This page explains how Attention Deficit/Hyperactivity Disorder (ADHD) assessment and support works for adults and for children and young people in our NHS area.
It also explains when Adult Mental Health Services can help, and what to do if they are not the right service for you.
We are following national guidance from the Royal College of Psychiatrists in Scotland, which sets out how NHS services should prioritise care.
You can read the national position here: Royal College of Psychiatrists – ADHD and neurodevelopmental care in Scotland: https://www.rcpsych.ac.uk/docs/default-source/members/devolved-nations/rcpsych-in-scotland/rcpsychis-ndc-paper.pdf?sfvrsn=e0553480_4
Understanding ADHD
ADHD (attention deficit hyperactivity disorder) is a neurodevelopmental condition that can affect attention, activity levels and impulsivity. Some people experience significant difficulties in daily life, while others have milder challenges that can be managed without specialist treatment.
ADHD services in the NHS are organised differently for:
- Adults (18 and over)
- Children and young people (under 18)
These are separate pathways with different criteria and different staff.
Adult ADHD: how services work
Adult Mental Health Services provide assessment and treatment for ADHD only when symptoms are causing severe and persistent difficulties that significantly affect daily functioning or safety.
Specialist mental health services were designed to support people with the highest level of need. They are designed to support people whose symptoms are causing the most severe and complex impact on daily life and mental health.
When Adult Mental Health Services may be appropriate
A referral may be considered where ADHD symptoms are causing severe, persistent and complex impact on daily functioning or mental health, for example:
- Significant difficulty maintaining employment, education or housing
- Severe and persistent problems with daily functioning
- Co-existing mental health conditions where possible ADHD is making recovery much harder
- High levels of distress or risk that cannot be managed in primary care.
Referrals to Adult Mental Health Services are made by your GP.
When Adult Mental Health Services are usually not the right service
A referral is unlikely to be accepted where:
- Difficulties are mild or moderate and can be managed with support in primary care
- Differential diagnosis is being considered, and another service is more appropriate
- The main request is for an ADHD diagnosis without severe functional impact
- You are coping in work, study or daily life with manageable adjustments
- Support needs are better met through community, educational or workplace strategies
If Adult Mental Health Services are not the right service, this does not mean your difficulties are not real or important. It means a different type of support is more appropriate.
What to do if you think you have ADHD
You can speak to your GP about your concerns. Your GP can:
- Discuss your symptoms and how they affect your life
- Consider other possible explanations
- Offer advice, signposting and support
- Decide whether a referral to Adult Mental Health Services is appropriate
Many people benefit from:
- Self-management strategies
- Workplace or study adjustments
- Psychological support
- Coaching or peer support
- Information and resources
These options can help whether or not you have a formal diagnosis.
Private ADHD assessments
Some people choose to seek an ADHD assessment privately.
In some cases, people may choose to continue care privately if NHS specialist criteria are not met.
If you have a private diagnosis:
- Your GP will review the information provided
- NHS prescribing usually requires ongoing specialist clinical oversight
- GPs are not able to take on prescribing without appropriate shared-care arrangements in place. We currently are not taking on shared care agreements.
- A private diagnosis does not automatically mean NHS treatment will be provided
If ongoing specialist support is not in place, your GP may not be able to prescribe ADHD medication. This reflects national guidance and patient safety requirements.
Children and young people (under 18)
Children and young people are assessed through a different pathway called Neurodevelopmental Assessment Services (NDAS).
Adult Mental Health Services do not assess children.
If you are concerned about a child or young person:
- Speak to your GP, health visitor, school or other professional involved in their care
- They can advise on referral to the appropriate children’s neurodevelopmental pathway
Transition to adult services
Young people with a confirmed ADHD diagnosis in childhood who still need specialist support as adults will be supported to transition to adult services where appropriate.
Why services have thresholds
Across Scotland, there has been a significant increase in people seeking ADHD assessment and support. National guidance recognises that specialist mental health services must prioritise people with the most severe impact and highest level of need.
This approach aims to:
- Ensure people with the greatest difficulties receive timely care
- Use specialist services safely and effectively
- Provide support through the most appropriate service
We understand that waiting for answers or support can be frustrating. We are working across services to improve information, advice and support for everyone affected by ADHD.
This page may be helpful to share with patients when discussing referral options.