News Story

There have been calls to stop women and girls from being “missed” from ADHD diagnoses in Scotland, after a professor said there has been “decades of underfunding”.

One woman who was eventually diagnosed with attention deficit hyperactivity disorder at a private clinic at the age of 63 has described feeling unsupported by the NHS.

According to the Scottish Government, it is estimated that ADHD affects around 5% of children and 2.5% to 4% of adults in Scotland.

While there is no specific statistics on women and girls diagnosed with ADHD in Scotland, researchers at University College London found that since 2000 to 2018 the proportion of diagnosis of ADHD in men was 74.3 per 10,000 compared with 20 per 10,000 women.

This means men are 3.7 times more likely to be diagnosed compared to women in the UK.

Helen Minnis, professor of child and adolescent psychiatry at the University of Glasgow, co-authored a study which found girls with ADHD from deprived backgrounds may face a higher risk of long-term health conditions.

Part of the findings, which were released in May, was that ADHD in females has been historically under-recognised, underdiagnosed and undertreated.

As a result, the long-term consequences of ADHD in girls and women have been largely overlooked in both clinical practice and research, the study found.

Professor Minnis said: “There’s a lot of speculation about whether girls mask more.

“It may just be that the research tools, the story that the clinical measures that we use to diagnose ADHD just were perhaps not really designed to be thinking about girls, so we need to be better at identifying ADHD in girls at a younger age.”

In July, the Royal College of Psychiatrists in Scotland (RCPsychiS) warned that a decade of health and social care integration has left the country’s mental health services fragmented as it called for an urgent independent inquiry into the effect on patient safety.

Neurodevelopmental services, which is where ADHD and autism assessment sits, are named among those affected.

Minister for mental wellbeing Maree Todd chaired a neurodevelopmental roundtable in August to establish a timeline and route map for adoption and integration of the Royal College of Psychiatrists proposals.

However, Ms Minnis said while the Scottish Government has expressed that they are working towards further support for neurodivergence in Scotland, the problem is “decades of underfunding.”

She continued: “We have really excellent clinicians in Scotland, and it’s so frustrating that the services are so stretched that often they are just seeing emergencies, and you know they would be perfectly able to help these young girls and young women if they could just get at them.”

She added: “I think there’s real will from the Scottish Government, the problem is that there’s been decades of underfunding.”

In Perth, after seeking support from the Scottish ADHD Coalition, 63-year-old Christine Aston received a diagnosis for ADHD only last year after attending a private clinic.

Ms Aston, a part-time pupil support assistant said that while her GP was supportive of her concerns, she felt she would not be supported to pursue a diagnosis through the NHS.

She said: “The NHS aren’t going to support me with my ADHD late diagnosis, they’ve already said that.

“Because part of the interview over that was, well academically in school you were actually fine between five and 12. That was their diagnosis.

“And you’ve coped as a woman, you’re academic, you’ve studied, you’ve trained, you’ve been to university and you’ve managed, and that’s kind of where they left it.”

Ms Aston continued: “I thought to some extent I can understand why if there’s a big spike and a rise, or more research, or more funding, then you would be looking at younger people and school and dysfunctional families or whatever it is.

“You could say, well, that’s where the money needs to go. That’s where the research needs to go, we really need to look at this.

“People who have got it later in life, well, they’ve managed, haven’t they?”

Bill Colley, chairman of the Scottish ADHD Coalition said clinical professionals are now becoming aware of ADHD in women but more needs to be done.

He said: “Too many girls are still ‘missed’ within the education system because of faulty attribution and a tendency to blame hormones rather than a neurodevelopmental disorder, and too many women with ADHD go unnoticed because adult clinicians feel more confident about treating the externalising symptoms of a mood disorder or depression rather than ADHD.

“The current crisis in services is the direct result of legacy issues and the failure of healthcare services in the past to recognise ADHD in females.

“There is no overdiagnosis of ADHD in Scotland. The problem is quite the reverse.”

A Scottish Government spokesperson said: “The Scottish Government welcomes the study from the University of Glasgow into ADHD in women and will consider it and all emerging evidence as part of implementing the route map.

“We also welcomed the participation of the Scottish ADHD Coalition as part of the roundtable which informed the route map and we will continue to engage with all stakeholders on these issues.

“In our Programme for Government, we said that we would adopt the Royal College of Psychiatrists’ four-tiered national pathway for neurodevelopmental conditions (including ADHD) to ensure anyone with or without a formal diagnosis can access the support they need when and where they need it.

“Alongside this work, we are continuing to improve neurodevelopmental support for children and young people.

“This includes the recently announced £7.6 million Children and Young People’s Neurodevelopment Support Fund, which will help strengthen local neurodevelopmental support for children and families as part of wider work being taken forward with local government and partners across Scotland.”