ADHD crisis in NI is a dark, gut-wrenching parody of neglect

We should, I suppose, be thankful that at least a briefing paper has been created for the Northern Ireland Assembly on ADHD. Reading it is, however, a devastating indictment of where we sit in NI. Don't get me wrong, I'm not for a second suggesting Wales, England, Scotland or the South of Ireland has got their collective shit together, but there's at least faint glimmers of progress.

Were Netflix involved, with its pithy short descriptions of shows, Uncle Ted would no doubt mark up Northern Ireland's current ADHD situation as a "gut-wrenching, dark parody"... and one whose documentary would open with a dark screen whilst a voice actor read the briefing paper's first sentence with a tone of melancholy...

"Attention-deficit/hyperactivity disorder (ADHD) was, until recently, perceived as only present in young people, with little or no impact later in life."

I'd hope it would then fade to someone laughing hysterically, thinking this was a joke. Because, they'd probably be wondering, like myself, wtf? Didn't NICE (National Institute of Clinical Guidance) officially recognise ADHD in adults for the first time 16 years ago? Relative is... relative, I guess. Some historians might say the Great Fire of London was recent.

This may seem like a trivial thing. It is not.

That sentence is the starting point for the key points section. A briefing paper for politicians is vitally important because those who read it may have limited or zero understanding of the topic it is covering and it's an opportunity to educate. So we need to stop perpetuating nonsense like this. I don't really have words in me to describe opening a paper designed to educate politicians with "here's what people who aren't educated in ADHD think".

Those same politicians who read it will, at some point, be in a room where ADHD and the lack of a commissioned service is discussed. With a background of online noise around ADHD being "a trend" or "fashionable" (two phrases I recently had the misfortune to read) it's really important to deliver the facts. Starting the paper with a sentence like this, which makes it seem like this is a recent thing for adults feeds into dumb social media fodder.

The document does, however, do a good job at setting out that we're not in a great place. It's the PDF version of Spud in Trainspotting waking up with brown sheets and realising he's in a bit of a predicament. The 42-page document gives an overview of where other areas are too. Scotland, in particular taking up a sizeable chunk of the pages.

Half full or half empty?

It does at times take a glass half full approach, stating that the SPPG (Strategic Planning and Performance Group) is "committed to working closely and collaboratively with HSC Trusts to develop innovative, cost effective, co-produced, quality and evidenced based services that can meet NICE compliant pathways for ADHD diagnosis and support", but let's throw in a massive caveat.

The paper also acknowledges the fact there is no regionally commissioned services for adult ADHD and as such there is no requirement for Trusts to manage a 'dedicated and comparable waiting list'. Take into account last week's post (focusing on the Department's decision to withhold internal communications on ADHD), which stated that services in future "will be in the context of budget availability, as well as the determined level of demand for services", and that's a recipe for disaster.

Simple equation

No requirement to manage waiting list + funding decision being partially decided on by demand = ADHD at bottom of the health service's waiting list for funding. The paper does set out and shine a light on the fact a different approach to ADHD service delivery is needed in both adults and children, though in a wider context that shines through in England, Scotland and Wales too.

Its final sentence sums up the current situation "Undoubtedly, early identification, diagnosis and effective management of ADHD are critical to removing some of the challenges faced by people with ADHD. It is unlikely, though, that most UK residents with ADHD will have access to this unless there is a substantial change in the financing and resource allocation of ADHD treatments".

It's a fitting way to end the report because it feels like there's a lot of similarities to Spud's accident... if things don't change, it's only gonna end one way, and it stinks.