How our service can help you
We aim to provide a comprehensive expert assessment and treatment
for adults with a suspected or diagnosed ADHD and/or ASD.
We also provide a range of treatment options specified by the
National Institute for Health and Care Excellence (NICE). These
include management of pharmacological treatments, often in shared care
arrangements with local services.
- Service Type: Adult Mental Health Services (National) Service Borough Covers: National (Adult services) Treatment type: Outpatient
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Contact the service
Site Location: Maudsley Hospital Email: adhdasdadmin@slam.nhs.uk Fax Number: 020 3228 8521 or 020 3228 6791 -
Disabled Access:
Yes
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Address:
Maudsley Hospital
Outpatient Department
Denmark Hill
Camberwell,London, SE5 8AZ -
Business Hours/Visiting Hours:
Monday - Friday 9-5 excluding bank holidays.
- Conditions: Addictions, Anxiety, Attention deficit hyperactivity disorder (ADHD), Autism, Bipolar disorder, Body dysmorphic disorder (BDD), Childhood degenerative disorders, Conduct disorder, Dementia, Depression, Dissociative disorders, Eating disorders, Learning disabilities, Neuropsychiatry, Obsessive compulsive disorder (OCD), Perinatal disorders, Persistent physical symptoms, Personality disorders, Post-traumatic stress disorder (PTSD), Psychosexual, Psychosis, Self-harm
Other essential information
- Interventions
- Eligibility criteria
- Outcomes
- Care Options
- Referrals
- Our experts
- Administration Address
Interventions
Autism spectrum disorder (ASD) diagnostic assessment
The initial assessment may include an autism diagnostic interview (ADI-R) with a parent or carer, and/or an autism diagnostic observation schedule (ADOS) with the patient. These will be carried out by a neurodevelopmental specialist or other trained member of the clinical team.
There will be an appointment to consider the ADI/ADOS results with a clinical psychologist, clinical nurse specialist or consultant psychiatrist. This will include a medical and psychiatric history taking. We will also consider potential co-morbidities and differential diagnoses. This appointment will usually include discussion with the patient about the diagnostic outcome.
Attention deficit hyperactivity disorder (ADHD) diagnostic assessment
The initial assessment will include a diagnostic interview (DIVA) with the patient and informant(s) to identify potential ADHD symptoms and impairments. This will be carried out by a neurodevelopmental specialist or other trained member of the clinical team.
There will also be an appointment to consider the DIVA results with a consultant psychiatrist or senior clinical nurse specialist. This will include medical and psychiatric history taking. We will also consider potential comorbidities and differential diagnoses. This will also usually include discussion with the patient about the diagnostic outcome.
Brief assessment - ADHD
We can assess patients diagnosed elsewhere with ADHD, either in childhood or adulthood. We would need details of previous diagnostic assessments and any treatments at the time of referral. Our assessment focuses on the existence of current symptoms and impairments related to ADHD and any current differential diagnosis and treatment recommendations.
This assessment is for patients transitioning from child and adolescent services. But it can include patients assessed privately or abroad, for whom GPs are being asked to continue treatment. However, if the patient’s mental state or presentation has altered significantly they may need a full assessment. Examples include queries about emerging comorbid condition/differential diagnosis, or about their prior ADHD diagnosis. If there has been no review in the past 12 months then they may need a full assessment.
ASD – medical review assessment
A consultant-led review of a patient’s response to medication prescribed for co-morbid mental health conditions, in the context of the patient having an ASD. This may include review of the management of side effects or the appropriate use of second or third line agents for mental disorder. This review does not include a second opinion of diagnosis. We make recommendations to the local referring team.
Second opinion diagnostic assessment
An extended assessment to review previous assessment documents in addition to the standard assessment protocol detailed above.
Outreach diagnostic assessment
ADHD and ASD assessments described above where clinicians travel to the patient’s home or alternative local venue. We offer this where the patient is unable to travel to the Maudsley Hospital. This could be due to physical or mental health reasons, or where patients are detained.
Treatment
Initiation and titration of medication for ADHD
Initiation and titration of medication for ADHD symptoms from assessment within the clinic until the dosage is stabilised. At this point primary and secondary care would continue to prescribe the maintenance dose under shared care. A nurse (non-medical prescriber) or a consultant psychiatrist will deliver the prescribing appointment.
ADHD treatment optimisation
A consultant psychiatrist or nurse will undertake this appointment. They will monitor the patient's response to pharmacological ADHD treatment and provide further treatment recommendations to local services. This would usually need two or three sessions over 12 months.
ADHD annual reviews
Annual appointments to monitor response to pharmacological ADHD treatment and provide further recommendations to local services, in line with NICE guidance.
Eligibility criteria
- 18 years and over (three months before the 18th birthday is a transition patient)
- Suspected or diagnosed attention deficit hyperactivity disorder (ADHD) in adulthood
- Suspected or diagnosed autism spectrum disorder (ASD) in adulthood
- We consider people with an alcohol addiction or problem if there is evidence they will engage with their local services to address this
- Genetic or chromosomal abnormalities including, but not limited to, 22q deletion syndrome (VCFS), neurofibromatosis, Turner syndrome, Klinefelter syndrome, Down’s syndrome, fragile X syndrome, and single gene defects
Exclusion criteria
A known addiction to street drugs, where they are using at the time of referral and not engaged with local services to address this
Current major mental illness and no available developmental history
Outcomes
- Improved access to diagnostic assessment of attention deficit hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) for adults
- All patients assessed for ADHD and/or ASD will receive a comprehensive diagnostic report with recommendations within four weeks of their last assessment appointment
- Follow-up reports (for patients having their ADHD medication initiated or reviewed by our clinic)
Service user outcomes (ADHD)
- An accurate diagnosis and an appropriate treatment plan
- Treatment recommendations for GPs and local community mental health teams (CMHTs)
- Improved awareness of national support services post diagnosis through signposting.
- Patients reporting improvement in symptoms after treatment, measured through clinical outcome ratings. This includes: improved concentration and attention, decreased hyperactivity and impulsivity, improved interpersonal relationships, occupational performance and improved quality of life
Service user outcomes (ASD)
- Improved understanding of their ASD symptoms and why they experience certain difficulties
- Improved interpersonal relationships and occupational performance
- Improved quality of life
- An accurate diagnosis and an appropriate treatment plan
- Treatment recommendations for GPs and local CMHTs
- Improved awareness of national support services post diagnosis through signposting. For example, National Autistic Society and support groups for people with ASD
Care Options
Referrals
Access
Referrals can come from across the UK but funding must be sought for each individual referral and each intervention.
Access to this service is subject to clinical commissioning group (CCG) or commissioning support unit (CSU) specialist mental health commissioning arrangements.
Referrals can come from GPs or secondary mental health services. We provide assessment and treatment for areas:
- with no attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) services
- where secondary mental health services are not commissioned to provide assessment or treatment of ADHD or ASD
- We also accept referrals from specialist ADHD/ASD services for a second opinion assessment or treatments they don't provide
Referrals
Referrers: You must complete the service referral form in full before we will accept a referral for clinical screening. This referral must include information outlining:
- Presenting difficulties suggestive of ADHD/ASD
- Resultant impairments
- Confirmation that at least some of the symptoms were present in childhood or adolescence
The team cannot accept self-referrals.
Please find the service referral form below:
national-adult-adhd-autism-service-referral-form-08062020.docx [docx] 87KB
Outcome of referral
All referrals are clinically screened for appropriateness in the first instance. We will respond to the referrer, GP and patient within two weeks of receiving the referral.
Our experts
Administration Address
Bethlem Royal Hospital
Monks Orchard Road,
Beckenham
BR3 3BX
