Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness. It can affect people of all levels of intelligence and all walks of life.

Dr Andy Montgomery

Dr Andy Montgomery (MbBChir, PhD, MRCP, MRCPsych)

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Welcome to the Psychiatry-UK ADHD service. We have a large number of ADHD specialist psychiatrists working in our organisation, for children, for adolescents – and for adults.

You do not need a GP referral if you are not seeking NHS funding. (Find out more getting NHS funding here)

Organising an online ADHD assessment couldn’t be simpler – you can book online here.

What is ADHD?

ADHD stands for Attention Deficit (Hyperactivity) Disorder. It is a neuro-developmental condition, so it develops as your brain develops, in childhood. It is often associated with (co-morbid with, as doctors put it), other neurodevelopmental conditions such as dyspraxia, dyslexia, Tourette’s syndrome and what are generally called autistic spectrum disorders.

These co-morbidities can easily mask or counteract some of the more obvious symptoms of ADHD, and an experienced psychiatrist will be well aware of this.

ADHD Comorbidity

In adults, ADHD is also commonly co-morbid with other common mental health problems such as anxiety or depression, where the underlying ADHD has been masked for years by the associated problems that it has resulted in.

A truly shocking statistic is that around 40% of those in prison reach the threshold for diagnosis of adult ADHD and most adults with undiagnosed ADHD will have developed and often sought help for other social problems and mental health conditions.

3 Recognised Sub-types of ADHD

1. Hyperactive – Normally associated with impulsive behaviour and that commonly perceived lack of control in children that has allowed some to dismiss the diagnosis as just bad behaviour and the result of poor parenting. The hyperactive behaviour tends to become more easily controlled as a child goes through adolescence – and to become a more generalised restlessness and or irritability. This is perhaps why there used to be a belief that ADHD was only found in children. In the last 20 years we have understood that this is not really true.

2. Inattentive – Which is now more commonly known as ADD. Where sufferers mainly experience difficulties staying focused and attending to daily, mundane tasks without being distracted, perhaps moving from one activity to another or becoming bored quickly. In children this is often missed as the resulting behaviour – daydreaming, inattentiveness, underachievement, can be dismissed as laziness or even praised as imaginative but unfulfilled potential.

2. Combined – As the name suggests, where there is a combination of inattention and hyperactivity. In most cases, this is probably the best description of most people with ADHD as they really have a spectrum of types of behaviour, any of which, on their own, could be regarded as quite “normal”, but which when part of a larger picture, lead to a diagnosis of ADHD.

Common Perceptions and Misunderstandings about ADHD

That common perception of ADHD; of badly behaved little boys being disruptive in class, is a huge element of the stereotypical prejudice in how many parents and teachers react to a diagnosis or even a suggestion that a diagnosis should be considered for their child.

The familiar perception is of the most visible sign of ADHD which is at its most florid in young boys. Young girls (and older ones), can also have ADHD but are less likely to be diagnosed, both because they show less hyperactivity and because the present statistics show that ADHD is more prevalent among boys by a factor or about 2 or 3 to 1 – (though this may be partly due to these historic prejudices.)

This common (mis)understanding of Attention Deficit Hyperactivity Disorder often leads  to treatment of the condition with stimulants which are chemically similar to some recreational drugs – and which can have adverse effects on those without the condition. It is important to note that they do not give the sort of “rush” that those who use stimulants recreationally desire.

In fact, the medication has positive effects for over 80% of those with  ADHD who try them. They are not addictive, whereas those with untreated ADHD are highly vulnerable, as they become adults, to succumbing to addiction – often by using illegal drugs to self-medicate. The research evidence is that medicating for ADHD actually reduces substance abuse.

ADHD Treatment (First Steps)

If you think your child – or you – have got ADHD, the first step to getting treatment is to receive a diagnosis from a specialist doctor, this is generally a psychiatrist with considerable experience of working in the field of neurodevelopmental conditions.

Though it is now understood that ADHD is a lifelong condition, it is not necessarily such a terrible diagnosis to have – 80% of those with ADHD will react positively to medication and, with better understanding of the condition, can easily learn to manage the difficulties that they would otherwise face.

Only with such a diagnosis can these most suitable medications be accessed. For many with ADHD these medications are highly effective but, as they are stimulants, to get them prescribed you need to have a special type of prescription that your GP will only give you if they know a specialist psychiatrist has made a formal diagnosis of ADHD.

Getting a diagnosis through Psychiatry-UK

NHS patients

If you live in an area where there is no specialist ADHD service, or where the delay in receiving an appointment from the local service is likely to be more than one year, we would be happy to work with you and your GP to seek funding from your local CCG for us to provide you with a diagnosis.

If you or one of your children have a diagnosis of ADHD, you may also wish to take advantage of our the specialist support services for children and adults with ADHD that we can help you access and for which you should be NHS funding with the support of your GP.

Find out more about NHS funding here.

Private Patients

The benefit of funding our services yourself is that we can start helping you tomorrow – but you do have to pay for it. As well as being convenient, we believe that we are the cheapest private ADHD diagnostic and treatment service in the UK. However, we want to make sure that you do not find that there are any surprises in the cost of getting treatment – as there is more to it than just getting a diagnosis.

First Step – Diagnosis

If you are an adult who is here because you think you have ADHD, all you will probably want to do is get on with having that consultation and getting that diagnosis. That’s what it is like to have ADHD! So, press the button, fill in the form, for the initial consultation, and make an appointment.

If you are here to arrange for a consultation for your child, the process is slightly more complicated – most of the medications for ADHD are these controlled drugs and this is a child to whom we may be prescribing them – so we have to be very sure.

The first stage is for us to send out some ratings scales for you, your child, and one of the teachers at your child’s school to fill in and return to us before we do the assessment on your son or daughter. When you send back the ratings scales the specialist assess them. Then there will be the consultation which will be longer than for an adult, perhaps 90 minutes.

Whether for a child or an adult you can start the process within a few days. You will have a diagnosis within a week of us receiving the information that we need from you and, if the diagnosis is confirmed and you want to proceed, you will be able to start on the medication immediately.

As the diagnosis for a child or adolescent involves input from teachers as well as you, the parent(s), it does take slightly longer than for an adult, but using our system, it can still be done in a few weeks rather than months – and that is so important when a child’s ability to get an education is so dependent on their ability to concentrate in class.

After Diagnosis – Medication

If the consultant diagnoses you or your child as having ADHD, and you want to try the medication, you will then go through the process of titration – when the psychiatrist and you correspond by email for a few weeks to work out the correct level of medication, and then you will also have a second, short interview with the psychiatrist before he or she writes to your GP and hands over prescribing to them.

There will be one variable cost: We will be providing you with private prescriptions for the medication which are sent by recorded delivery. We charge £25 for each prescription and a pharmacy will charge you around £70 for the first line of treatment – which is normally methylphenidate or atomoxetine.

If you are unlucky and these don’t agree with you or are ineffective you may then have to try other medications such as dexamphetamine and lisdexamfetamine which can cost up to £150 for the medication. Once your GP has agreed to take over prescribing, you will receive a monthly NHS prescription from them. We would expect them to ask you or your child to receive an annual check up from us as well.

ADHD Treatment Costs (approx)

 Diagnostic Assessment and Report Private PrescriptionTitration*MedicationReview

While you are titrating onto medication, you will be have weekly progress correspondence with your consultant by email. The cost of one month’s supply of medication can vary depending on what form and dose is recommended, but you will have to pay for this at the pharmacy counter if you have a private prescription from us. Titration fees shown above include the initial prescription charge.

**Although we will aim to complete your assessment in the initial one hour appointment, sometimes it will take longer to allow a full exploration of your symptoms and history in order to make an accurate diagnosis. You can help the consultant by completing all paperwork and questionnaires that you are sent in advance, and by being clear what questions you want to be answered during the appointment. Additional time spent with the psychiatrist is charged at £180 for every further 30 minutes or part thereof.

ADHD Support Services

Medications help most adults and children to start to manage their ADHD, but all the research shows that  medications are just the starting point for effective treatment. Any family who has a member – or members – with ADHD,  needs to receive some specialist coaching.

Families with one or more ADHD children are often unaware that their family dynamics can be hugely improved by getting some individual and family coaching. To start with, that coaching is usually about improving organisation and time management as outcomes for kids with ADHD are much improved when they do such specialist individual – work.

However, ADHD is a lifetime condition – and it is very common for such preliminary work to result in an understanding of wider needs within the family – and sometimes a recognition that the adults are the ones who need to do much more to help themselves.

The fact is, if you are an adult and you have ADHD, you will probably be having other mental health issues.  If you are depressed, or having problems with drugs and alcohol, or finding that your relationship is failing, you need help – and the help you need has to be from an ADHD specialist or it will not be effective.

There is no point in receiving a course of CBT or undertaking a drug counselling course if the underlying issue of your ADHD isn’t at the centre of the treatment.

Adults with ADHD usually underestimate the extent of their own ADHD-related impairments and are likely to under report their symptoms. We would always recommend that those who have a diagnosis of ADHD then receive some specialist coaching and we refer many of our patients on for things like specialist relationship counselling, and both child and adult  individual and family coaching with experienced professionals who can then introduce you to useful apps or tools to manage some of the typical problems that are associated with ADHD. Even those who are uncomfortable with a life on medication can learn to manage their little ways a bit better.

NHS Funding of our ADHD Support services

NHS funding is definitely available for the online therapy services that we offer if you have an ADHD diagnosis from us – as long as your GP supports your application for funding.

If you want us to do so, we will help you to approach your GP surgery to discuss this with them. We can provide your GP with a priced, bespoke, medically overseen, multidisciplinary approach to helping you to manage your ADHD online over the following 12 month period so they can then apply to your local CCG to fund.

Find out more about applying for NHS funding here

Supplying ADHD support services to Psychiatry-UK LLP

If you are an existing supplier of specialist coaching or therapy services for those with ADHD who would like to be considered for addition to the panel of online service providers to whom we refer our patients, please complete this form to arrange an appointment to discuss this with us.

Further Reading

In the close future we intend to provide further details and links to other services and facilities. In the meantime, if you are now seeking some further information and would like to read further, these books are all on our bookshelves and recommended:

Useful Videos

ADHD patient feedback

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I have struggled with the behavioural effects of ADHD since childhood. If I sit down and look back at my life, the trail of destruction it has left is clear to see. Having tried non-drug options for many years including psychotherapy and self-help reading, I came to a point where I realised that there was a ‘higher power’ pulling the strings in my life – my brain. The more I tried in life, the more opportunities for failure I had and the more my self esteem, self-competency and sense of hope was ground down to dust. I have always been sceptical of the notion of ‘free will’ in humans. To contemplate the notion that I, or anyone else for that matter ‘chooses’ to harbour pathological emotions and engage in self-destructive behaviours is quite simply preposterous. Once I understood and accepted the deterministic powers of the human brain, I realised that I needed help in my life.

My G.P referred me to the ADHD clinic at the Maudsley hospital in london. However, I soon realised that the waiting list was 6 months. I’m a 34 years old single male, still living at home, in financial debt and without a clear purpose in my life. I had waited for my inner and outer life to ‘begin’ for long enough and I simply could not wait for another 6 months.

I found Psychiatry-UK online and decided to pay for a consultation with Dr [ ]. Firstly, the medical secretary was extremely helpful in first arranging my appointment with Dr [ ] and helping me to set up and test the video conferencing software.

Dr [ ] was very easy to talk to – sensitive, compassionate and a great listener. Having wrote an extensive description of my difficulties when booking my appointment, he quickly put my mind at ease by acknowledging that I had already done the hard work in the consultation and so It was easier for him to reach a conclusion. Nevertheless, we discussed other aspects of my life which I had not mentioned just to get a clearer picture. I also greatly appreciated his efforts to save me money on the cost of my prescription and the drug.

I am always anxious when it comes to talking to doctors but I found the whole experience with Dr [ ] to be very reassuring. The total cost of my initial consultation was £300 which quite frankly is a fraction of the financial debt I am in and pales in to insignificance when compared to the emotional pain I have experienced as a result of my condition. If the drug that Dr [ ] has prescribed me has the desired effect I think I would be happy to pay ten times as much!

I highly recommend Dr [ ] and Psychiatry-UK.