Specialist adult Attention Deficit Hyperactivity Disorder (ADHD) services across England are facing a severe crisis, as an investigation reveals many are closing their doors to new patients or implementing stricter criteria due to overwhelming demand. This comes amid a significant surge in individuals seeking diagnostic assessments for the neurodevelopmental condition, leading to unprecedented waiting lists and concerns for patient welfare.

Current figures paint a stark picture: over half a million people in England are currently awaiting ADHD assessments, with a staggering 144,000 of these individuals having endured waits of two years or more. The dramatic increase in demand is largely attributed to a heightened public and professional understanding of ADHD, particularly how it manifests in girls and women, prompting more adults to recognize potential symptoms in themselves.

A report by an NHS taskforce, established to address this escalating crisis, further substantiates these findings, concluding that ADHD is currently both underdiagnosed and undertreated within the health system. The taskforce has advocated for a more integrated approach, calling for collaborative efforts across health, education, and the criminal justice system to better identify individuals with the condition. Furthermore, it recommends comprehensive training for community NHS staff, including General Practitioners (GPs) and pharmacists, to enable them to play a more active role in supporting people with ADHD, thereby reducing the sole reliance on overstretched specialist services.

Despite these urgent recommendations, a BBC investigation, based on Freedom of Information (FOI) requests to 59 services (representing the majority in England), uncovered troubling trends. The findings revealed that 15 local specialist services have completely closed their waiting lists, while an additional 31 have introduced tighter eligibility criteria, often based on age or symptom severity. This reflects the intense pressure these services are under as they grapple with the sheer volume of individuals requiring support.

Professor Anita Thapar, chair of the NHS taskforce, described the BBC's findings as "disturbing," cautioning that turning away patients carries "enormous risks" for their health and well-being. The investigation highlighted long-standing issues, citing examples such as Cheshire, where the adult ADHD service has not accepted new patients since 2019. In another concerning case, the Coventry and Warwickshire Integrated Care Board is facing potential legal action for unlawfully restricting adult assessments to individuals under the age of 25.

Dr. Selina Warlow, a psychologist and clinical director at The Nook Clinic, echoed these concerns, telling the Daily Mail that the BBC's investigation "highlights the stark reality we're seeing across the country." She emphasized the immense strain on ADHD services, which leaves many without timely access to assessment and support, noting that even the NHS relies on private sector partnerships, through initiatives like the 'NHS Right to Choose' scheme, to manage these burgeoning backlogs. However, awareness of the 'Right to Choose', which grants patients in England the legal right to select their mental healthcare provider if wait times are excessive, remains low.

ADHD, a neurodevelopmental condition, impacts concentration, impulse control, and activity levels, though its presentation varies significantly among individuals. Historically, ADHD, much like autism, was predominantly believed to affect boys, leading to a substantial increase in women discovering their diagnosis later in life. Recent studies indicate that women and girls may have been overlooked due to presenting primarily with the inattentive type or exhibiting less obvious, internalized hyperactivity.

There are three recognized types of ADHD: inattentive, hyperactive-impulsive, and combined type. In adults, the inattentive type can manifest as being easily distracted or forgetful, struggling with time organization, difficulty following instructions or completing tasks, and frequently misplacing items. Conversely, the hyperactive-impulsive type might involve high energy levels, restlessness, excessive talkativeness, interrupting conversations, and making hasty decisions without adequate consideration of consequences.

The increasing understanding of ADHD's diverse presentations, especially in females, is empowering more women to seek diagnoses. For instance, Scottish singer Annie Lennox recently revealed her ADHD diagnosis at 70, stating it has provided her with a better understanding of herself. While increased diagnosis is positive, late diagnoses carry significant risks. Worryingly, some studies have linked later diagnosis of ADHD to premature death, and others have shown that a high percentage (80%) of adults with ADHD develop secondary conditions such as depression or anxiety, underscoring the critical need for timely intervention and support.