ADULT ADHD AWARENESS in Ireland is on the rise, but the State support services are not there to back it, according to Chief Executive of ADHD Ireland, Ken Kilbride.
The Oireachtas sub committee on mental health was told today that ADHD Ireland, the national representative organisation for those with this condition, has seen calls to the organisation double to 6,000 contacts per year.
ADHD stands for Attention Deficit Hyperactivity Disorder and is a neurodevelopmental condition, which means that the brain has developed differently. There are three different types of ADHD.
Kilbride told the committee that its service has been hearing anecdotally from a range of personnel in the HSE that community mental health services are being overwhelmed by adults looking for ADHD assessment and treatment.
“We are hearing that some clinics are reporting that up to one third of new referrals are now for ADHD. Getting a diagnosis privately even if you can afford it, is also no less onerous, particularly if medication is indicated,” he said.
Concerns were also raised at today’s meeting at the lack of regulation of private assessments being carried out, with worries around parents of children and adults being exploited.
“The awareness is there but the service is not there to back it,” said Kilbride, who added:
“We have considered developing a workshop for people on how to talk to their doctor. It is that level of concern. When I talk to people about ADHD, I always say that if we got a euro for every woman who came to one of our support groups, particularly those aged from 40 to 45, who said they had been on anti-anxiety and anti-depression medication over the past 20 years and have just found out they have adult ADHD, we would not need funding from the HSE. It is that common.”
At the moment, there are four clinics for adults with ADHD, the committee was told today.
Once they are fully rolled out, there should be another 12 or 13 across all the CHOs.
‘They do not have funding for them this year. It may be next year or the year after. At the moment, unless you live in the catchment areas, which are in south Dublin, north Wicklow, Cork, Limerick and Sligo, you cannot access these services. At least 50% of the country does not have access to dedicated adult ADHD services through the HSE,” said Kilbride.
He told the committee he recently cried during a seminar organised for people with late ADHD diagnosis where they spoke about how their life could have been different had they been diagnosed earlier, stating that people are “grieving” almost for the life they could have led.
However, while he said much of the discussion was centred around the difficulties of living with ADHD, there is a need to highlight the positives, stating that many people with ADHD have played to their creative strengths and are top of the game in areas such as sport, business and the arts.
“Apart from the impact on family and lives, there is an ongoing cost to Irish society in general. Research would show that the socio-economic cost to Ireland each year is €1.8 billion.
“Reasonable estimates show that 15% of adults getting treated by the Mental Health service with the HSE will have undiagnosed ADHD. We, as a society are overpaying for ignoring this condition and we will continue to pay €1.8bn each year till we do pay attention to it” he said.
Core funding from the State has not increased to the organisation in the last number of years, but the demand for their service has more than doubled, members were told.
The committee was told that more support groups, events, and public seminars could be held if funding was increased.
The organisation states that it suspects that less than 10% of adults with ADHD are getting formal treatment.
ADHD adults will have higher rates of marital breakdown, higher rates of unemployment, higher rates of substance misuse, higher rates of anxiety and depression, the committee was told.
Kilbride said the majority of adult presentations to the organisation seeking support have also had diagnosis of anxiety and depression within their lifetime.
Dr. Sonia Morris, a psychologist who is on the board of ADHD, said there are also issues around prescribing those with the condition, stating that there are limited professionals who can do so.
Speaking about ADHD in children, she said the limitation of having ADHD under the remit of Child and Adolescent Mental Health Services (CAMHS) is there is a waitlist prioritisation, where urgent referrals for children considered at risk with severe mental health concerns will always be seen before an ADHD referral.
“CAMHS waitlists are therefore largely populated by children awaiting ADHD assessment. To cope with rising waitlists for services, the HSE have recently been funding ‘waitlist initiatives’.
“These are advertised as temporary contracts making suitable recruitment difficult, and retention of any gains difficult, with waitlists rising again once the initiative ends,” she said.
There is also no guidance for clinicians working in CAMHS on what a good ADHD assessment looks like, and what good intervention for ADHD looks like, she added.
ADHD Ireland called on the committee members to ensure Government rolls out services that are adequately resourced and that each person with ADHD in Irish society can live meaningful, happy, productive lives.
In a statement to The Journal, the HSE said that once the ADHD in Adults National Clinical Programme’s model of care is implemented there will be 12 Adult ADHD Clinics that will provide assessment and multi-modal treatment in the community.
However, no clarity was provided as to when the full model of care will be up and running.
The HSE said the patient’s should present to their GP for referrals to their local Adult Mental Health Team (AMHT) where they will be assessed for co-morbid mental illnesses and screened, and if needed, patients will be referred to the ADHD Adult Clinic.
Regarding waiting list data, the HSE said it is developing a data system to capture day in community services at patient level.
“There is no system in place which currently calculates waiting times or by diagnosis for each team for this reason,” said the HSE.
More information on ADHD Ireland can be found here. ADHD Ireland and the UCD School of Psychology Adult ADHD App which provides specific information for adults who have ADHD or think they may have ADHD is available for download here.
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