1. Introduction: A Postcode Lottery for Adult ADHD Care
For adults in Northern Ireland who suspect they have ADHD, the route to a diagnosis through Health and Social Care (HSC) depends almost entirely on which of the five Health and Social Care Trusts covers their home address. Some Trusts run a small, heavily stretched service. Others have had no adult ADHD pathway at all. As of the most recent published data, at least two of the five Trusts offered adults no route to a first ADHD assessment.
The Department of Health confirmed the scale of the problem when it published its ADHD Needs Assessment on 12 February 2026. The review found that Northern Ireland has had no policy position on the provision of ADHD services and no ADHD-specific service commissioning arrangements, and that, partly as a consequence, “considerable variability has evolved between and even within Trusts” in how assessment, care, and treatment are provided. Announcing the report, Health Minister Mike Nesbitt said it is clear that “there are no cost neutral options for implementing a commissioned ADHD service.”
This guide sets out what each of the five Trusts actually offers adults, drawing on Freedom of Information (FOI) responses published on WhatDoTheyKnow and on the Department of Health’s own Trust-by-Trust review. It then explains why provision is so uneven, and what the private alternative involves.
2. ADHD Waiting Times Across Northern Ireland at a Glance
Not every Trust can give a single waiting time, and some hold no adult ADHD waiting list at all because there is no service to wait for. Rather than force every Trust into one figure, the table below shows what is actually known about each one, and when that information was published.
FOI responses are snapshots, and several of these figures are now a few years old. The more recent evidence suggests the pressure has grown rather than eased. The Northern Ireland Assembly’s Research and Information Service reported in December 2024 that adults in the Belfast Trust may face waits of up to eight years for an ADHD assessment, and the Department of Health’s 2026 review recorded more than 4,000 people waiting for assessment in that Trust alone.
3. What Each Health and Social Care Trust Actually Offers
The detail behind each Trust’s figures matters, because the headline numbers hide very different situations. Each section below links to the underlying FOI response, so you can read the Trust’s own words.
3.1 Belfast Health and Social Care Trust
The Belfast Trust serves Belfast and part of the Castlereagh area, the largest urban population in Northern Ireland. In an FOI response in February 2023, the Trust indicated that adults referred for an ADHD assessment faced a wait of around three years. A second FOI response in March 2023 explained why: adult ADHD provision consisted of 0.5 whole-time-equivalent Consultant Psychiatrist, the equivalent of one consultant working half the week, covering all new assessments as well as review appointments for patients already on treatment.
The picture has not improved since. The Department of Health’s 2026 review found there is no dedicated ADHD team within the Trust’s adult services, only a small resource of 0.5 whole-time-equivalent Consultant Psychiatrist and 0.2 whole-time-equivalent Advanced Nurse Practitioner, focused largely on reviewing patients already prescribed ADHD medication. The service still accepts referrals from GPs, but the review describes the waiting time as several years and records more than 4,000 people waiting for an assessment.
If you live in the Belfast area, our guide to ADHD diagnosis in Belfast explains your options, costs, and timelines in more detail.
3.2 South Eastern Health and Social Care Trust
The South Eastern Trust covers Lisburn, North Down, Ards, and Down, including Bangor, Newtownards, and Downpatrick. Its FOI response, based on data as at 31 March 2022, showed that 85 adults had been waiting more than 52 weeks for a diagnostic assessment, with the longest recorded wait reaching 729 days, or almost two years.
There is an important caveat. The Trust’s figures combine referrals for ADHD and autism into a single neurodevelopmental waiting list, so the response does not show how long adults wait specifically for an ADHD assessment.
Capacity remains extremely limited. According to the Department of Health’s 2026 review, the Trust has only 0.8 whole-time-equivalent Consultant Psychiatry for adult ADHD, and new assessments are restricted to young people transitioning from children’s services. The review notes that growing demand has created long delays, with some patients remaining under paediatric services into their twenties.
3.3 Northern Health and Social Care Trust
The Northern Trust covers Antrim, Ballymena, Coleraine, Larne, and Magherafelt. Its FOI response in February 2023 contained the most striking finding of any Trust: there was no commissioned adult ADHD service at all. The Trust had only begun keeping a register of adult referrals in November 2021, and a small, unfunded pilot was due to start in February 2023.
That pilot has since taken shape, but on a very small scale. The Department of Health’s 2026 review describes a limited dedicated service of 0.4 whole-time-equivalent Consultant Psychiatrist and 0.4 whole-time-equivalent Advanced Nurse Practitioner, created from existing resources to test clinical pathways ahead of any future commissioned service. GPs can refer, but they must evidence that the patient meets the service criteria, and no non-medication interventions are offered through the Trust. No waiting time figure has been published.
3.4 Southern Health and Social Care Trust
The Southern Trust covers Armagh, Newry, and Craigavon. When asked about its adult ADHD waiting time, the Trust’s FOI response was unambiguous:
“There is no waiting list held as this is an uncommissioned service and not currently provided in the SHSCT.”
The Department of Health’s 2026 review confirms that the Trust’s adult mental health services do not provide a dedicated ADHD service. They take on young people transitioning from the Trust’s CAMHS team and, on occasion, GP referrals for adults with a confirmed diagnosis who have had a break in treatment. For an adult seeking a first diagnosis, there is no waiting list to join because there is no service to wait for.
3.5 Western Health and Social Care Trust
The Western Trust covers Derry/Londonderry, Omagh, Fermanagh, Strabane, and Limavady. Its 2023 FOI response did not provide a clear figure for adult ADHD assessments. Instead, it described two related services under strain. The adult autism service had 12 people on its waiting list but was holding no clinics because of vacant Clinical Psychologist and Speech and Language Therapist posts, and the children’s combined ADHD and autism waiting list stood at 1,547 as at 31 December 2022, with the longest wait reaching 898 days.
The Department of Health’s 2026 review fills the gap on adult ADHD, and the answer is stark: “New patients are not accepted into Western Trust.” The Trust’s ADHD pathway only accepts people referred from CAMHS or paediatric services who already have a confirmed diagnosis and are established on medication. Because ADHD services are not commissioned in the Western Trust, no dedicated resource is assigned to them.
Adults in the North West can read more about local private options on our ADHD assessment in Derry page.
4. Why the Picture Is So Uneven
The gaps in adult provision have their roots in how ADHD was historically understood. For decades, it was treated as a childhood condition, so services in Northern Ireland grew up around Child and Adolescent Mental Health Services (CAMHS) and community paediatrics. As evidence grew that ADHD often continues into adult life, adult mental health services were given neither a regional mandate nor dedicated recurring funding to build equivalent assessment pathways.
The Department of Health’s Needs Assessment describes the result. Despite the Department endorsing the NICE guideline on ADHD (NG87) during 2018 to 2019, no commissioned service followed, and Trusts have developed pathways for people with ADHD without additional funding, adapting and reconfiguring existing resources wherever they could. That is why referral criteria, staffing, and assessment approaches differ so widely from one Trust to the next. The review estimated the cost of the first phase of a commissioned ADHD service at more than £12.6 million, and the Minister has made clear that any future commissioning decision must be taken in the context of overall affordability and significant funding constraints across health and social care.
The lack of specialist adult teams also affects treatment after a diagnosis. GPs in Northern Ireland are not obliged to take on shared care prescribing for ADHD medication, and the Department of Health’s review notes that people diagnosed privately are often unable to access prescribed medication through their GP under shared care guidelines, leaving them either untreated or paying substantial monthly sums. Our guide to ADHD medication in Northern Ireland explains how prescribing and shared care work in practice.
Finally, Northern Ireland has no equivalent of England’s Right to Choose, which allows NHS patients in England facing long waits to be assessed by an alternative NHS-funded provider. Adults in Northern Ireland are limited to what their own Trust provides, or to paying privately.
5. The Private Alternative: ADHD Now in Northern Ireland
For many adults, waiting years for a Trust assessment, or discovering there is no service at all, is simply not workable while symptoms affect their job, studies, relationships, and mental health. ADHD Now Northern Ireland provides Consultant Psychiatrist-led ADHD assessments online through secure video consultations, available to adults in every Trust area, from Belfast and Lisburn to rural Tyrone, Fermanagh, and communities along the border. No GP referral is needed.
The adult assessment follows three clear steps:
- Step 1: Initial Consultation (£49). You complete an intake questionnaire, including ASRS and DIVA-5 screening, followed by a 30-minute video consultation to review your concerns and history and confirm whether a full assessment is appropriate. Initial consultations are typically available within seven days of booking.
- Step 2: Full Assessment (£495). A comprehensive clinical evaluation covering your developmental and psychiatric history, current symptoms, input from someone who knows you well, and validated diagnostic instruments.
- Step 3: Diagnosis and Report (£325). The clinical team brings together all of the findings to confirm or rule out a diagnosis, and issues a formal written report that can be shared with your GP, employer, or university.
The full pathway costs £869 across the three steps, and you only move on to each stage if it is clinically appropriate. Full details are set out on our Northern Ireland pricing page.
At ADHD Now, we do not use the QB test or the CAARS in our adult assessment process. Instead, our clinicians use four validated instruments: the Adult ADHD Self-Report Scale v1.1 (ASRS) for current symptoms, the Wender Utah Rating Scale (WURS-25) for childhood symptoms before the age of twelve, the WEISS Symptom Record (WRS II) for co-occurring conditions and functional impact, and the Diagnostic Interview for ADHD in Adults (DIVA-5), a structured clinical interview based on DSM-5 criteria.
If ADHD is confirmed, our adult ADHD medication service, overseen by General Medical Council-registered Consultant Psychiatrists, provides medication initiation, cardiovascular checks, careful dose titration, and regular reviews, alongside practical strategies for managing symptoms day to day. A formal diagnosis can also support workplace adjustments through Access to Work in Northern Ireland.
6. Conclusion: Your Postcode Should Not Decide Your Care
Across Northern Ireland, adult ADHD care through Health and Social Care is shaped less by clinical need than by address. The Belfast Trust has a waiting list measured in years and thousands of names long. The South Eastern and Northern Trusts run very small services with tight limits on who can be seen. The Southern and Western Trusts offer adults no route to a first diagnosis at all.
The Department of Health’s Needs Assessment is an important step, but a regionally commissioned service will depend on funding decisions that have yet to be made. If ADHD symptoms are affecting your life now, a private assessment offers a clinically rigorous route to answers and treatment without the wait.
Works Cited
- Belfast Health and Social Care Trust. (2023). Waiting list time for ADHD assessment both adult and under 18. Freedom of Information response via WhatDoTheyKnow. [LINK]
- Belfast Health and Social Care Trust. (2023). Current provision and wait times. Freedom of Information response via WhatDoTheyKnow. [LINK]
- South Eastern Health and Social Care Trust. Waiting list time for ADHD assessment both adult and under 18 (data as at 31 March 2022). Freedom of Information response via WhatDoTheyKnow. [LINK]
- Northern Health and Social Care Trust. (2023). Waiting list time for ADHD assessment both adult and under 18. Freedom of Information response via WhatDoTheyKnow. [LINK]
- Southern Health and Social Care Trust. Waiting list time for ADHD assessment both adult and under 18. Freedom of Information response via WhatDoTheyKnow. [LINK]
- Western Health and Social Care Trust. (2023). Waiting list time for ADHD assessment both adult and under 18. Freedom of Information response via WhatDoTheyKnow. [LINK]
- Department of Health Northern Ireland. (2026). Developing ADHD Services for Children, Young People and Adults in Northern Ireland: Needs Assessment Report. [LINK]
- Department of Health Northern Ireland. (2026, 12 February). ADHD Needs Assessment report published. [LINK]
- McMurray, S. (2024). Addressing the complexities of ADHD care: challenges and opportunities. Northern Ireland Assembly Research and Information Service. [LINK]
- National Institute for Health and Care Excellence. (2018, updated 2019). Attention deficit hyperactivity disorder: diagnosis and management (NG87). [LINK]