Here at AADD-UK we avidly followed the news about mental health issues during Mental Health Awareness Week. We admired the bravery of those telling their own stories, we retweeted some general mental health links instead of those that only dealt directly with ADHD, all the while preparing for our 10th Year Anniversary by revamping our website. Then suddenly we realised we’d forgotten the elephant in our own parlour! So we decided to write, just before the week ended, our own position for Mental Health Awareness Week.. Here it is:
First, we thanked the Mental Health Foundation for hosting the week, and thanked them for commissioning the survey and consequent report “Surviving or Thriving? The state of the UK’s mental health.” The authors of the report wrote that despite “many areas of advances in human health we are not seeing these reflected in mental health. If anything, the signs are that we are slipping back.” They backed this up by shockingly disclosing that only 13% of those surveyed in England, Scotland and Wales had “high positive mental health” and that nearly “two-thirds of people say that they have experienced a mental health problem” and others were clearly “just about surviving.”
The authors further reported that those of us living with either low household incomes or unemployment have worse mental health than those employed at higher incomes. 3 in 4 people at the lowest income level, 85% of unemployed people, 7 in every 10 women, 7 in every 10 young adults (aged 18-34), and 7 in 10 people living alone experienced poor mental health. Additionally, the authors quoted the “Mental Health and Wellbeing in England: Adult Psychiatric Morbidity Survey 2014” (published last year) which revealed that every week 1 in 6 adults experienced a “common mental health problem, such as anxiety or depression. 1 in 5 adults reported that they had considered taking their own life at some point.”
I sat in silence and reflected upon those numbers and felt an overwhelming sadness. So much unnoticed desperation and despair! Swiftly followed by anger; “Who can I blame?” “Where shall I point my finger?” You see, all this correlated almost exactly with our own experiences in the ADHD world.
It’s been almost 10 years since we set up AADD-UK with hope and optimism. During that 10 years, the National Institute for Health and Clinical Excellence (NICE) published ADHD Guidelines in which adults were included for the first time. Of course there was some initial resistance but over the years more and more professionals became interested, more and more moved into the field, more and more research confirmed ADHD as valid (even the usual tabloid suspects now, tentatively, report positive ADHD stories) and there are more ADHD services in the UK than the 3 that existed 10 years ago.
But all is not well! As awareness of ADHD grows, funding for ADHD services dwindles. Some GP’s, due to funding shortages, are reluctant to refer us to services. In truth, not all of the ADHD services have enough funding to meet the NICE Guidelines. It’s even been suggested, in one known circumstance, that the Guidelines be disregarded. A couple of services have surreptitiously tried to close. Some have decided not to publicise their contact details for fear they’ll get more referrals than allowed for by their funding. Of course, this means that waiting lists are getting longer and longer; even up to 2 years long! It’s true that gate keepers and sign posters cheerily point us to psychological therapies suggesting we use them while waiting. But guess what? Yep that’s right! We’re shuffled onto the end of another waiting list where some of us must try not to listen to whispers about the low quality of the offerings. So, there we are, stuck waiting, struggling to cope with abysmally low self-esteem, hurting, lonely, barely surviving. What does this matter when it’s said that ADHD makes us resilient, that we’re used to hard knocks, that we’re survivors? It matters because we understand too well that surviving is not thriving and that knowledge is painful!
And what about those of us who’ve been diagnosed and are taking medication? We’re all thriving right? Well not exactly. Medication is indeed all that some of us need. We can now concentrate as well as focus better. That helps us to, at last, move on and up. It helps us to feel relief as well as feel the joy of achievement. Some of us can even choose between seeing a consultant privately for follow-ups or waiting months to see the same consultant on the NHS. There’s a group of us too who, after a competent diagnosis of ADHD, don’t need any further help, not even medication. It’s enough that somebody listened, took us seriously, evaluated patterns underlying our difficulties, and found a way to help us understand. That’s all we needed to find our own way, to thrive and flourish.
Some of us, though, have been so pressured and battered by an uncomprehending and stigmatising life that the clarity that comes with medication also carries the aching revelation that our graceful childhood spirits have turned into cut-down and subjugated ghosts. Taking the right medication is not all we need. Before we can move from surviving to thriving we need help, we need to rediscover our true spirits, our real potential. Yet we’re stuck in the low income, or underemployed, or unemployed bracket. So we ask the NHS for help, get sign posted to psychological therapies, by the same cheery folk our clan members encountered, and off we shuffle to join the end of a waiting list. There we are waiting, masks firmly in place (we don’t want pity), acting as if we don’t care but feeling worn-out, inside crying, mourning for our lost and trusting childhood. We’re surviving and that’s all!
Still, at least the mere fact that we’re waiting allows us a bit more hope than those of us who’ve not been noticed. Some of us in this group are being shuffled from one wrong diagnosis to another wrong diagnosis, from one wrong medicine to another wrong medicine. Never having our true reality heard or acknowledged. Some of us become disheartened, lose faith and sink into helplessness. And then what about those of us who learn to believe from early on that we are seemingly born to live life as a failure, never understanding why that appears to be our fate? All of us too are barely surviving!
It’s such a waste because every single one of us with ADHD has the potential to flourish. We would love to use our strengths and abilities to help others, to be a benefit. We don’t need much. Just the right attention and the right support at the right time. Actually you know what? That’s not hard to provide!
Now I’m angry again so I’m jumping right off the fence and pointing my finger squarely at you, the Government. I’m pointing at you, Theresa May, as well as at you, Jeremy Hunt. If you get back in charge, for goodness sake stop with your wasteful changing, privatising and building inequality into the health service. Instead, if you really care about helping people to thrive, helping the country to prosper (you do, don’t you?), stand back and for once look at the big picture.
The prevalence rate for children with ADHD is between 5 to 7%, of whom approximately 65% will continue to experience symptoms in adulthood. In other words, roughly 3% to 4% of all adults have ADHD. To make it clearer, about 1 in 25 adults have ADHD. That’s a lot of us! That’s a lot of us costing you a lot of money!
Leaving us unrecognised, undiagnosed, untreated or treated ineffectively, or pushing us onto waiting lists is costing you, the Government, a lot of money in lost tax revenue, inappropriate treatments, repeat visits to A&E, clearing up after our accidents, looking after our brothers and sisters in prisons, and so on and so on (you want evidence, ask and we’ll give it freely). It’s cheaper, far cheaper, to increase NHS mental health funding so that all of us can receive proper help! We want to use our strengths, abilities and skills. We can use them to thrive and flourish!
And here’s a final note, the need for mental health awareness and funding did not disappear with the end of Mental Health Awareness Week. The two thirds of people living in England, Scotland and Wales who’ve experienced mental health problems, including all of us with ADHD, are still here on Monday morning. Funding and treatment for everybody experiencing mental ill health is still needed and is still vital. With that, and with preventative care, all of us will thrive and flourish and so too will the country.
I’ve had my say for now! It’s time for you, the Government (whichever of you ends up in charge) to listen and act!
The UK Adult ADHD Network (UKAAN) will host its 7th Congress from Thursday 21st to Saturday 23rd September 2017 at the Mermaid Conference and Events Centre in London.
The title of this conference, ADHD in the Mainstream, reflects the increase in recognition and treatment of ADHD by adult mental health services. But despite the fact that ADHD is a common disorder, and despite the fact that the role that ADHD plays in the health of many adults presenting with mental health problems is more recognised, recent evidence suggests that the disorder is still being unrecognised or untreated for many adults using mental health services. Since there is considerable psychiatric morbidity associated with ADHD, this lack of full recognition leads to unnecessary distress to individuals, ineffective targeting of treatments, poor control over chronic mental health problems and the development of adult onset disorders later in life.
Licensed drug treatments for adult ADHD are now available for the first time, including both stimulant and non-stimulant mediation and recommendations from guideline groups such as the National Institute of Health and Clinical Excellence (NICE). The importance of concurrent psychological treatments is also recognised.
Mainstream psychological treatment services need to develop the understanding and skills required to manage mental health problems related to ADHD. This conference, therefore, is designed to raise the level of awareness, knowledge and expertise among health care professionals about people with ADHD and to provide a better understanding of the persistence of the disorder, the development of comorbid mental health problems as well as the delivery of effective treatments.
This conference is relevant for all health care professionals interested in the mental health of people from the adolescent years through to early, middle and later adult life.
The program will be delivered by prominent opinion leaders, clinical experts and internationally recognised investigators and is designed to cover key topics relevant to the diagnosis and treatment of ADHD from adolescence to early and late adulthood. The selection of speakers is particular important so that the audience can hear directly from the most experienced professionals working in this rapidly developing area of clinical psychiatry.
The Scientific Programme, list of speaker, and registration information are all available on UKAAN’s website here https://www.ukaan.org/adhd-in-the-mainstream/
We are currently updating our website and so far we have added new information to 3 of our Library pages, namely ADHD in the News, Research Articles, and Books. And we have also added new ADHD events to our Calendar.
And at long last we are in the process of adding new names, and updating contact details, on our lists of Psychiatrists, Psychologists/Counsellors, Occupational Therapists (a brand new list so we’ve only got one name at the moment), Coaches, and Support Groups. So if you would like to have your services added to our lists, or to have your details updated, you will find how to contact us on the relevant page. There is no charge for adding your details to our website because we are managing and maintaining this website as a free resource for the ADHD community.
When we have completed our lists of Help & Support, we will be updating and adding new information to the remainder of our pages so please bear with us.
And in the meantime please feel free to join us in our support forum where you can ask questions and chat with others about all ADHD matters.
Background and context
This survey came as a result of the researcher’s collaboration with AADD-UK and his regular attendance to 4 support groups which generated questions in relation to the development of adult ADHD support groups; how many groups are there in the UK, what is their membership and what do they do? The numbers of groups making contact with AADD-UK and its website has been growing in the last five years; they are very diverse in their organization, in what they provide and so are the local contexts in which they evolve. But they all have in common that they provide a much needed space for information, help and support for individuals who are or have yet to be diagnosed with ADHD as well as for their relatives and partners.
The aim of this survey was to provide an updated picture of the state of adult ADHD support groups in the UK; we hope this would in turn help individuals, families and professionals in accessing updated information on the AADD-UK website for better local signposting.
SUMMARY OF FINDINGS
1. Significant increase in numbers of support groups, starting from 2009, peaking in 2011 and an increase of membership.
It is worth noting a rapid increase in numbers of groups since 2009, but it is unclear if this trend will continue. Some groups have also folded in the last 2 years, mainly for reason of lack of funding and so the present economical context may make it difficult for some groups to develop or sustain their activities. An increase in membership has also been observed in the three groups the researcher has had contact with since 2009; the average attendance then was of 11 members per meeting, it is now in 2013 an average of 19 members per meeting with a gender mix of 52% male, 48% female.
2. 9 groups out of 23 , just under 40% , receive funding
There are more groups receiving funding than ever before, and the more recent groups seem very good at that. More data is required to understand how funding is accessed, if groups are set up as charities, social enterprise and how sustainable the funding is.
3. Three quarters of the groups are run by adults who describe themselves as having ADHD.
Despite the difficulties that ADHD can produce the large majority of groups are run by facilitators that identify themselves as having ADHD, and some do this in partnership with people who do not have ADHD. Out of the 14 new groups that have formed since 2009, 13 of them have been formed by adults identifying themselves as having ADHD. More research would help in understanding what their experiences bring in the running of a support group.
4. Wide range of activities, including 6 groups providing structured courses.
The groups are adapting to the local context and the needs of their members with ADHD and provide more and more services that are not provided anywhere else. But the main activity the groups have in common is the support and help they give to each other through the sharing of their experience of living with ADHD.
We believe these findings show a vibrant and growing community of support groups for adult with ADHD that are resourceful and determined to provide a safe place to share experience and information.. This survey highlights some of the common points between groups but the diversity between groups is also worth noting, each group is unique in its history and style and respond to particular local circumstances. The full survey is available in our library here.
Claude Jousselin and the AADD-UK team.
The UK Adult ADHD Network (UKAAN) will host its 4th Congress in September 2014, entitled ADHD – Mind, Brain and Body, in conjunction with ENAA and APSARD. The conference will take place over 3 days, at the Mermaid Conference and Events Centre which is situated between the City and the West End in London. Located on the North Bank of the Thames, it enjoys spectacular views towards the Tate Modern, the Globe theatre and the Millennium Bridge. The theatre will accommodate 600 people, and there will also be opportunities to attend parallel sessions throughout the event.
The conference will bring together internationally recognised experts in the diagnosis and treatment of ADHD across the lifespan and highlight basic science and clinical research that contributes to our current understanding of ADHD as a lifespan disorder. Clinical services for ADHD during the transition years from adolescence to adulthood and for those newly diagnosed as adults are developing rapidly throughout many parts of Europe. The conference will build on this growing expertise by providing a uniquely European perspective that highlights the full range of functional, cognitive and mental health impairments, the impact that ADHD has on adolescent and adult mental health and the contribution to adolescent and adult psychopathology. This meeting will address important clinical and scientific questions relating to ADHD and will be relevant to anyone interested in the mental health of people from the adolescent years through to early, middle and later adult life.
This meeting aims to raise the level of awareness and knowledge among health care professionals about people with ADHD as they grow older; and to provide a better understanding of the causal pathways involved in the persistence of the disorder and the development of important clinical comorbidities. The program will be delivered by prominent opinion leaders, clinical experts and internationally recognised investigators and is designed to cover key topics relevant to the diagnosis and treatment of ADHD during the critical period from adolescence to adulthood. The selection of speakers is particular important so that the audience can hear directly from the most experienced professionals working in this rapidly developing area of clinical psychiatry.
The UK Adult ADHD Network (UKAAN) was established in March 2009 to provide support, education, research and training for mental health professionals working with adults with Attention Deficit Hyperactivity Disorder (ADHD). UKAAN was founded by a group of experienced mental health specialists who run clinical services for adults with ADHD within the National Health Service.
More information about the 4th Congress, and registration details are available on UKAAN’s website here.
UKAP (the UK ADHD Partnership) will host its first conference on Friday 4th April 2014. This one day event will take place at the Thistle Charing Cross Hotel, London, with a conference on ‘Reducing the Costs of ADHD across Education, Health and Care’ .
The aim of the meeting is to introduce, education, healthcare and allied professionals to the UKAP committee’s objective to raise the profile of ADHD on the political agenda in order that young people with ADHD gain better recognition and access to treatment across educational, occupational, youth justice and healthcare settings.
UKAP would also like to invite parents, carers other voluntary sector organisations and support groups who are working to support ADHD, to join them in their call to action which seeks to inform policy makers and authorities of the importance of early identification and intervention.
With presentations on the costs of ADHD, the impact on education, the family, the youth justice system, health service, accidental injury and driving, UKAP will consider what can be done to reduce the burden of ADHD on children, the family and more broadly in society. The programme will include presentations by prominent opinion leaders, and internationally recognised clinical and educational practitioners.
This meeting will be relevant to all education and healthcare practitioners working with children and young people, together with allied professionals involved in multi-agency working including educational, occupational and youth justice settings, as well as commissioners and policy makers.
For more information and registration details see the UKAP website here.
A very interesting paper in The Harvard Review of Psychiatry looks at the effect methylphenidate has on the brain. This is a link to the original article (the abstract is free).
There is a more layman friendly description in ScienceDaily. (And before anyone writes in, yes, we are aware that the word ‘normalises’ is spelled differently on either side of the Atlantic.)