ADHD assessment

Recognising ADHD in adulthood

If you have spent years feeling like you are working twice as hard as everyone else just to keep up, you are not alone. Many adults with ADHD describe a lifetime of being told they are lazy, disorganised, or just not trying hard enough, when the reality is that their brain works differently. Difficulty concentrating, impulsiveness, restlessness, and problems staying on top of things are often put down to stress, personality, or other mental health conditions. A specialist assessment can finally provide an explanation and, where appropriate, open the door to treatment that can make a real difference.

At Caledonian Psychiatry, your assessment is carried out by one of the practice’s psychiatrists, and you keep the same named doctor throughout your care. Most patients see Dr David Crocker, an experienced psychiatrist (MRCPsych) with deep expertise in adult ADHD and neurodevelopmental conditions; you can also choose Dr Abderahman Kamaledeen, Associate Specialist Psychiatrist, for ADHD assessment and ongoing medication management: the fees and standards are identical whichever doctor you see. Your psychiatrist takes the time to understand your individual story and follows a structured, evidence-based approach in line with NICE NG87 guidance and the AQAS quality assurance standard for adult ADHD assessment. Assessments are carried out entirely by secure video, so adults across Edinburgh, Glasgow, Aberdeen, Dundee, Inverness and the rest of Scotland (and anywhere else in the UK, from London to Cornwall) can be seen from home. We have written in more detail about what this looks like locally for patients considering ADHD assessment in Edinburgh, ADHD assessment in Glasgow, ADHD assessment in Aberdeen, and ADHD assessment in Dundee, though the assessment itself is identical wherever in Scotland you join from.

Considering your options? Read our guide to private ADHD assessment in Scotland: costs, timelines and what to expect, an honest comparison of private vs NHS ADHD assessment, or see the dedicated pages on NHS waiting times in Scotland and why Right to Choose doesn’t apply in Scotland.

What to expect

Our psychiatrists have a reputation for being relaxed and non-judgemental: if you are looking for a psychiatrist with a bow tie, you have come to the wrong clinic. The aim is an assessment that stays rigorous and structured while still feeling like a conversation.

The assessment takes place over two 60-minute appointments by secure video link, so you can attend from wherever is most comfortable for you. Your psychiatrist draws on multiple sources of information to build a thorough clinical picture:

• A detailed clinical interview covering your developmental history, education, work, relationships, and how things are for you day to day.
• A semi-structured ADHD diagnostic interview using validated tools including the ASRS and Barkley Current and Childhood Symptoms Scales. The Barkley scales are completed by both you and, where possible, someone who knew you as a child and knows you well now, providing independent perspectives across both developmental periods. Additional structured diagnostic instruments, including the DIVA-5 (Diagnostic Interview for ADHD in Adults), are used where clinically justified, for example to support Therapeutic Use Exemption (TUE) applications in competitive sport. This is not a tick-box exercise; he uses open questions and real-life examples to understand how symptoms show up in your life.
• Validated measures of functional impairment, because ADHD is about more than symptoms. It is about how those symptoms affect the things that matter to you.
• A collateral history from someone who knew you as a child or knows you well now, obtained with your consent. This may include completing the informant versions of the Barkley scales as well as contributing to the clinical history. You are welcome to have a family member or friend join part of the appointment if you prefer.
• Review of any available supporting records, such as school reports, previous psychiatric correspondence, or your GP clinical summary.

The specific combination of tools and measures used is tailored to each individual, based on what will provide the greatest diagnostic clarity for their particular presentation. Other validated instruments may be incorporated where the clinical picture is complex or where coexisting conditions need to be explored further.

Your psychiatrist also carefully considers whether other conditions might better explain your difficulties, or might coexist alongside ADHD. Anxiety, depression, bipolar disorder, autism, trauma, sleep problems, and substance use can all look like ADHD or occur alongside it, and getting this right matters. Every differential is addressed with a clear rationale in your report.

In practice, the first appointment usually begins with getting to know one another and building up a picture of your life history. This includes any previous work or treatment with psychiatrists or psychologists, your physical health, and a chronology from childhood through to now. Your psychiatrist will also ask about the coping mechanisms you have leaned on (there is no need to be shy: people often turn to less than healthy ways of coping when they are struggling) and your family history. The second appointment looks in greater detail at your symptoms, the impact they have on your life, and your treatment options, including a prescription where appropriate.

After the assessment

Unlike clinics that write weeks later to confirm or deny a diagnosis, your psychiatrist will give you a clear answer at the end of your assessment, so you are not left waiting to find out. They typically write the report on the same day or the day after your appointment. Reports are checked carefully before they go out, and are sent to you within 7 to 10 working days and, with your consent, to your GP. The report sets out the diagnostic findings, the evidence supporting the conclusion, and clear recommendations.

Booked and wondering what to do next? Our guide to preparing for your ADHD assessment covers what to gather, who can help with your history, and why you should come as you are rather than as you cope.

If ADHD is confirmed, your report will include a proposed medication plan and a clear explanation of what happens next, including how titration works, what monitoring is needed, and the process for establishing shared care prescribing with your GP so that they can eventually take over routine prescribing. Not everyone with ADHD wants or needs medication, and we will discuss all the options, but many people we diagnose do choose to explore it and find it helpful.

If ADHD is confirmed during your appointment, it is quite likely you will be able to start treatment before the full letter arrives, though there is never any pressure to do so. If you would rather wait until the letter is in your hands before deciding, just let us know. Many people find it helpful to reflect on their options without the pressure of being in the midst of the appointment, and you are always free to start treatment only when you feel ready.

If ADHD is not confirmed, you will still receive a thorough formulation explaining what he thinks is going on, with recommendations for next steps. An assessment is never wasted.

Who this is for

This service is for adults aged 18 and over who have not previously been assessed for ADHD, or who have been assessed elsewhere but did not receive a clear outcome. We accept self-referrals directly, and no GP referral letter is required. However, we do recommend letting your GP know you are being assessed. ADHD treatment often involves controlled medications, and we will normally require a summary of your medical history from your GP before any controlled medication can be prescribed. Where there is a delay in obtaining GP records, we may take alternative steps to verify key safety information before prescribing. Early GP involvement also makes shared care arrangements easier to set up later.

If you have already been diagnosed with ADHD and are looking for help with medication or ongoing management, please see our ongoing management service.

Fees

ADHD assessment (2 sessions × 60 minutes): £800.

Previously diagnosed ADHD, medication review and ongoing management (60 minutes): £350.

Follow-up appointments (30 minutes): £130.

Private prescriptions: £30 per prescription for controlled medications (ADHD stimulants such as methylphenidate and lisdexamfetamine), or £25 for non-controlled medications. The cost of the medication itself is paid directly to your dispensing pharmacy and varies depending on the drug and dose. See our medication cost guide for typical prices.