This has been an interesting year for some people who are important in my life.
Late last year my SO and I were talking about some of his professional struggles and I suggested he look at ADHD. After reading about it, he came back and we talked more about it, and he managed to find a research study looking at ADHD in adults, and got his diagnosis of ADHD (inattentive subtype). Unfortunately due to the stresses bought about by living in an earthquake damaged city, he was not able to follow through on the research trial, but has now started on medication and is making huge strides in overcoming many of his challenges in life. He admits it has not been a “cure” because he has lots of bad habits to unlearn, but the extra focus the use of methyphenidate in extended release form has given him has allowed him to start addressing some of his difficulties.
At the same time, J my flatmate has been struggling in his workplace. J has a formal diagnosis of dyslexia and his workplace support worker suggested that he might have dyspraxia in addition to the dyslexia. He felt this was not right – because I am dyspraxic and he does not present in a similar way to me. He did his own research and also came up questioning whether he has ADHD.
Anyway, the process for J could not have been much more different than it has been for M my SO. The first attempt was with a psychiatrist who spoke to him for less than 1 hour and then blamed J’s work problems on his personality being wrong for his chosen profession – not the best thing to say to someone who has worked for 22 years to get into his chosen field…and that his depression had never been properly treated. He was left dismayed and confused. I was furious.
Assessment of adults for any psychiatric or neurological condition is not something that should be done using one methodology. Where possible there should be both objective and subjective measures and some form of triangulation with observers who know the person. This is all clearly laid out in the NICE Guideline on ADHD, which was completely ignored by this psychiatrist.
As you will know from my previous posts, I am all for practice based evidence being used for development of new ideas, but where there is a good robust and evidence based process then it SHOULD be followed.
Fortunately or unfortunately J decided he needed a second opinion when he realised his employers were looking for reasons to fire him, so tomorrow he goes to see a psychiatrist who specialises in adult ADHD. The cost of this consultation is a bit of a brain bender, but already we can see she is following the process, as J has had several tests to complete, he has completed an extensive health and social questionnaire, and he had required both me and his Mum to answer questions on his behaviour as we see it.
I am hoping that he gets a positive diagnosis tomorrow and then he will fight the battles with his employer from a stronger position. I am afraid to say I will probably have a lot to write about in terms of disability and discrimination in the next few months.