How to get a Private Assessment for ADHD
Step 1- Will your GP accept a ‘Shared Care Agreement’?
Before going for an assessment, you need to think about if you want treatment after you have been diagnosed. This is important because if you are diagnosed privately, you will initially receive treatment privately, rather than through the NHS. This applies to both medication and CBT therapy.
Even if you just want the diagnosis without treatment, be aware that your feelings may change in the future as you learn more about how ADHD affects you. You don’t want to get stuck in a position where you have a private diagnosis but are unable to afford private treatment.
If you want a private diagnosis but think you may want to access ADHD treatment through the NHS, you need to check that your GP will accept something called a ‘Shared Care Agreement’. Ideally, you want to make sure that your GP will accept one of these BEFORE you go for a private assessment, so that you don’t end up paying for private follow up treatment.
Many GPs are happy to recognise a private diagnosis, however there are some who are not. If your GP is unwilling to accept your diagnosis, you can ask them to refer you through the NHS pathway, and take on shared care while you are waiting. In this situation, it is up to you to convince the GP. It is possible to change GP if you are having difficulties with them, though it is important to make sure that a new GP will accept shared care.
Step 2- How to choose an ADHD Assessor
Select a clinic or practitioner to assess you for ADHD. Do your research, and make sure that the person you choose is a member of the General Medical Council and on their specialist register. You can check their register here. You can also call the assessment clinic or company to check their credentials.If you are an adult in the UK, the only people who can formally assess you for ADHD are a Psychiatrist, a specialist ADHD Nurse or a Psychologist. It is important to note that Psychologists cannot prescribe medication.
Before booking an assessment, you should ask:
-If the provider requires a GP referral letter in order to assess you.
-Their fees for assessment, follow up appointments and treatment.
-If they are able to prescribe ADHD medication.
Step 3- What to expect at an ADHD Assessment
Once you have chosen a assessor, completed payment and any necessary paperwork, your provider will book an assessment for you. Your assessment may be in person, but it is not unusual to have one conducted via video call.
The assessment usually takes 45-90 minutes, during which you will discuss your overall mental health, mental health history, and any family mental health issues that you are aware of. If anyone else in your family has ADHD, it can be helpful to mention that during your assessment, as ADHD is genetic.
You will also be asked questions relating to Hyperactivity and Inattention, and assessed according to the DSM V criteria for ADHD. You will be asked a number of questions that relate to this criteria, and you need to answer with examples that demonstrate the trait (symptom) that is being assessed. To receive a diagnosis, you must have at least 6 traits (symptoms) which are present now, and when you were a child.
For example, you may be asked if you often lose things. To answer this, you need to give a general description of how often you lose things (e.g. “I lose things all the time”), and give several examples of times that you lost things that were necessary for a task. You will also need to give examples of times that you lost things when you were a child e.g. “When I was in school, I always used to forget my homework.”
We recommend that you familiarise yourself with the different traits (symptoms) of ADHD that will be assessed during your appointment. Many people with ADHD find that their mind goes blank in such situations, so it is important to think about which traits (symptoms) of ADHD you can identify in your own life, and write down examples before your assessment.
After the clinician has finished asking you questions, they will let you know what happens next. If you are given a diagnosis of ADHD, your clinician should discuss treatment options with you. If not, they will tell you why they think that you do not meet the criteria for an ADHD diagnosis. It may be that you did not give enough detail about the difficulties you experience, or that another diagnosis explains your traits (symptoms) better than ADHD. You do not have to accept this diagnosis if you disagree with it, and you are entitled to seek out another provider for assessment if you still think you have ADHD.
Many adults who receive a diagnosis find that it comes as a huge relief to know that they are neurodivergent, because it explains a lot about why they have struggled in life, but the feelings that it brings up can also be difficult to deal with. If you would like support, to share your experiences, or meet other adults with ADHD, you can sign up for the ADHD Aware newsletter here and come to one of our (free) monthly meetings.
Step 4- What Kind of Treatments Are There For ADHD?
If you are given an ADHD diagnosis, your clinician will discuss whether you want to consider medication or another form of therapy, such as CBT. You should then decide together on what your treatment plan will be.
Medication
The first-line treatment for ADHD is stimulant medication, because that is what has shown to be the most effective treatment for ADHD. If you want to try medication, it is likely that you will be offered a brand of methylphenidate, lisdexamfetamine or dexamfetamine. These are not the same as illegal drugs you may have heard of, and it is important to be aware of any misconceptions you may have about ADHD medication, due to misinformation and stigma.
If you are not able to take stimulant medication for medical reasons e.g. a heart condition, or untreated high blood pressure, then you should ask to try a nonstimulant medication instead.
Atomoxetine is an example of a non-stimulant that you may be offered, but some clinicians will also prescribe Modafinil, Venlafaxine, Bupropion Hydrochloride or Tricyclic Antidepressants.
It is likely that you will need to try different medications and doses before you find the right one for you. This process is known as titration.
If you would like more information about the different kinds of ADHD medication, you can find it here.
CBT Therapy
CBT stands for ‘Cognitive Behavioural Therapy’, which is a type of talking therapy. CBT for ADHD is very different to the way that CBT is used to treat other conditions such as anxiety. CBT therapy for ADHD specifically deals with the difficulties caused by executive function, and other traits (symptoms).
For this therapy to be effective, the therapist should have experience of treating adults with ADHD. If the clinician who diagnosed you does not provide CBT Therapy and you would like to try it, they may be able to give you recommendations for another therapist. If you would like more information about CBT for ADHD, you can find it here.
Most people find that a combination of medication and CBT therapy is most effective, but everyone is different. It’s about finding out what works best for you!
Step 5- What happens after you have a treatment plan for ADHD?
Shared Care Agreement
If you are planning on returning to the NHS for treatment, the private clinician who diagnosed you should write to your GP with paperwork for a ‘Shared Care Agreement’. This means that your care and treatment will be shared by your private clinician and your GP. If your GP has previously said that they will accept this agreement, you need to wait for this paperwork to go through. In the meantime, you will be paying privately for prescription medication or CBT therapy.
Once the GP has accepted the agreement, you will be able to get treatment via the NHS. For medication, this means that the private clinician you saw is still the one writing the prescription, but you get the prescription filled through your GP. You will pay the usual NHS prescription charge.
However, you may still need to pay the private clinician you saw for an appointment if you need to adjust your prescription, as well as for your annual check up.
For CBT, you will be referred to a therapist on the NHS. There is more information about CBT on the NHS here. You should be aware that CBT is only available short term on the NHS, and that if you want to access it long term you will have to pay for it privately.
Continued Private Treatment
All follow up appointments and prescriptions are done by your private provider. This means that you will have to continue to pay for follow-up appointments, prescriptions and medication charges. If you are having CBT therapy, you will need to continue to pay for that privately as well.
Full Discharge to GP
If you are fully discharged to your GP, it means that it is not a requirement for you to continue to see your private clinician for follow up appointments. However, you can return to them if you need to.
Prescriptions will be renewed by your GP and your ongoing treatment plan will be decided between you and your GP. GPs are not able to prescribe you a new type of ADHD medication, so they may refer you back to your private clinician if that is what’s needed. You will pay the NHS prescription charge and you will no longer need to pay privately for medication.
For CBT, you will be referred to a therapist on the NHS. There is more information about CBT on the NHS here. You should be aware that CBT is only available short term on the NHS, and that if you want to access it long term you will have to pay for it privately.