Adults with ADHD in Northern Ireland Face Significant Treatment Gaps, Incurring High Costs

Adults with Attention Deficit Hyperactivity Disorder (ADHD) in Northern Ireland are calling for urgent action to address a severe lack of publicly funded services. Many are forced to pay thousands of pounds each year for private treatment due to the absence of a formally commissioned adult ADHD pathway, a service available in other parts of the United Kingdom.

Rebecca Bryson, who co-owns three businesses, described the situation as "wildly unfair and kind of inhumane." She and her husband, who also has ADHD, collectively spend approximately £4,000 annually on private psychiatric reviews, prescriptions, and medication. Bryson stated that this financial burden is substantial for most people and highlights the disparity in healthcare access, comparing it to needing treatment for conditions like cancer or a broken bone.

"You can get a diagnosis as a child, but once you turn 18, you're on your own. It's bananas," Bryson added, emphasizing the need for a clear diagnostic route for adults with ADHD in Northern Ireland.

Comparison of UK Services

While Northern Ireland lacks a commissioned service, other regions offer different models:

• England: Adults have a legal right to choose their provider within the NHS. If local waiting lists are long, GPs can refer patients to alternative NHS-approved providers.
• Scotland: Services are not centrally commissioned. Local authorities are responsible for planning and delivering neurodevelopmental support, including services from the third sector.
• Wales: Health boards commission ADHD services locally. The Welsh government is working to increase capacity and improve assessment pathways through its Neurodiverse Improvement Programme.

In Northern Ireland, health trusts manage referrals within existing resources. However, demand consistently outstrips available capacity, leading to lengthy waiting lists and prompting individuals to seek private diagnoses and treatment.

Dr. Allen McCullough, a GP with 35 years of experience, acknowledged the difficulties faced by those seeking ADHD diagnoses, referring to it as an "evolving picture." He noted that while he can refer patients to an adult ADHD service in his area, there is currently no one available to receive these referrals. GPs also express concerns about prescribing medication for patients undergoing private care, especially when the qualifications of the diagnosing practitioner are unknown, as they bear responsibility for the prescription.

Jordan Young, 28, shared his struggle to access ADHD services, recounting being turned away by multiple facilities. He eventually traveled to England for a diagnosis, with his grandmother covering the cost through private health insurance. Young advocates for increased government funding and a more serious approach to addressing ADHD.

Alliance MLA Peter McReynolds criticized the Department of Health, stating that adults with ADHD have been "completely forgotten about." He has been advocating for a commissioned service since 2024 and has met with three health ministers, expressing disappointment with the lack of progress.

A spokesperson for the Department of Health acknowledged the demand exceeding capacity and the resulting long waiting times. They stated that "significant work has been undertaken to better understand the level of need for ADHD services." However, they cautioned that any future commissioning decisions would need to be made within the context of "overall affordability" due to significant funding constraints across health and social care.