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No psychiatrist in private practice available for children with ADHD amid surge in demand

ADHD Ireland said it is “drowning” in calls from people asking about assessments and services.

THERE ARE CURRENTLY no psychiatrists in private practice to assess, treat, and prescribe medicine for children with ADHD, amid a surge in demand last year for ADHD supports.

Ken Kilbride of ADHD Ireland told The Journal that there had been two or three private-practice psychiatrists for children with ADHD up until two years ago, but that they left the industry due to the overwhelming demand for their services.

Children with ADHD could be waiting up to two years to be seen in the public system, and Kilbride said that there is a ‘postcode lottery’ in terms of the resources available to help people seeking to be diagnosed.

ADHD is a common neuro-developmental disorder. There are three core symptoms: inattention, hyperactivity and impulsivity. Around 5% of children are estimated to have ADHD, and around 3% of adults will have symptoms, with 1.5% of the adult population having at least two of the three core symptoms.

“So what happened with the other 2%? Those people have symptoms but are managing it,” Kilbride says, adding that ‘attention deficit’ disorder is a misnomer, as it is more of an inability to retain focus than a deficit.

“Your attention is all over the place because you’re focusing on too many things at the one time, and you’re constantly disappearing down rabbit holes.”

He said that although ADHD services had been primarily focused on children several years ago, there has been an increase in demand in recent years for services and information for adults who think they may have ADHD – with half of all their queries now about adult supports.

“One of the difficulties is that there is no psychiatrist in private practice dealing with ADHD with children,” he said.

“The Child and Adolescent Mental Health Services (CAMHS) are understaffed, and they operate on the basis of priority. So if they are seeing a child who is self-harming, the child with ADHD might be waiting a year and a half, two years before they are seen.

“They can be seen privately by a psychologist, but if the child needs medication they need a psychiatrist.”

There were two or three child ADHD psychiatrists two years ago, but they were overwhelmed by the numbers coming to them. And it’s not like you treat a person once and it’s done. with medical reviews you get so many people coming back. One of the former psychiatrists said to me ‘I got to the stage that I needed to stop taking new referrals’.

This week, the Irish Independent reported that a doctor linked with the CAMHS unit in south Kerry is alleged to have made diagnoses of ADHD without proper assessment, and that this junior doctor had no previous CAMHS experience.

  • ASSESSING AUTISM - Read more here on how you can support a major Noteworthy project to find out what is causing the long wait time for autism spectrum disorder (ASD) assessments and impact these delays are having on children.

Kilbride said that ADHD Ireland is currently “drowning” in calls to their service of adults and parents looking for assessments and advice on ADHD.

“The phone line has exploded,” Kilbride said.

While last year ADHD Ireland received 3,000 calls, which averages at around six calls a week, in the months between September and Christmas they were getting around 100 calls a week – “double of what we did last year”.

He said that 80-90% of calls were people who thought they might have ADHD and looking to get assessed. Five years ago, the charity was primarily child-focused, whereas now it’s 50-50 between adults and children.

“We have got funding from the HSE, and it has increased to allowed us to employ more staff, which allows us to create much more awareness of the condition.

“We have two full-time staff and four part-time, but we’re stuck to the walls and drowning in calls.”

To get assessed through the public healthcare system, you go to your GP and tell them that you think you may have ADHD. They should refer you to your local community mental health service for assessment.

But Kilbride says this is where it becomes “a postcode lottery”.

In CHO9 (north Dublin) or CHO1 (Louth, Meath and the North West) there’s nowhere to refer you for an ADHD assessment with the HSE. There isn’t a specific ADHD clinic, but psychologists and psychiatrists can assess you and if you need medication, psychiatrists can manage that.

To get assessed privately, it costs around €650, but after that there is also the possibility of medication and review appointments. “It’s not a cheap condition,” Kilbride said.

In a statement to The Journal, the HSE said that young people with ADHD can be referred by their GP to services at primary care level or specialist mental health services.

“Many young people with mild to moderate mental health difficulties can be treated at primary care level and make progress without needing to access specialist mental health services. Primary Care services include GPs, Jigsaw and other NGO service providers, Primary Care Psychology services and counselling in Primary Care (CIPC) which is available to those over 18.

CAMHS is a specialist clinical service for people under 18 with moderate to severe mental health difficulties. It is not for everyone; only a small percentage (approx. 2%) of the population would require access to this service.

There are 73 CAMHS Community Mental Health Teams nationwide.

“Every effort is made to prioritise urgent referrals so that young people with high risk presentations are seen as soon as possible and this is often within 24 to 48 hours. This may impact on wait times for cases that are considered, by a clinician, to be less severe.

“As of the end of November 2021, 75.3% of referrals accepted by child and adolescent community teams nationally were offered an appointment within 12 weeks against a target of 78%.
Nationally, 93.8% of urgent referrals to CAMHS were responded to within three working days, above the 90% target. 95.8% of accepted referrals/ re-referrals offered first appointment and seen within 12 months.

The HSE set out its aims for providing services and treatments for adults with ADHD in its ‘model for care’ document launched in January last year.

The plan is for 11 adult ADHD clinics to be set up to provide assessment and treatment, with each clinic consisting of a consultant psychiatrist, a senior psychologist, a senior occupational therapist, CNSMH (nursing staff) and an administrator.

The HSE said in a statement that funding is in place for three teams in CHO1 (Louth, Meath and the North West), CHO3 (Limerick, Clare and north Tipperary) and CHO6 (Dublin south east).

Additional funding for 2022 will provide a further 3.5 adult ADHD teams in CHO4 (the Cork and Kerry area), CHO7 and CHO8 (Dublin west and Leinster counties).

The National Clinical Programme is also working with ADHD Ireland and UCD School of Psychology on a patient app to provide specific information for adults who have ADHD or think they may have ADHD.

It is expected to be available from the end of the first quarter of 2022. 

If you need further information, you can also call the ADHD helpline on 01 874 8349, from Monday-Friday from 9am to 5.30pm. Other resources include:

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24 Comments
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    Mute GClare
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    Jan 26th 2022, 12:53 AM

    My child waited 1 year for an appointment after suicide attempt and self harming. Had to have her ADHD diagnosis done privately as the system wasn’t sure she needed testing, 4 years of psychiatrist registrars changing every 6 months and OT eventually offered 2 months before she turned 18 and signed off without a referral to adult services. The system is a shambles and not fit for purpose, but at that I do still feel like a lucky one, at least we got some service, which many many do not.

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    Mute Paul Gorry
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    Jan 26th 2022, 1:05 AM

    @GClare: Same the service provided was second to none imo.Turn 18 get lost we don’t want to know. Shambles.

    62
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    Mute John Johnes
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    Jan 26th 2022, 10:04 AM

    @GClare: Irish health service is worse than in a 3rd world country.

    28
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    Mute Neil Neart
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    Jan 26th 2022, 12:07 PM

    @John Johnes: according to the OECD we are in the top 5 in the world in healthcare spend per person. That figure includes public and private spend plus insurance. There are no poor consultants in Ireland and many have paid huge settlements to the Revenue after tax audits, both of which suggest we are picking the wrong people to subsidise with taxpayers funds to do medicine. It can cost 50k a year of our money to train them!

    11
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    Mute Doug
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    Jan 26th 2022, 12:37 PM

    @John Johnes: You obviously haven’t visited a 3rd world country.

    7
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    Mute Ciaran bolger
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    Jan 26th 2022, 8:42 PM

    @Neil Neart: nonsense. Most consultants pay for their own training. Where you getting your figures from??

    1
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    Mute Ciaran bolger
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    Jan 26th 2022, 8:44 PM

    @Neil Neart: there are no consultants…….that’s the problem. Why do you think that is?

    1
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    Mute The Guru
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    Jan 26th 2022, 2:49 AM

    The Govt has had its biggest tax take ever this year and boasts about our impressive economic growth. Meanwhile our health system and in particular mental health system is third world standard. We also treat our disabled residents shamefully. On top of that we have an horrific housing crisis which only adds to people’s anxiety. If these are the “good times” I shudder to think of what happens if/when we have another downturn.

    196
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    Mute B Ó Raghallaigh
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    Jan 26th 2022, 8:02 AM

    @The Guru: We have the lowest investment in education of any OECD country. We have far too many committees and quangos with jobs for the lads draining the budget and not enough left over for essential services

    99
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    Mute lenny
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    Jan 26th 2022, 8:53 AM

    Waited 9 years for appointment, gp aged 4 to diagnosed aged 13. 9 vital, significant years. Shocking lack of understanding and education around ADHD itself and supports, both within education system and subsequent services. CAMHS wrote a script, no teen counselling or teen support groups or child focused education or strategies. Just a script and directed to GP to pay for heart and bloods check up. That script needs to be phoned in every single month! Every single month! It’s the same, but it needs someone available to take your call, it needs to be posted and it needs to be written correctly! 40 mins of resources a week for exam years only required 9 years of hardship and filling out paperwork and all the years since enduring CAMHS.
    Autism services are no different, we’re 5 years waiting now. AON deemed him needing immediate services, thankfully. There’s still hope it’ll not be the full 9 years wait! And if you’ve a complaint.. well that’s a whole other article!
    There’s a serious underestimation of just how difficult it is to advocate and educate within our very broken system here, and the parents who have to give up everything to do just that.

    79
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    Mute Michael Dikie Foran
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    Jan 26th 2022, 5:54 AM

    The government obviously have no children that suffer with it that’s why the service is so bad government couldn’t care less they might think about it at election time

    83
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    Mute Johannes Baader
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    Jan 26th 2022, 7:40 AM

    Government letting once more people down. The HSE saga continues

    60
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    Mute Danger
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    Jan 26th 2022, 8:45 AM

    I’d happily pay higher taxes if I knew it was funding additional mental and health services. Meanwhile the government is focusing on a WFH bill……

    49
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    Mute FiannaFáilness FineGaelness
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    Jan 26th 2022, 9:51 AM

    @Danger: Absolutely, it’s utterly scandalous.

    10
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    Mute thesaltyurchin
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    Jan 26th 2022, 8:27 AM

    Flat earthers at the HSE will deny it even exists!

    36
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    Mute joe celtic 1888
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    Jan 26th 2022, 6:50 AM

    Feckin scandalous

    53
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    Mute Daniel Muldoon
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    Jan 26th 2022, 1:09 PM

    I think its a bit of a disgrace that people are always looking for someone else to shoulder the responsibility of raising their kids or looking for something else to blame. My kids have ADHD at at one time were out of control because we were following the advice of the experts (And as a father i was ignored and undermined by my wife and the teachers). I took a job closer to home so i could have more control over the situation. I didn’t have to abuse them to get them in line, working in IT i have been able to use my skills to limit their access to devices. I then implement a reward scheme where if they do well they get rewarded, if not they don’t they loose access. Before i implemented my strategy we were following the recommended way of capitulating to them which only made it worse. By giving them structure and consequences i was able to modify their behavior and now my kids are top of their class and cause no issues around the home. The main thing i think is the problem is that parents are too fixated on being their kids friends rather than a parent. As i say to my kids, “My job is to be your father, not your friend,” Anyone who thinks they can be both are delusional, a person of authority can not be a friend.

    22
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    Mute Colm Hennessy
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    Jan 26th 2022, 1:38 PM

    @Daniel Muldoon: sorry, your comment is a bit garbled… did you say that your kids had been diagnosed with ADHD? Or that they just had behavioural concerns?

    Your points about parenting approaches are valid. But don’t conflate behaviour/parenting issues with ADHD. They are not the same thing.

    19
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    Mute Mike Dé Vere
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    Jan 26th 2022, 4:35 PM

    @Daniel Muldoon: Absolutely.

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    Mute Mike Dé Vere
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    Jan 26th 2022, 4:36 PM

    @Mike Dé Vere: The dads need to step up.

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    Mute Gavin Tobin
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    Jan 26th 2022, 9:57 AM

    Useful review paper here linking ADHD to aberrant mast cell behaviour.

    Mast cell-mediated neuroinflammation may have a role in attention deficit hyperactivity disorder (Review)

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388140/#:~:text=Certain%20studies%20indicated%20that%20ADHD,brain%20inflammation%20and%20neuropsychiatric%20disorders.

    9
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    Mute Gavin Tobin
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    Jan 26th 2022, 10:10 AM

    @Gavin Tobin: *suggesting a potential link worthy of further study.

    6
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    Mute Hear me now
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    Jan 26th 2022, 11:09 AM

    Great little country

    4
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