ADHD services map reveals major gaps in care, failing the vulnerable

July 28, 2020

New research has called for urgent action after creating a map that identifies gaps in services for adults with ADHD across the UK, leaving vulnerable people struggling to access vital support and treatment.

Research led by the University of Exeter, published in the British Journal of Psychiatry Open, has led to the first national map of ADHD service provision, based on responses to a survey completed by more than 2,600 respondents. The NIHR-funded research found huge variation in available care, patchy provision of dedicated ADHD services, and variation in the reports of services between people with ADHD, service users and health workers. Now, researchers are calling for urgent action to address the inequalities in services that the map has revealed, amid concerns that people in some areas may struggle to access care. Of the 44 dedicated services identified, only 12 (27 per cent) provided the full range of services recommended by the National Institute for Health and Care Excellence (NICE).

Previous research has found that without the right treatment and support, people with ADHD are at higher risk of poor health, unemployment, difficulties in education, going to prison, and being involved in a car accident. While children with ADHD are generally well supported in the NHS, provision is far more variable for adults, with earlier studies highlighting the risk of many slipping through the net during transition into adulthood.

Lead author Dr Anna Price, of the University of Exeter Medical School, said: "We know that getting the right support and medication is absolutely critical for people with ADHD to make the most of their lives, and to avoid complications that can really set them on a downward spiral. The NHS is meant to provide equal access to care - yet our research has revealed significant gaps in services across the UK. This is likely to hit the most vulnerable the hardest, who may be getting no support at all - we must address this as an urgent priority."

The researchers worked with colleagues at the Universities of Nottingham, Warwick and Kings College London as well as the UK Adult ADHD Network (UKAAN), AADD-UK, The Royal College of Psychiatrists, and the NIHR Clinical Research Network South West. They surveyed 2,686 people who were either affected by ADHD, worked in ADHD health care, or commissioned services. Respondents were asked to identify health services they knew of that support adults with ADHD. Of 294 unique services identified across the UK, 44 were dedicated ADHD services, and 99 were generic mental health services. The research revealed that there's disparity in how services are labelled. The best provision appeared to be from services specifically labelled as ADHD or neurodevelopmental services - yet only 12 of these dedicated services provided the full range of treatment recommended by NICE for adults with ADHD. Only half of the dedicated services (55%) and a minority of other services (7%) were reported by all groups surveyed, highlighting a lack of awareness surrounding available support, both among healthcare workers and service users.

Professor Tamsin Ford, who was involved in the study at the University of Exeter Medical School, said: "Our research has revealed significant knowledge gaps among both service users and healthcare workers including GPs, which must mean people are being let down. Our map is the first step in addressing that gap. Demand is clear - a pilot version of our map was viewed over 35,000 times, but much more needs to be done to provide people with the services to which they are entitled. It doesn't really matter whether a service is specialist, or treats many different types of mental health condition. What matters is prompt access to support and ongoing medication for adults with ADHD who need it."

The full paper is entitled: 'Mapping UK mental health services for adults with Attention-Deficit/ Hyperactivity Disorder; survey findings, with an analysis of differences in reporting between stakeholder groups'
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University of Exeter

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