Adult ADHD Assessment: What Happens on the NHS, From Your GP to How Right to Choose Works

Getting an adult ADHD assessment can feel like a job in itself. Not because the steps are especially complicated, but because they involve the exact things ADHD can make harder: booking appointments, remembering details and waiting.

You might have spent years wondering whether ADHD explains a lot. Then you finally decide to do something about it, and you're not sure where to start.

That's what this article is for.

Where the assessment starts

On the NHS, the starting point is usually your GP.

The NHS says that if ADHD symptoms are affecting your studies, work or relationships, you should make an appointment with a GP to find out what support is available.

If you were diagnosed with ADHD as a child and need help with symptoms now, the NHS says to talk to your GP about getting a referral.

The GP appointment

The GP will ask about your symptoms and how they affect your life.

They may also want to consider other conditions that could be causing your symptoms, such as autism, Tourette's or anxiety.

After that, the GP may decide to refer you for an assessment with a mental health professional who specialises in ADHD.

What NICE says about referral

NICE guidance says adults without a childhood diagnosis should be referred for a specialist assessment where there's evidence of ADHD symptoms that:

• began during childhood and have persisted throughout life
• aren't explained by other mental health diagnoses (although other conditions can exist alongside ADHD)
• have caused, or are linked to, moderate or severe difficulties in areas like work, education, relationships or day-to-day life

That last point matters. ADHD isn't just about having some of the traits. It's about how much they affect your life.

Getting your thoughts in order first

It's easy to walk out of an appointment having forgotten half of what you meant to say.

You might want to jot down a few real examples beforehand, like missed deadlines, lost things or jobs that never get started, and how those have affected work, home or relationships.

The specialist assessment

The NHS says the assessment will be with an ADHD specialist, such as a psychiatrist.

They'll ask about the history of your symptoms, particularly whether they started when you were a child and how they affected you at school.

The assessment looks at different areas of your life, including:

• work and education
• family and friends
• medical history, including any mental health issues

The specialist may also want to contact someone who knows you well, such as a family member or close friend.

It isn't just a questionnaire

You might be asked to fill in forms, but NICE says a diagnosis shouldn't be made on rating scales or observation alone.

Instead, NICE says it should be based on a full clinical and psychosocial assessment, including a developmental and psychiatric history, observer reports and an assessment of your mental state. It should only be made by a specialist with training and expertise in diagnosing ADHD.

NICE also says the process should look at your needs, any other conditions, your circumstances and your physical health.

The Wait

This is where things can stall.

The NHS says waiting times vary, and you may have to wait several months or years to access ADHD specialist services.

For someone who has finally built up the momentum to ask for help, that can be really disheartening.

Using Right to Choose

The NHS says you may be able to find a clinic with a shorter waiting list through your GP using the Right to Choose scheme.

You can ask for an NHS appointment at any clinic, including a private clinic, if it provides ADHD services for the NHS in England.

The details worth knowing

Government guidance on NHS choice in England says that if you're referred to a mental health professional, you can usually choose which provider you see and the clinical team in charge of your care.

But there are a few conditions:

• the choice applies at the point of referral, so it's worth raising it with your GP then
• the provider must have an NHS contract for the service you need
• the service must be led by a consultant or mental health professional

There are also some situations where you don't have that legal right, such as when you're already being treated for the condition and it's an onward referral, or when you're using urgent or crisis services.

The NHS says you should always be offered a choice at the point of referral, and a chance to discuss the options with the person referring you.

Once you and your GP have agreed a shortlist, the guidance says you can view providers' details, including waiting times, through Manage your referral or the NHS e-Referral Service.

After the Assessment

If you're diagnosed with ADHD, the NHS says the specialist will talk to you about what this means and what happens next, including what help and support may be available.

That doesn't automatically mean medication. The NHS says ADHD can be managed in different ways, and not everyone needs or wants to take medicine.

If you're not diagnosed, you can still talk to your GP about what's going on and what support might be available.