Health / New pilot project aims to improve access to ADHD support amid high demand
A SIX month pilot project is set to take place aimed at improving access to Attention Deficit Hyperactivity Disorder (ADHD) support in Shetland.
It comes amid a significant increase in demand for ADHD support, with a near 900 per cent increase in referrals in Shetland between 2021 and 2024.
The plan is to utilise more dedicated staff resources to provide additional administrative, diagnostic and therapeutic expertise for assessment and treatment.
This should then inform sustainable ways of delivering ADHD support beyond the pilot.
As of 24 November, there were 367 people in Shetland on the waiting list for ADHD assessment.
A report to a meeting of Shetland’s integration joint board (IJB) on Thursday added that local prevalence of ADHD is likely to be between “920 and 1,150 adults, though not everyone with ADHD requires support.”
The increase in referrals equates to a rise from 11 assessments a year in 2021 to 98 a few years later.
Funding for the scheme – which could cost nearly £100,000 – will be transferred from a project which was due to pilot a primary care mental health nurse.
No-one was appointed to that mental health nurse project despite two recruitment rounds.
While recruitment was unsuccessful, the project group continued to meet and reviewed wider mental health and neurodevelopmental pressures.
“ADHD demand has escalated substantially, creating a critical pressure point across NHS Shetland,” the report said, with the two projects said to share some similar intentions.
The NHS describes ADHD as a group of behavioural symptoms that can include difficulty concentrating and paying attention, hyperactivity and impulsiveness.
Introducing the report at Thursday’s meeting, NHS Shetland’s head of mental health Rona McArthur explained that demand for what she said is a life-long condition has risen across the whole country.
She said this was down to increased awareness, including on social media, as well as greater understanding, unmet historical need, population growth, social change and the impact of Covid.
McArthur said adults often seek assessment because they start to gain an understanding of what ADHD is, and can relate to the condition.
Given that it can be inheritable, she added that there is an “element of families beginning to understand their children and how that relates to them”.
She said ADHD can significantly impact people’s lives and that diagnosis and medication can be “life changing”.
The meeting heard how work has already been taken place locally, with NHS Shetland community mental health team providing a pathway.
“This pilot is not starting from zero – we have local knowledge and skills, we have pathways,” McArthur said.
She also explained that the pilot does not require extensive recruitment, with only a band three healthcare support worker – who would commit two days a week to the project – needing to be brought in.
However, this role could be filled by existing staff, the meeting heard. Meanwhile, a consultant psychologist is proposed to contribute via a service level agreement with NHS Orkney.
McArthur said the pilot would be “significant in terms of the capacity it would create”.
Members of the IJB were happy to approve the proposal.
IJB chief officer Jo Robinson reassured members that the proposal should give a clearer picture about the next steps once the pilot concludes.
Robinson added that the pilot is “designed to take account of the projections that we have around current evidence of the incidence of ADHD”.
She also said that for some people just having a diagnosis is enough, while some need medication, and beyond that there are more complex cases.
“I think it is heading in the right direction in terms of us knowing the size of the issue,” Robinson said.
NHS Shetland’s director of pharmacy Anthony McDavitt said the proposal should give a more robust diagnosis approach in the longer term.
He added that the pilot tries to recognise that the current model is not sustainable, but that it needs time.
Meanwhile vice-chair and councillor John Fraser said the figures about increased demand were “mind-blowing”.
But he said Shetland, not for the first time, is being proactive.
Fraser also highlighted the prevalence of dual diagnosis with ADHD – adding that early intervention and treatment could act as a “spend to save” as it may prevent people having to go through other pathways.
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