I’ve been more than a bit annoyed this week at an interpretation I heard of a CQC report into Psychiatry UK, which was described as exposing a ‘diagnose and run’ approach in relation to ADHD. The report reveals that Psychiatry UK has been downgraded from ‘good’ to ‘needs improvement’.
I didn’t have an experience of ‘diagnose and run’ at all. I found Psychiatry UK – a popular diagnostic provider for ADHD, autism and dementia, to be attentive, thorough in their pre-assessment processes and the actual psychiatric assessment. I had to wait a long time to start titration for medication, which I was not pushed to try in any way.
When I underwent titration, I was handheld and supported throughout, my dosage adjusted as necessary, under assessment every five days for three months and now I’m waiting for a final in-depth appointment with the psychiatrist who diagnosed me, before being signed back to my GP for further prescriptions going forward and the regular checks required on my bloods, weight and more.
I’m not going to make excuses, I don’t know what’s gone on, but this has been my lived experience and the diagnosis and medication has made a massive improvement to my life, in which I’ve struggled with ADHD unrecognised for over five decades. I’ve no complaints.
The CQC is a body I’ve had engagement with when my late parents were in care. It’s largely toothless but has some modest purpose in highlighting areas for improvement and encouraging Best Practice, but no powers as such. Downgrades from ‘good’ to ‘needs improvement’ can be for many reasons with care homes and they can go up as well as down at any inspection. I would think it’s likely just the same with services like Psychiatry UK. They, like all neurodivergency investigatory clinics both NHS and private – in their case they offered both avenues – are massively overwhelmed and that’s got significantly worse year on year.
I don’t get the waiting list critique by the CQC. I waited two years. If I’d stuck with a local regional referral I was due to be seen when I reach 67. I’m 56 now. I wonder what grade the CQC would give the NHS itself when it comes to the ‘managed waiting list’ when referrals for ADHD and autism range in waiting times from 7 to, in some regions, over 10 years?
Suspension of new intakes is common as a response to such a downgrade in care homes while they review and modify their business practices. Again, I don’t immediately see pirates on the high sea diagnosing people for profit who aren’t neurodivergent. I see a common process that’s played out across the UK every day.
I do have ADHD, I knew it long before diagnosis, not long enough to avoid childhood and early adult guilt and shame for manifestations of my disability, but there is an energetic lobby within government seeking to downplay the validity of ADHD and autism as diagnoses largely because they intend to attempt forced entry into the workforce of many people with all sorts of disabilities who the majority of which will not be able to do what they’re told to do and will be cut off from financial support through the welfare system because of that.
Yes, I am a political therapist insofar as how can we not be when we have an ethical framework for what we do?
Having read that CQC report fully, such comments in it as, “Governance systems, including for incident reporting and management, had not kept pace with the growth of the service” underscore what I’m saying about the pressures of growth and demand.
Most importantly, the report makes clear:
• The service provided safe care once patients were assessed and in a treatment plan.
• Staff worked well with multidisciplinary organisations to coordinate care for patients living with comorbidities and complex needs.
• Staff described good working relationships and on-demand support in a positive, collaborative culture.
To say ‘diagnose and run’ is insulting to those of us who received our diagnoses from Psychiatry UK, largely because that isn’t what the CQC report says or implies. It outlines an overburdened, even overly successful (odd phrasing, I know) service that has not given time to developing its policies and practices to keep step with its growth.
To be clear: the CQC has not in any way invalidated anyone’s diagnosis.
I am sick of the current determination by some politicians to marginalise and degrade diagnoses of neurodivergency, which is because more and more people are being correctly diagnosed, and they don’t like it. Inevitably some are not going to diagnosed correctly, but that’s true of many illnesses and disorders, physical and mental. And it isn’t what this CQC report is saying anyway.
The report will be jumped on and exploited regardless. Or maybe I’m a hypochondriac junkie who chased a fix? Perhaps those who downplay the impact and even the reality of neurodivergency would like to tell me. It seems neurodivergency has been brought in for deconstruction and dismissal in the ‘war on woke’ – which appears to be a war against diversity and compassion.
Becoming a counsellor did not mean I signed up to be silent in the face of attacks on the vulnerable. And I won’t be.
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