but if the GP is out of options for where to refer you, would it be appropriate to make suggestions of your own to your GP?)
posted by Cheese Monster at 3:39 PM on December 27, 2016

I thought I should add an update for anyone else that might find this question.

I've finally managed to be referred to a Clinical Psychiatrist on the NHS. One three hour meeting later --and with much, much more discussion and involvement than an "incredibly subjective questionnaire"-- I was diagnosed with ADHD. In the last ~year I've researched every self-help method I could find online (and off) to try and successfully navigate what I suspected was ADD/ADHD in my lfe. In addition, I completed at least two 9-week stints of CBT, a meditation clinic, and a little bit of group therapy. Though the research into 'productivity' methods, mindfulness, and CBT techniques have been somewhat valuable, nothing truly helped. Do you know what did? Medication.

Continuing on from the information in the original post, my path was as follows: GP, Primary Mental Health Care Team, CBT Referral, GP, CBT Referral, GP, Group Therapy, GP, Referral to a second GP because the one I'd been seeing straight up asked me 'what do you want me to do about any of this?' when I recounted how hopeless and worthless I felt that nothing so far had worked, Second GP that actually took my symptoms and mental health experiences seriously, Referral to a Psychiatric Nurse who interviewed me extensively and then convened with a group of her peers (which included the Psychiatrist I later met) before finally referring me to, Clinical Psychiatrist.

It was long and extremely frustrating, but it was all worth it. I feel like I'm finally beginning my life after spending far too long just struggling through it. Medication is seriously life changing. If you think you have ADD/ADHD, please go and find out for sure. Don't rely on internet spectators to tell you about comforting questionnaires and YouTube videos that promise 'hacks for staying focused'. Go and speak with a medical professional that is legitimately qualified to assess your symptoms and experiences. Be honest, and be brave.

PS: If you don't want to go the medication route, I've also discovered that ADHD Coaches are a people that exist. More specifically: Consultant Psychiatrists who are medically qualified to provide help and guidance for the daily management of ADD/ADHD.
posted by Vrai at 9:34 PM on December 2, 2017