Young adults in England disappointed by ‘postcode lottery’ for ADHD treatment, national survey finds

A national study by the University of Exeter has found wide disparities in the treatment of ADHD, highlighting the struggle many young adults face as they turn 18.

“Support for prescribing medicines in primary care for adults with ADHD in England: national survey” is published in British Journal of General PracticeA related article, which examined qualitative experiences of primary care for young people with ADHD across England, is published in the same magazine.

Researchers warn that the current system is failing many young adults as they transition from childcare to adult care, finding themselves suddenly unable to access treatment because services are not well-coordinated.

More than 750 people from across the country, including commissioners, healthcare professionals working in primary care and people with personal experience of ADHD, completed the MAP National Survey. The survey highlights the challenges GPs face when prescribing ADHD medication.

ADHD affects up to 7% of children and up to 5% of adults, with symptoms including patterns of hyperactivity, impulsivity and/or inattention that interfere with daily life functioning. Failure to treat ADHD and gaps in treatment, especially as young people become adults, can have serious consequences for patients and families, increasing the risk of mental health crises and problems with employment, education and relationships. This failure also places additional pressure on those working in health care.

The study found that there were variations in the “shared care” agreements between GPs, mental health specialists and patients, which are needed to allow GPs to prescribe ADHD medications. This was a particular problem as young people transitioned into adult mental health services, suggesting that the current system is failing adolescents at a critical time in their lives.

According to current NICE guidelines, GPs prescribe medication to adult ADHD patients on the basis of a shared care agreement with adult mental health services.

However, the research found that such agreements are not always easy to set up, with evidence suggesting that GPs may not feel sufficiently supported to prescribe in this way. Without appropriate support, some GPs may not prescribe ADHD medication due to insurance and liability concerns. This can be a particular problem for patients with a private diagnosis of ADHD, preventing GPs from providing effective care and leaving many patients unable to access the medication they need.

Furthermore, over 40% of survey respondents reported waiting times of two years or more for an adult mental health appointment. This leaves GPs responsible for providing care, but without the support they need to give their patients the best care at a crucial time in their lives.

This can mean that access to medication is taken away, despite successful treatment in childhood. Problems with access to treatment for ADHD are also worse for some underserved groups, such as young women and youth leaving care, exacerbating health disparities.

The survey results come as NHS England has announced the creation of a taskforce and a major review into ADHD services. stated by NHS England: “People with ADHD deserve a caring and effective service from the NHS and wider society. We know there is more to do, but we do not underestimate the complexity and challenges in achieving this ambition.”

Dr Anna Price, Senior Research Fellow at the University of Exeter, said: “Our findings highlight the need for a coordinated approach to address the issues that are leading to a postcode lottery for patients trying to access treatment for ADHD. GPs and other primary care professionals really need better support so they can provide shared care when prescribing ADHD medication in line with UK guidelines.

“We know that not treating ADHD can have a huge impact. Turning 18 is often a crucial and sensitive time in life, and our research shows that not getting treatment at this time can be particularly damaging for young people who are learning to manage their own health needs, perhaps taking important exams, leaving home for the first time and starting a career or university.

“We welcome the establishment of the NHS England taskforce. It is a much-needed step towards improving outcomes for people with ADHD.”

Experts from the University of Exeter recently published a Collaboration between ADHD and neurodevelopmental scienceworking with people who are experts by experience and caregivers. The collaboration aims to develop solutions, such as curated digital interventions and standardized shared care agreement templates, to help people with ADHD thrive.

The MAP national survey was conducted as part of the MAP research project.