1. Who Should Conduct the Assessment?
The qualifications and expertise of the person conducting the assessment are paramount. Ideally, an adult ADHD assessment should be carried out by a consultant psychiatrist. Why is this important? A consultant psychiatrist brings a wealth of knowledge and experience to the table, allowing them to:
- Evaluate the individual holistically: ADHD doesn't exist in isolation. A qualified psychiatrist can assess how ADHD symptoms interact with other aspects of a person's life and mental health.
- Address complex mental health concerns: ADHD often coexists with other mental health conditions. A psychiatrist is trained to recognise and diagnose these comorbidities.
- Assess ADHD symptoms, severity, and life impact: Understanding ADHD isn't just about ticking boxes on a checklist. It's about comprehending how symptoms manifest in an individual's life and the extent of their impact.
- Recognise and diagnose co-occurring mental health problems: Conditions such as depression, anxiety, and OCD frequently co-occur with ADHD.
A comprehensive assessment should identify these issues. It's worth noting that research shows 60-70% of undiagnosed adults with ADHD also have other mental health problems. This statistic emphasises the importance of a thorough evaluation by a qualified professional who can see the bigger picture of an individual's mental health.
2. How Long Should the Assessment Take?
Time is a crucial factor in conducting a thorough ADHD assessment. A good ADHD assessment should take at least two hours. This might seem like a long time, but it's necessary to cover all the bases.
Here's why:
- Understanding ADHD symptoms: The assessor needs time to explore the full range of ADHD symptoms, their severity, and how they impact daily life.
- Identifying co-occurring conditions: As mentioned earlier, other mental health issues often accompany ADHD. These need to be identified and differentiated from ADHD symptoms.
- Exploring neurodevelopmental history: ADHD is a neurodevelopmental disorder, meaning its roots often lie in childhood. A good assessment will delve into early life experiences, including pregnancy and school years.
- Reviewing physical and medical health history: Sometimes, physical health issues can mimic ADHD symptoms. A comprehensive assessment should rule out these possibilities.
3. How Should the Assessment Be Conducted?
The methodology of the assessment is just as important as who conducts it and how long it takes. A good adult ADHD assessment should follow established guidelines, such as those set out by NICE (National Institute for Health and Care Excellence).
This typically involves:
- Standardised questionnaires: Both the individual being assessed and family members should complete standardised questionnaires. These provide valuable insights into symptoms and behaviours across different contexts.
- Verified diagnostic tools: Tools like the Diagnostic Interview for ADHD in adults (DIVA) are designed to ensure a thorough and standardised approach to diagnosis.
- Computer-based cognitive tests: While not always necessary, these can provide objective data on attention, impulsivity, and other cognitive functions relevant to ADHD.
What Should You Receive After the Assessment?
The end of the assessment isn't the end of the process. A good ADHD assessment should provide you with clear, actionable outcomes:
- A clear diagnosis: You should know definitively whether you meet the criteria for ADHD or not.
- A comprehensive medical report: This should detail your ADHD symptoms, their severity, any co-occurring mental health conditions, and a full explanation of the diagnostic process.
- A treatment and support plan: This might include recommendations for ADHD coaching, therapy, or medication, tailored to your specific needs and circumstances.
- Next steps: You should have a clear understanding of what comes next, whether that's starting treatment, seeking additional support, or exploring other possibilities if ADHD isn't diagnosed.