Adult ADHD Patients in Community Mental Health Teams – an Unmet Need

Abstract

Aims

This Service Survey is a part of a Quality improvement project which aims to :1- To assess the extent of the problem regarding accessing Adult ADHD assessment and treatment by getting the views of clinicians.2- Evaluate negative impact on care coordinators of the delay in accessing timely and effective diagnosis and treatment of ADHD; This will: a-Increase understanding of the care needed by this patient group. b-Clarify current practice and any difficulties staff face in condition management when diagnosis not confirmed i.e. outline training needs. c-Determine if waiting time for diagnosis results in iatrogenic harm (deterioration driven by ‘unmet need’). 3-Inform the development of an alternative pathway of care; thus: a-Reduce inequality of healthcare access for those with this neurodevelopmental condition. b-Reduce stigma. c-Improve service user health and well-being. d-Support families and carers. e-Reduce social costs to individual and community. f-Support community staff and increase knowledge and effectiveness.

Methods

Methods of the service survey part:

1. 1. Service survey: Sent to 21 consultants who are working in Adult CMHT.

2. 2. Service Satisfaction survey for all of the Redcar & Cleveland Affective disorder team's clinical staff members (18).

Results: Consultants Service Survey

11 consultants responded out of 21 (52%)

Approximate number of the diagnosed ADHD patients / team varied between 7–80 patients.

Wait time for an ADHD assessment varied between 12 -30 months.

Number of patients/ team waiting for assessments by the specialist team 2- 27 patients.

50% of the consultants reported significant delays between referral to the services and initiation of treatment 6–36 months.

All consultants reported commencing treatment of ADHD, if a patient already had the diagnosis.

9/11 (82%) consultants reported making the initial diagnosis and treating ADHD patients in CMHTs. However, all consultant reported the need for further training in assessment and management of ADHD patients.

6/11 (55%) consultants stated that ADHD patients should be managed in CMHTs provided they are care coordinated by another clinician.

Clinical Staff Satisfaction Survey

All 3 staffs responded out of 18 staff, reported un satisfaction with the current service provision.

Conclusion

1. 1. The current service model is not able to meet the increasing demand for the services and leading to significant delay in accessing appropriate treatment.

2. 2. There is a need to improve competencies of community mental health teams to manage these patients.

3. 3. This survey will be used to model a new care pathway.