I’ve been reviewing my NHS activity over the past 2.5yrs, since I moved to a front line mental health Consultant Psychiatrist role. It seems that I have diagnosed 413 new cases of ADHD in clients who were referred to our service for other mental health conditions. The referrals queried depression, anxiety, possible bipolar, personality disorder – the usual range of mental health conditions. Almost all of these patients once diagnosed and treated with medication were able to be discharged from the service and to my knowledge are all doing well with no need to be referred back for anything.
Contrast this with what would probably have happened if these clients had seen a non-ADHD specialist colleague. Since few non-specialists understand that ADHD in adults often presents with mood/anxiety/emotional or sleep issues, rather than the so called “core” symptoms of hyperactivity, impulsivity and inattentiveness, very few if any would have been diagnosed with ADHD. They would have received other mental health diagnoses, most commonly those listed above, and would have been referred into the main part of the service. People with underlying undiagnosed ADHD don’t usually do particularly well on just the treatment for the comorbid issues/mood/anxiety problems unless the ADHD is also addressed, so they would likely have languished in the service, inching their way up psychology waiting lists, achieving disappointing results from therapies/medication input and joining the ranks of the treatment resistant.
Hopefully we can get some proper research showing this – I think the NHS still needs to realise that rather than it being an expensive “extra” – diagnosing ADHD quickly in the frontline will not only transform patients’ lives, but with about 25% of psychiatric referrals/patients now known to have underlying comorbid adult ADHD, could drastically reduce service costs as well.
This could literally transform mental health services if we can get the message across!!