Scotland facing 'system-wide' crisis in support for people with ADHD and autism

Key Points

Scotland is experiencing a dramatic rise in demand for assessments and support for neurodevelopmental conditions (NDCs), particularly ADHD and autism.
There is no national, standardised system to meet this need. As a result, individuals are being referred into general mental health services, which are not designed for NDCs.
This has led to unsustainable pressure on mental health services, long waiting lists, and delays in care for both neurodivergent individuals and those with severe mental illness.
The Royal College of Psychiatrists in Scotland (RCPsychiS) is proposing a society-wide, public health-based response.
The economic cost of untreated NDCs is vast: estimated at £44bn for autism and £17bn for ADHD annually in the UK.

Scotland is facing a “system-wide crisis” in how it supports people with conditions such as ADHD and autism, according to psychiatrists.

Royal College of Psychiatrists in Scotland (RCPsychiS) is urging the Scottish Government to adopt a new nationwide approach to meet the needs of neurodivergent people.

It has set out a ten-point plan for change in its new report, which includes national standards for ADHD and autism assessments.

The report also proposes a new four-tier service model across all age groups, school and workplace support that does not depend on a formal diagnosis and dedicated funding to improve awareness and reduce stigma.

The document highlights a wider economic impact, estimating the cost of autism to the UK to be more than £40bn a year.

It estimates untreated ADHD costs about £17bn annually through lost productivity, unemployment and pressure on health and justice services.

RCPsychiS is calling for a public health approach to tackle the issue.

Dr Pavan Srireddy, vice-chair of the Royal College of Psychiatrists in Scotland, wants to see a public health approach to tackle the problem.

“The scale of the challenge is so massive that our current health-based approach is just not going to be adequate,” he told STV News.

“Over 65,000 people are waiting for an assessment for autism and ADHD in Scotland right now, and that includes over 40,000 children.

“There is no mental health system anywhere in the western world that can cope with that level of demand, nor be able to provide the level of support and care that is required for the people who deserve it.

“This isn’t a health issue, this is a society-wide issue, this is an education issue, this is an issue for employers, for the workplace, but it’s also an issue for society and how we support people who at times have slightly different needs.

“That’s exactly why we need a system-wide approach.”

The Scottish Parliament released research in June on waiting lists for assessments for NDCs. There are 65,000 people, including 42,000 children, currently waiting for an assessment.

The research also shows that people are frequently waiting years for a assessment, with waiting times of more than five years reported.

In some areas demand has surged by more than 2,000% since 2020.

Carol Stobie from East Lothian discovered her ADHD symptoms at 60. She is currently on a ten-year waiting list for diagnosis.

She said: “The need for psychosocial education, peer support and one-to-one coaching is becoming more urgent and we’re always full because people can often not afford private ADHD coaching or diagnoses.

“New thinking is needed all round on how we manage the increase in those coming forward.

“I know different approaches are being used elsewhere in the world. For example, some of our materials are from the US, where awareness is 20 years ahead of the UK on ADHD.”

Carol currently works at at Procrastination Station, a community enterprise company that coaches people with ADHD.

She added: “People with ADHD are more likely to experience things like addiction and depression and as someone with lived experience of the condition, I know this is something decision-makers must sort out.”

Mental wellbeing minister Tom Arthur said: “I welcome the Royal College of Psychiatry’s report on autism and ADHD support in Scotland.

“Demand exceeds current capacity so, following the May 28 debate, we committed to a cross-party summit. We’re grateful to the college for its work and will now carefully review the report.

“Diagnosis can be important but should not be a barrier to accessing the help and support that an individual needs. That’s why we’re investing £2.5m in the multi-year Autistic Adult Support Fund to support third-sector organisations to help autistic adults reach their full potential.

“We are also investing an additional £500,000 this year to improve access to support for children, young people and families.”