Thread by @GoCarpediumDoc

A 🧵 collated to hopefully help people think about their views before/after watching the upcoming BBC panorama on fake private ADHD diagnosis. I don’t know if I can watch it, so this is the best I can do to contribute to the related discussions #ADHDtwitter #Neurodiversity 1/n

Grateful to ND medics who trusted me to share these experiences anonymously. These highlight the issues even clinicians within the NHS face in accessing timely assessment and treatment for ADHD, so one can imagine the bigger hurdles for a lay person navigating the system 2/n

This account highlights existing issues with accessibility and affordability. We are lucky in the UK to have some amazing services such as @NHSPracHealth tailored for medics, but ADHD assessments/treatments have historically not been funded even in such services 3/n

This experience highlights issues with stigma/disbelief if the diagnosis is done privately. This issue can be worsened by unbalanced views represented on media, without adequate real lived experience accounts of why people are driven to seek private diagnosis as last resort 4/n

And the most painful account I’ve received so far - highlighting the impact on the person but also how this lack of support for ADHD assmt drove a doctor out of the NHS and the UK permanently. Can we afford to lose out on people like this when retention already a big issue? 5/n

As @DrMBotha explains nicely in her thread 👇🏽, the current issues & controversies around ADHD diagnosis need to be discussed, without further stigmatising and marginalising the already marginalised adults who are unable to access right support for neurodivergent conditions 6/n

https://twitter.com/drmbotha/status/1656962554277646338

I promise you - it is NOT fun. None of it - the grief of adult ND diagnosis, the burnout, dealing with moral injury, and then trying to get on with your life, job and all else. There will always be a few bad apples, but please don’t make things harder for the genuine majority 7/n

https://twitter.com/ZJAyres/status/1657298169393184768

Completing this thread with few more thoughts before my work week starts tomorrow.

Yes quality of assmts & safety of care provided needs scrutiny (as with other conditions in medicine). There wouldn’t be so much room for non-ideal private clinics if NHS provision was better 8/n

Re: malingering &secondary gain, these are matters taught in med school and in further training. It is however complex &nuanced. But most would agree that they are a minority of patients in most conditions. In ADHD, concerns maybe compounded by the Rx involving stimulant meds 9/n

It is imp. to note in this regard that stimulant meds have entirely diff impact on the brains (& functioning) of people with ADHD vs someone without it. ADHD meds can be life changing for many. Evidence shows up to 50% reduction in road accidents in men treated for ADHD. 10/n

Adults with ADHD (undiagnosed, yet to be assessed,not met primary care criteria for referral, on NHS waiting lists for years, and diagnosed) face varying degrees of rejection/stigma/disbelief from professionals &society around them while trying to get the help they deserve. 11/n

So my plea to clinicians in primary care & psychiatry is that you consider this while interacting with patients in coming weeks as it’s a difficult time for the ND community, with increasingly frequent narratives on media that risk worsening the stigma/barriers they face 12/12