Scottish Lib Dems back strategy for Adult ADHD

Yesterday, the Scottish Liberal Democrats passed a comprehensive motion calling on the Government to produce a detailed strategy to deal with undiagnosed and untreated ADHD in adults and to ensure that health professionals and those working within the justice system are trained in the diagnosis and management of ADHD.

I summated the motion. My son was diagnosed with ADHD earlier this year. We are fortunate to live in the only part of Scotland where there is a clinic for adults with ADHD and we are currently on the journey of finding out what treatment is going to help him.

However, I didn’t do any of the research into the motion. Ross Stalker, who wrote and proposed it did all of that and he did a fantastic job. In his proposing speech, he very movingly told us how ADHD affected him:

I can remember clearly, at 27 years of age, the first time I felt ADHD medication working for me. It was during a meeting at the party’s headquarters in Edinburgh. Someone was talking… and talking… and I suddenly realised that I was just, taking in every word. Instead of missing half of the conversation, nodding along and faking it as I normally would, I was really paying attention. And for the first time in my life, it didn’t take an exhausting amount of effort to do so.

Now, I know some of you must be thinking – we’ve all been there, right? We’ve all had times when we get distracted, when our attention wanders. But imagine if that was your whole life, all the time – every conversation, every book, every lesson, every TV show, every social occasion, everything. Now imagine: just not being able to pay full attention, even when there’s nothing actually distracting you. It’s strange, now that I’ve had medication for a few years, for me to think: that’s just how life used to be for me.

ADHD comes in three varieties – predominantly hyperactive, predominantly inattentive, and combined. I grew up at a time when knowledge about ADHD in children was on the increase, and teachers were starting to be on the lookout for symptoms – hyperactive symptoms. Those in the inattentive group were, and still are, more likely to miss out on a diagnosis. The cruel irony of this is that, even though predominantly inattentive ADHD sufferers like myself are less likely to be diagnosed, we are more likely to have significant symptoms into adulthood – because it’s the hyperactive symptoms that tend to get better with age.

That’s not to say, of course that there aren’t also plenty of undiagnosed adults who are in the predominantly hyperactive and combined groups. We’ve all been let down by a system that has failed to act on the latest research – which shows that the majority of people with ADHD, right now, are adults; and that the previous perception that ADHD is a childhood disorder that most people ‘grow out’ of is completely wrong.

It’s a misconception, as well, that managing to be successful in certain contexts means that someone couldn’t possibly have severe ADHD. It all comes down to which specific symptoms are strongest in the individual, and what kind of coping mechanisms – healthy or unhealthy – they develop. I managed to get my Highers, mostly Cs, but with Bs and As in the sciences, which got me into university. But I struggled heavily with my symptoms as a student. My method for completing essays was to pull all-nighters with an unhealthy quantity of caffeine pills and fatty food.

Again, some would say, what student hasn’t pulled an all-nighter? But in my case, it wasn’t because of extra-curricular activities – it was because that was the only way I found to get the work done with my attention span. And when I came up against a piece of work that was just too large to complete that way – my Honours dissertation – I just froze up completely. I didn’t understand why I couldn’t do the work; I knew how, I wanted to do it, but I just couldn’t get my brain into gear for it. I eventually turned it in eight days late, and graduated with a third.

I was also by this time quite deeply depressed. Roughly half of adults with ADHD will also have at least one comorbid mental health condition – our brains are unfortunately just wired that way – and mine is depression. I had no idea why I had just been so useless as a student, and I was embarrassed about it. I pretended that it was because I had been too side-tracked by student politics – but that was a lie. After graduating, I didn’t work for over a year – and I still haven’t put that degree to use.

I did eventually get my biotechnology Master’s degree four years later. A bit older, with a bit more adult life experience of working around my symptoms, I made a better job of it. But, as I later told the psychiatrist who was initially sceptical about giving me a diagnosis, I was only able to do it by cutting everything else out my life for nine months. And I was lucky that my landlord at the time never visited my flat, which pretty much spent that whole nine months getting progressively messier.

There’s so much more I could say about my own experience if I had the time, about how my ADHD symptoms interact with my depression, about how things would be different for me if I’d gotten an earlier diagnosis – and to be honest, there’s still so much that I simply don’t have the courage to put in a speech.

When I finally, eventually realised that I have a diagnosable and treatable condition, I did some reading about how to go about navigating the NHS for an adult diagnosis. What I read shocked me. In much of Scotland, indeed much of the UK, there’s simply no pathway to getting an adult diagnosis at all. Those few who have managed to get their diagnosis had to fight long and hard to get recognised. In the end, I decided to take the quicker but more expensive route of paying a private psychiatrist by the hour. It wiped out all my savings, but in my case, it was worth it.

The Scottish Government pledged in their 2012-15 mental health strategy that they would improve diagnostic pathways for adult ADHD and increase awareness. But not only did they entirely fail on this front, they dropped all mention of it from their 2017-27 strategy. There are 40 actions laid out in the new strategy, and not one of them relates to adult ADHD in any way. They seem to have reverted to an obsolete view of ADHD being a behavioural and learning disorder mostly affecting children.

But that’s not what ADHD truly is. It’s a cognitive disorder – it affects how the brain works, in ways that matter for adults as well as children. Untreated ADHD in adults can ruin livelihoods and relationships. Adults with untreated ADHD are more susceptible to addiction. For those who end up in the criminal justice system – a population of which ADHD sufferers make up a disproportionate number – getting treatment for ADHD can turn their life around. Research by Demos shows that untreated ADHD costs our economy billions of pounds per year.

The Scottish Government needs a strategy that recognises what ADHD truly is – a lifelong cognitive disorder. So, that’s what this motion calls for. In ‘calls for 1’, we ask for the strategy to be detailed enough to address the needs of four patient groups defined by the Royal College of Psychiatrists.

Ross’s motion even got some media coverage as the Herald reported it. 

* Caron Lindsay is Editor of Liberal Democrat Voice and blogs at Caron's Musings

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3 Comments

  • https://www.rcpsych.ac.uk/pdf/ADHD_in_AdultsFINAL_GUIDELINES_JUNE2017.pdf

    This from 2017 seems to contradict the position of the party in Scotland.
    From the Royal College of Psychiatrists, it places the onus squarely on the various Scottish Health Boards, noting the commitment by the Scottish Govt.

  • Oliver Craven 11th Sep '18 - 10:26am

    Big thanks to you both!

  • Ross Stalker 12th Sep '18 - 12:15am

    Andrew: there is no contradiction. I have read the RCPsych guidance document and even referenced it in the notes of the motion. One of the calls for in the motion actually does directly call on health boards too.

    You are right that it is up to individual Scottish health boards exactly how they organise their mental health services. But that doesn’t stop the Scottish Government from having a strategy either, like the one they committed to in their 2012 mental health strategy document then dropped from the 2017 one.

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