Adult ADHD assessment (private) - how to choose a provider?

[BoobsOnTheMoon]

Is it better to be seen in person, or is remote as good, for a start? Of the two places we are looking at, one offers in person assesment by a registered mental health nurse, and the other is remote but done by a psychiatrist. What else should we be looking for? I'm aware of the recent Panorama report but not all private providers are terrible cowboys, right?

This is a one-shot for us as money is extremely tight but there is literally no pathway for adult assessment via our local NHS at the moment and the person in question urgently needs a) some answers about why they struggle so much with normal daily stuff, b) why anti depressants/therapy don't work at all for them, and c) some sort of evidence/proof that they're not just lazy and making it all up.

Psychiatry UK was recommended to us on here, and we used them. I cannot fault their service.

I would prefer assessment by a psychiatrist rather than a mental health nurse.

Thanks.

So now I'm trying to choose between Clinical Partners and Psychiatry UK

CLINICAL PARTNERS
Online or in person (30 miles from home)
2 hours ish
6 questionnaires pre assessment
Asks for someone who knew you as child to give info (this will be a problem for the person as they're estranged from family and don't have any contact with school friends etc)
Diagnostic report
Clinical psychiatrists
£895

PSYCHIATRY UK
50 mins online only
Psychiatrist
Diagnostic report
£360

Hmmmmmm...

Asks for someone who knew you as child to give info (this will be a problem for the person as they're estranged from family and don't have any contact with school friends etc)

This part is very important as in order for ADHD to be formally diagnosed, it must be demonstrated that it affected the patient in childhood rather than 'just' as an adult.

Both parents deceased. School records presumably unobtainable? Not in contact with siblings. Was taken to a child psychologist in the 80s and mother was told they were "hyperactive" but no idea how to obtain records?

I'm interested in this too. What happens after the diagnosis? Are you handed back to the NHS & how does this work?

A lot of adults with neurodivergent difficulties may have family who won't acknowledge their childhood struggles because they don't "believe" in ADHD/autism or they can't accept that their child might be different or in their eyes flawed in some way. This part is particularly difficult for those with narcissistic parents.

Despite the fairy hideous difficulties I had throughout my childhood and 20s including lots of misdiagnosis my mother still won't even go near the conversation that maybe just maybe I could have done with support and an assessment. In her mind I was a "genius" child who became "difficult" when I hit adolescence.

This having to involve a family member is what puts a lot of people off seeking an assessment particularly when it's expensive.

@BoobsOnTheMoon are you fairly confident that it's ADHD as

"why anti depressants/therapy don't work at all for them"

doesn't sound like ADHD??

I'm not trying to criticise but aware you say that money is tight so I wouldn't want you to go through the expense (and potential) angst trying to get a diagnosis and then you don't as it's something else rather than ADHD.

I’m in process of doing this. I didn’t realise only a psychiatrist and not a psychologist can prescribe meds for it. I am sick and tired of trying to manage it and want to have a tablet when I need one!

I just typed a long response to you then lost it @HundredMilesAnHour

But in short, yes. We are 100% certain they have ADHD. We just don't have anything to back that up, like a piece of paper saying so, and they need that.

I would think a lifetime of being misdiagnosed as depressed yet no anti depressants or therapy having the slightest effect was quite typical for adults with undiagnosed neurodiversity, no?

And yes @Courgeon that's my own experience and what holds me back from getting my own ASD and ADHD assessments. Fortunately I'm coping well enough these days that I can manage without that all important proof that I'm not just making it up or flaky or lazy or awkward or forgetful or pick your own inappropriate label...

I’d be really wary of the £360 seems too good to be true. Not sure what part of the UK you are in where I am there are issues with the nhs accepting diagnosis done by private provider so I guess it depends on what you need it for really and if it will be accepted in terms of getting other supports?

Why do you feel you need one? Aren't you just who you are?

I received my diagnosis at age 53 so I'm VERY familiar with the impact of a lifetime of being undiagnosed. My life could have been very different. I haven't discussed it with any (still alive) family members. Quite possibly I never will. But doctors state that both therapy and anti-depressants can be useful and do make a positive difference, and that's consistent with my own experience.

For me, getting a formal diagnosis changed everything and yet changed nothing. It is a fairly gruelling experience and not something I went through lightly.

I would look at clinics that

Offer an MDT assessment: Nurse Specialists, Psychiatrists and Clinical Psychologists. Ideally assessment/s will involve at least 2 different clinicians.

Provide services to the NHS.

Offer comprehensive assessment using recognised tools leading to DSM - 5 diagnosis. This will include developmental assessment, informant questionnaires, symptom checklist and clinical interview. Qb testing is offered by some centres now & encouraged by NICE.

Offers a separate appointment for medication after a pause for reflection. Beware of same day prescription services.

Will tell you if you don't meet the criteria. Be very wary of clinics offering 100% diagnosis. You are paying for assessment, not diagnosis.

I was diagnosed by Psych UK under the NHS "right to choose" scheme. They are currently not accepting private patients, only NHS right to choose. I waited 6 months for assessment & a further 6 months for titration.

Psychiatry UK also have several pre-assessment questionnaires for you & someone who knows you well. I got my husband to fill in for someone who knows me. He'd known me for about 16 years at the time & not since childhood. This was fine. The psych who assessed me was also able to say, (without being questioned on it first) that he was 99.9% certain from talking to me that I'm also on the autistic spectrum, but I'd need another referral to confirm that.

Titration hasn't been the greatest tbh because Methylphenidate doesn't work for me & the psych UK pharmacy partner take ages. Currently waiting on Elvanse. Fingers crossed that helps.

I used one of the providers who were on the panorama program. I just want to say, that programme has been widely discredited for it's poor journalism and bias.

Not to say that no mistakes have been made, but there was a clear agenda to prove an already agreed outcome.

The psych who assessed me was also able to say, (without being questioned on it first) that he was 99.9% certain from talking to me that I'm also on the autistic spectrum, but I'd need another referral to confirm that.

This is well meaning, but a professional really shouldn't be saying 99.9% without the assessment.

Its because I was being assessed for ADHD at the time, not ASD.

I asked my GP who they would recommend and be willing to do 'shared care' with (regarding medication) and they gave me the name of a local Psychiatrist. That way I knew I could access medication without having to pay for a private Prescription

I didn't have any family to be involved in my assessment, but I did have my school reports

I have experience of ADHD360. Did not have to have someone fro my childhood but I did have school reports etc. They spoke about them but did not ask to see them.

After diagnosis we tried medication and found it completely changed my life in the best way. Went back to shared care with the GP and now get everything through them.

It was expensive but worth it as so much has improved for me now.

I was diagnosed privately 3 years ago (I'm 52) at an adhd clinic local(ish) to me, it cost £1450 and took most of a day, I did a QB test, diva test, and was assessed by a psychiatrist and psychologist, my dh also completed a questionnaire about me. I was asked if I could get a questionnaire completed by someone who knew me as a child but as I'm no contact with any living family that wasn't possible and they said it wasn't a problem. I do have a few old school reports but since I could remember (sadly) most of the comments about not trying hard enough etc I didn't need to take them along.

The same clinic (which was recommended by a friend) had Lao previously diagnosed my son, and we both had no problems with getting our gp to do shared care for prescribing meds.

It's not for me

Due to where in the UK they live, shared care or Right To Choose via the NHS are not options.