Adults who were assessed or treated as children

NICE describes a specific route for adults previously treated as children who still have symptoms, and it is worth naming in the GP appointment because it is a different starting point.

The short version

NG87 says such adults should be referred to general adult psychiatric services for assessment.
It attaches a threshold: symptoms associated with at least moderate or severe impairment.
The impairment can be psychological, social, educational or occupational.
This is a different conversation from a first assessment, so say so at the start of it.

A large group of adults seeking assessment are not seeking a first one. They were seen as children, or treated as children, and then the thread was dropped at some transition point. NICE addresses that situation specifically.

Adults who have previously been treated for ADHD as children or young people and present with symptoms suggestive of continuing ADHD should be referred to general adult psychiatric services for assessment. The symptoms should be associated with at least moderate or severe psychological and/or social or educational or occupational impairment.

NICE guideline NG87, recommendation 1.2.11

What the recommendation does and does not do

It establishes a route, and it attaches a threshold. The route is referral to general adult psychiatric services for assessment. The threshold is symptoms associated with at least moderate or severe impairment, across any of the psychological, social, educational or occupational domains.

It does not carry the previous diagnosis forward automatically. The word in the recommendation is assessment, and that is what is being referred for.

Why it changes the appointment

The GP conversation for a first assessment is largely about establishing that impairment exists across settings. For someone previously treated, part of that groundwork already exists in records, and the useful preparation is different: find the evidence of what was done before.

Old letters, discharge summaries, the name of the service and the medicine you were prescribed all help. If the records sit with a childhood GP practice or a service you have since left, requesting them is worth starting early, because it is usually the slowest part.

How this sits with Right to Choose

The choice of provider in regulation 39 attaches to the referral in the usual way, so the pathway is the same once your GP agrees to refer. The prior question is whether an assessment is clinically appropriate, and for this group the NICE recommendation is directly on point.

Provider criteria still apply on top. Check the age range and, if medication was previously prescribed, whether the provider you want handles prescribing rather than assessment alone.

Questions people ask about this

I was diagnosed with ADHD as a child. Do I need a new assessment as an adult?

NICE NG87 says adults previously treated for ADHD as children or young people who present with symptoms suggestive of continuing ADHD should be referred to general adult psychiatric services for assessment, where the symptoms are associated with at least moderate or severe psychological, social, educational or occupational impairment. The recommendation describes a referral for assessment rather than a simple continuation of the earlier diagnosis.

What records should I get from my childhood treatment?

Anything that establishes what was assessed, by whom and when: letters, discharge summaries, the name of the service, and any medication prescribed. Requests to former practices and services can take time, so start them before the GP appointment rather than after it.