Mapping UK mental health services for adults with attention-deficit/hyperactivity disorder: national survey with comparison of reporting between three stakeholder groups.
ADHD
UK
health services
stakeholders
survey
Journal
BJPsych open
ISSN: 2056-4724
Titre abrégé: BJPsych Open
Pays: England
ID NLM: 101667931
Informations de publication
Date de publication:
29 Jul 2020
29 Jul 2020
Historique:
entrez:
30
7
2020
pubmed:
30
7
2020
medline:
30
7
2020
Statut:
epublish
Résumé
UK clinical guidelines recommend treatment of attention-deficit hyperactivity disorder (ADHD) in adults by suitably qualified clinical teams. However, young people with ADHD attempting the transition from children's to adults' services experience considerable difficulties in accessing care. To map the mental health services in the UK for adults who have ADHD and compare the reports of key stakeholders (people with ADHD and their carers, health workers, service commissioners). A survey about the existence and extent of service provision for adults with ADHD was distributed online and via national organisations (e.g. Royal College of Psychiatrists, the ADHD Foundation). Freedom of information requests were sent to commissioners. Descriptive analysis was used to compare reports from the different stakeholders. A total of 294 unique services were identified by 2686 respondents. Of these, 44 (15%) were dedicated adult ADHD services and 99 (34%) were generic adult mental health services. Only 12 dedicated services (27%) provided the full range of treatments recommended by the National Institute for Health and Care Excellence. Only half of the dedicated services (55%) and a minority of other services (7%) were reported by all stakeholder groups (P < 0.001, Fisher's exact test). There is geographical variation in the provision of NHS services for adults with ADHD across the UK, as well as limited availability of treatments in the available services. Differences between stakeholder reports raise questions about equitable access. With increasing numbers of young people with ADHD graduating from children's services, developing evidence-based accessible models of care for adults with ADHD remains an urgent policy and commissioning priority.
Sections du résumé
BACKGROUND
BACKGROUND
UK clinical guidelines recommend treatment of attention-deficit hyperactivity disorder (ADHD) in adults by suitably qualified clinical teams. However, young people with ADHD attempting the transition from children's to adults' services experience considerable difficulties in accessing care.
AIMS
OBJECTIVE
To map the mental health services in the UK for adults who have ADHD and compare the reports of key stakeholders (people with ADHD and their carers, health workers, service commissioners).
METHOD
METHODS
A survey about the existence and extent of service provision for adults with ADHD was distributed online and via national organisations (e.g. Royal College of Psychiatrists, the ADHD Foundation). Freedom of information requests were sent to commissioners. Descriptive analysis was used to compare reports from the different stakeholders.
RESULTS
RESULTS
A total of 294 unique services were identified by 2686 respondents. Of these, 44 (15%) were dedicated adult ADHD services and 99 (34%) were generic adult mental health services. Only 12 dedicated services (27%) provided the full range of treatments recommended by the National Institute for Health and Care Excellence. Only half of the dedicated services (55%) and a minority of other services (7%) were reported by all stakeholder groups (P < 0.001, Fisher's exact test).
CONCLUSIONS
CONCLUSIONS
There is geographical variation in the provision of NHS services for adults with ADHD across the UK, as well as limited availability of treatments in the available services. Differences between stakeholder reports raise questions about equitable access. With increasing numbers of young people with ADHD graduating from children's services, developing evidence-based accessible models of care for adults with ADHD remains an urgent policy and commissioning priority.
Identifiants
pubmed: 32723405
doi: 10.1192/bjo.2020.65
pii: S2056472420000654
pmc: PMC7443899
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e76Subventions
Organisme : Department of Health
ID : 10/140/02
Pays : United Kingdom
Organisme : Department of Health
ID : 14/21/52
Pays : United Kingdom
Références
BMC Psychiatry. 2013 Jul 10;13:186
pubmed: 23842080
BMC Health Serv Res. 2019 Jul 9;19(1):468
pubmed: 31288805
N Engl J Med. 2012 Nov 22;367(21):2006-14
pubmed: 23171097
BMC Psychiatry. 2018 Sep 4;18(1):281
pubmed: 30180832
Arch Dis Child. 2010 Jul;95(7):513-7
pubmed: 20530525
J Health Serv Res Policy. 2014 Apr 3;19(3):169-176
pubmed: 24700210
JAMA Psychiatry. 2014 Mar;71(3):319-25
pubmed: 24477798
Child Adolesc Ment Health. 2019 May;24(2):113-122
pubmed: 32677182
J Psychopharmacol. 2014 Mar;28(3):179-203
pubmed: 24526134
J Psychopharmacol. 2015 Jan;29(1):39-42
pubmed: 25237121
BMC Psychiatry. 2016 Aug 26;16:301
pubmed: 27561259
Epidemiol Psychiatr Sci. 2017 Oct;26(5):453-458
pubmed: 28004618
Eur Psychiatry. 2019 Feb;56:14-34
pubmed: 30453134
BMC Health Serv Res. 2013 May 21;13:184
pubmed: 23692803
Br J Psychiatry. 2019 Jun 4;:1-7
pubmed: 31159893
Health Technol Assess. 2009 Oct;13(50):iii-iv, ix-xi, 1-120
pubmed: 19883527