If you can't access an ADHD specialist — what you can still do

Why this page exists

The adult ADHD medical pathway is designed as if everyone lived 10 minutes from a university hospital, had a private psychiatrist available within 3 months, and £150 / €80 / $300 spare per consultation.

That’s not the reality for most people. 40 to 60% of people in France live in a mental-health medical desert ^[1] — and the UK NHS (multi-year waits for adult ADHD), the US (uneven insurance coverage, stimulant shortages), Australia and Canada show similar access gaps. Specialist adult ADHD centre waitlists routinely exceed 12 to 24 months. France’s Mon Soutien Psy, the only reimbursed psychologist scheme, explicitly excludes ADHD ^[2] .

This isn’t a problem you should have to solve alone. It’s a documented systemic problem. What follows is the honest map of the options that remain — none are perfect, all are real.

Route 1 — Adult ADHD telehealth

Psychiatric telehealth is recognised by the French HAS ^[6] since 2020 and reimbursed under the same conditions as an in-person consultation (subject to an initial in-person consultation within 12 months, with exceptions). Similar frameworks exist in the UK (NHS and private), the US (covered by most insurers since 2020), Canada and Australia.

What it concretely opens

• Remote private psychiatrists: Doctolib, Qare, Livi (FR/EU), Cerebral, Talkiatry, Done (US, with caveats about stimulant prescribing), Psychiatry UK, ADHD 360, Harley Therapy (UK) offer video consultations. Clinicians can sometimes see you faster by video because they save transition time between patients.
• Specialist platforms: some platforms specialise in adult ADHD. Verify their clinician credentials, their relationship to your insurance (public / private), and whether they can handle controlled substance prescriptions in your country.
• Useful for medical deserts: no need to drive 200 km to see a specialist. The clinical framework is the same.

What it doesn’t solve

• Deep neuropsychological testing (WAIS, TAP, d2, CAARS Connors) is hard to do over video — most assessors will want one in-person visit for that step.
• In France, psychiatrists must have seen the patient in person at least once in the 12 months before a video consult (except urgent situations or severely under-served areas). Other countries have similar in-person requirements for controlled prescriptions.
• Cost: private fees (€50-120 / £100-250 / $150-400 per session), partial reimbursement.

Community testimony

It took me 2 years to find a psychiatrist trained in adult ADHD within 3 hours’ drive. On Doctolib telehealth, I found someone in 3 weeks. The neuropsych assessment, I had to go to Limoges once. It’s not ideal — but it happened.

Route 2 — Use patient associations as the entry point

ADHD patient associations (notably HyperSupers TDAH France in France ^[4] , ADHD UK and AADD-UK in the UK, CHADD and ADDA in the US, CADDAC in Canada, ADHD Australia) don’t diagnose — but they do three crucial things:

1. Clinician directories: they maintain informal lists of clinicians trained in adult ADHD, by region. That avoids the 6 months lost with a clinician who’ll tell you “adult ADHD doesn’t really exist”.
2. Peer groups: free, run by trained volunteers. Not therapy, but a space where your experience is credited without needing a diagnosis.
3. Listening lines: to vent, ask a concrete question, get oriented.

Concretely: write to your regional association, explain your situation, ask for orientation advice. Response times are often 1 to 2 weeks — it’s volunteer-run, but it’s human.

Route 3 — Sourced self-assessment, without self-diagnosing

An ADHD diagnosis must be made by a trained psychiatrist. But you have the right to explore the hypothesis yourself — it avoids paying for a consultation only to realise it wasn’t the right lead, or leaving a failed first appointment discouraged.

Validated tools you can use alone

• ASRS v1.1 (WHO / Harvard) — 18 questions, 10 minutes ^[5] . Internationally validated adult screening tool. It is not a diagnosis: it’s an orientation indicator. If you check 4+ of the first 6 items, that justifies a specialist consultation. Fewer checks don’t rule it out either.
• Personal timeline: write the history of your difficulties by period (childhood, adolescence, studies, working life, relationships). Not for a personal diary — to bring that written timeline to the psychiatrist. Many diagnoses close in 2 sessions instead of 4 when the patient arrives prepared.
• This site’s pillars — What ADHD actually is, Late-diagnosed ADHD, AuDHD. Not to label yourself. To recognise or rule out patterns.

Route 4 — Your GP can initiate the process

The GP’s role in adult ADHD is underestimated. Guidance bodies (France’s HAS 2024 ^[3] , the UK’s NICE, US primary care frameworks) agree the GP can:

• Spot and refer — that’s their core job. A refusal = you can ask for an explicit letter or change clinician.
• Prescribe a temporary sick note if the suffering is documented and the specialist wait is long (an untreated ADHD burnout is still a burnout, treatable even before diagnosis).
• Prescribe psychological support via national schemes for a linked motive (anxiety, depression, burnout) — even if ADHD itself isn’t covered. In France, Mon Soutien Psy for an anxious presentation; in the UK, IAPT / NHS Talking Therapies. It’s not cheating: the comorbidity is real, the care is legitimate, and it holds you through the wait.
• Initiate a renewal of stimulant medication once the diagnosis is made and the initial prescription is done by the psychiatrist — avoids needing to see the full-fee specialist monthly. (In France, strict hospital primo-prescription rules apply for methylphenidate and lisdexamfetamine.)

What you can explicitly ask

“Doctor, I have a cluster of difficulties that makes me suspect adult ADHD. Here’s my timeline [written document]. Here’s my ASRS [written document, 14/18]. I know you don’t diagnose. Could you refer me to a psychiatrist who diagnoses adult ADHD, and in the meantime prescribe support for the anxiety this generates?”

Why this phrasing works: it respects the GP’s role (referral + comorbidities), brings written material (also protective legally), and asks for a precise action — not emotional validation.

And if nothing works?

You’ve tried everything, you’re exhausted, you’ve got no energy left?

If you’re in crisis

Repeated medical dismissal is traumatic. If you’re going through a moment of severe distress:

• UK: Samaritans 116 123 (24/7, free, anonymous); SHOUT crisis text (text SHOUT to 85258).
• US: 988 Suicide & Crisis Lifeline (24/7).
• France: 3114 — national suicide prevention line (24/7, free, anonymous); SOS Amitié 09 72 39 40 50.
• Canada: Talk Suicide Canada 1-833-456-4566 (24/7).
• Australia: Lifeline 13 11 14 (24/7); Beyond Blue 1300 22 4636.
• Emergency: 911 (US/CA), 999 (UK), 112 (EU), 000 (AU), 15 / 112 (FR).

You don’t need to be “OK” to deserve to be heard. You don’t need an official diagnosis to be entitled to your feelings.

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This page is alive. If you know a route not listed here, or if an option listed no longer holds, write to nissieltb@gmail.com. We update fast, and we credit your feedback (anonymised, with your agreement).