HEALTH AUTHORITIES IN south Dublin and Co Wicklow are being accused of “closing the door” on adults seeking ADHD assessments, with new referrals “paused” and people facing a four-year waiting list. 

In a letter to Wicklow TD Jennifer Whitmore, the HSE said that adult ADHD treatment is provided by the ADAPT service and delivered in the Community Healthcare East area by St John of God Community Mental Health Services.

The HSE’s Community Healthcare East (CHE) serves Wicklow, Dublin South and Dublin South East and the ADAPT team was established in 2022 as a regional specialist in adult ADHD services.

The letter to Whitmore added that since commencing in 2022, the ADAPT team in the area has had a “very high level of demand and unfortunately this has resulted in very significant waiting times, up to four years”.

It was also noted that as of 27 May 2024, referrals from GPs to Community Mental Health Teams “will be paused to address the lengthening waitlist”.

The HSE’s referral pathway for adult assessment is via GPs.

The letter said that it was “hoped that in time a reduction in the waitlist, together with investment in resources and restructuring of the Model of Care, it will be possible to expand the CHE Adult ADHD service and accept new referrals again”.

The HSE designed a Model of Care for adults with ADHD and it was deemed that ten full-time teams and two half-time teams are required.

However, only seven such teams have been established, with two further teams currently in development. 

Whitemore, a TD for the Social Democrats, told The Journal that “it’s incredible this vital service is essentially being shut off to those that need it”. 

She added: “Rather than focusing on how they can fund and resource the service so it is fit for purpose, they are just closing the door. 

“The Government must revise this decision so that everyone, regardless  of where they live and what they earn, can access this basic yet crucial assessment.”

In a statement to The Journal, a spokesperson for the HSE’S CHE said “we have reached a juncture where the ADAPT team is unable to effectively meet the demand for its services within the current resource and service pathway configuration”. 

“As a result, we made the decision to prioritise the provision of care for those patients identified as having the greatest needs and the highest risk,” added the spokesperson.

The spokesperson said the ADAPT team is “providing assessments of people who are attending adult mental health services with other mental health difficulties and who are suspected to have co-morbid ADHD”. 

People with ADHD have high rates of co-morbid mental health disorders, such as anxiety and depression.

“We are committed to delivering efficient, high quality mental health services in the community, and the ADAPT team continues to work hard to find solutions to decrease the numbers waiting for assessment including looking at new models of care,” said the spokesperson.

They added: “We continue to advocate for additional resources for the ADAPT team which would enable them to reduce the waiting list more rapidly and reopen the service to new adult referrals.”

When asked if the four-year wait and pause of new GP referrals is a nationwide issue, the HSE said it was confined to the CHE area.

However, the HSE noted that there are “waiting lists for Adult ADHD services” elsewhere and that the “demand for these services has increased significantly post-pandemic and has been further driven by the greater public awareness of ADHD’s persistence into adulthood”. 

“Wait times can vary by location and we are actively working to manage these lists and ensure that individuals receive the care they need as efficiently as possible,” said the HSE.

In October 2023, Mental Health Minister Mary Butler admitted that ADHD adult services teams would not be expanded as there is no funding for 2024.

Speaking in October 2023, Butler told The Journal: “There is nothing in the budget to expand the ADHD teams for adults into 2024… so I am disappointed this year I won’t be able to continue the rollout of ADHD teams for adults. That’s an honest answer.”

In a statement to The Journal, the Department of Health said that “prior to the inception of the National Clinical Programme (NCP) for Adults with ADHD, which was launched in 2021, there were no specific ADHD public services available for adults in Ireland”.

A Department spokesperson said this “programme includes both assessment and treatment of the disorder and works collaboratively with voluntary agencies”. 

The spokesperson said the programme is being “implemented across the country by multidisciplinary teams on a phased basis” and that over €3 million has been made available for funding ADHD posts since 2021.

“It is the Minister’s stated intention to continue to deliver expanded services for people with ADHD, through reaching the planned 12 specialist teams as soon as possible”, said the spokesperson.

They added that Minister Butler has secured an additional €10 million of funding for mental health services in 2024 and some of this will be used for new posts to support ADHD and the rollout of a new ADHD team.