An adult ADHD assessment is a detailed, structured conversation with a specialist, such as a psychiatrist, backed up by questionnaires and by someone who knew you as a child. The specialist checks whether your difficulties started in childhood, affect at least two areas of your life and aren’t better explained by something else. You can prepare by gathering old school reports, real examples and an informant before the day.
In short
- NICE guidance says ADHD should only be diagnosed by a specialist with training in ADHD, after a full clinical assessment, never from questionnaires alone.
- Most assessments follow the same pattern: questionnaires, input from someone who knew you as a child, a detailed clinical interview, then a decision and a written report.
- To diagnose ADHD, symptoms must meet DSM-5 or ICD-11 criteria, go back to childhood, show up in 2 or more settings and cause at least moderate problems.
- There are three possible outcomes: ADHD is diagnosed, it isn’t, or more information is needed.
- Good preparation helps: documents, written examples, a willing informant and a quiet space for a video call.
What happens in an adult ADHD assessment, step by step?
Details vary between services, but a thorough assessment follows the same basic order. The NICE guideline on ADHD (NG87) says a diagnosis should rest on a full clinical and psychosocial assessment, a full developmental and psychiatric history, observer reports and an assessment of your mental state.
- Booking and basic checks. The service takes your details, your GP’s details and ID, and checks it’s the right service for you.
- Questionnaires. Before the appointment you fill in questionnaires about your current difficulties, your childhood and your health. They show how often symptoms happen and help the specialist plan the interview. They can’t diagnose ADHD on their own.
- Input from someone who knew you as a child. Usually a parent, older sibling or other relative fills in a questionnaire or talks to the specialist. If no one can, old school reports help.
- The clinical interview. A detailed conversation, by video or in person, sometimes split over two sessions. Many specialists use a structured interview for part of it.
- The decision. The specialist weighs all the evidence. Some can give you an outcome at the end of the appointment. Others need time to review everything first.
- The report. A written report explains the outcome, the reasons for it and what could help. With your consent, your GP gets a copy or a letter.
This guide covers what the assessment is like for you. To see what’s included with us, read about our private adult ADHD assessment. For the clinical rules we follow, including the full DSM-5 and ICD-11 criteria, see how we diagnose ADHD.
How long does an adult ADHD assessment take?
NICE doesn’t set a fixed length, and services differ. Most of the time goes on the interview, which needs to cover your whole life, from early school years to now. Some services use one longer appointment and others use two shorter ones. Questionnaires and your informant’s views, gathered beforehand, let the appointment time go on the clinical questions. On top of that, allow time to complete them and for the report to be written afterwards.
A careful assessment needs more than a score. Be wary of any service that offers a diagnosis from an online questionnaire alone, or after a short call that takes no history. Our guide on how to choose a private ADHD clinic lists other warning signs.
Who will be there?
- The specialist. NICE says a diagnosis “should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD”. For adults this is often a psychiatrist, though some NHS services use specialist nurses or psychologists.
- You. Most of the conversation is with you.
- A support person, if you’d like one. A partner, friend or relative can sit with you. They can also add their own view of how things are now. The specialist may ask to speak to you alone for part of the time.
- Your informant. The person who knew you as a child may join for part of the appointment, or give their view separately, by questionnaire or a short call.
What questions will they ask?
There’s no script, and you can’t pass or fail. The specialist needs enough detail to see patterns over your life. These are the areas most assessments cover:
| Area | What the specialist wants to understand |
|---|---|
| Childhood and school | What you were like before about age 12: concentration, behaviour, friendships, school reports and how adults described you |
| Current symptoms | Attention, organisation, time, restlessness and impulsivity, and how often they happen |
| Different settings | Whether difficulties show up at work or study, at home, in relationships, with money, when driving and in your free time |
| Impact | What the difficulties have cost you, such as jobs, exams, debts, accidents or relationships, and how you cope |
| Mental health | Mood, anxiety, sleep, past trauma, any self-harm, and earlier diagnoses or treatment |
| Physical health and family | Health conditions, medicines, heart problems in the family, and family history of ADHD or other conditions |
| Alcohol and drugs | What you use, how much, and how it affects you |
| Other explanations | Whether something else fits better or comes alongside ADHD, such as anxiety, depression, autism, bipolar disorder, a sleep problem, trauma, a physical illness or a medicine |
What a structured interview is like
Many specialists use a structured interview, such as DIVA-5, the Diagnostic Interview for ADHD in adults. It works through each of the 18 ADHD symptoms in DSM-5, one at a time. For each, you’re asked whether it happened in childhood and whether it happens now, with real examples. Specific stories (“I missed three flights last year”) help more than general ones (“I’m disorganised”).
Some questions touch on painful subjects. You can ask to pause, take a break or come back to something later. If talking about the past leaves you feeling unsafe, see our urgent help page.
How does the specialist decide?
NICE says that for a diagnosis of ADHD, symptoms should:
- meet the criteria in one of the two international classifications, DSM-5 or ICD-11
- cause at least moderate psychological, social, educational or work problems
- be pervasive, occurring in 2 or more important settings, such as work, home and social life
DSM-5 also asks for several symptoms to have been present before age 12, and for the difficulties not to be better explained by another condition. NICE says a diagnosis should not be made on rating scales or observation alone. A high questionnaire score shows that someone reports many symptoms, not why.
If there’s little information about your childhood, the specialist uses what there is, such as your own memories, school reports or old records, and explains in the report how this affects their view.
What are the possible outcomes?
- ADHD is diagnosed. The report says which presentation fits best: mainly inattentive, mainly hyperactive and impulsive, or combined. NICE recommends practical changes, such as adjustments at work, and then offering medication to adults if ADHD still has a significant impact. Treatment is a separate decision you make with a clinician. Read what to expect from ADHD titration if you’re thinking about medication.
- ADHD isn’t diagnosed. The specialist should explain why, what else might explain your difficulties, and where to get help for it.
- More information is needed. For example, an account of your childhood, or treatment for another condition first. You should be told exactly what’s missing and what happens next.
If you disagree with the outcome, ask the specialist to talk you through the evidence. You can also ask for a second opinion through your GP or from another specialist.
What should the report include?
A good report lets you, your GP and anyone else you share it with see how the outcome was reached. It should include:
- the outcome and, if ADHD is diagnosed, the presentation
- where the evidence came from: you, your informant, questionnaires and records
- examples showing how each criterion was or wasn’t met, in childhood and now
- other conditions considered, and the conclusion on each
- any limits, such as little information about childhood
- recommendations for support, adjustments at work or study, and treatment options
A full report matters later. GPs and NHS services decide for themselves whether to prescribe after a private diagnosis, and they look closely at how it was made. Read whether the NHS will accept a private ADHD diagnosis.
How to prepare: a checklist
Documents
- Photo ID, and your GP’s name and practice address
- A list of the medicines you take, including anything bought over the counter
- Old school reports, especially from primary school. Comments such as “easily distracted” or “could do better if they focused” are useful
- Any earlier assessments or letters, for example from an educational psychologist, a dyslexia assessment or mental health services
Examples
- Write down 2 or 3 recent, real examples for each area of life: work or study, home, relationships, money and driving
- Note what you do to cope, such as alarms, lists, working late or relying on a partner. Coping can hide how hard things are
- Note things other people often say about you, at work or at home
Your informant
- Ask someone who knew you well before age 12, such as a parent, older sibling or close relative
- Ask early, and tell them when their questionnaire will arrive and when it’s due
- Ask them to give their honest view, not the answer they think you want
- If there’s no one, tell the service when you book, and look for school reports instead
Questionnaires
- Do them somewhere quiet, and take breaks if you need to
- Answer for a typical week, not your best or worst day
- Finish them before the deadline, so the specialist has time to read them
Video set-up
- A laptop, tablet or phone with a camera and microphone, charged or plugged in
- A reliable internet connection, and the video link tested the day before
- A quiet, private room where you won’t be overheard. Headphones help
- Your phone nearby, in case the connection drops
- Water, your glasses if you need them, and your notes
Tip from our clinicians
Keep your notes in front of you during the appointment and read from them if you need to. If your mind goes blank on a question, say so. The clinician can come back to it later.
Can you ask for adjustments?
Yes. Long forms, long appointments and video calls can be hard work with ADHD. Tell the service before the day what would help, for example:
- breaks during the appointment, or turning the camera off for a moment
- extra time for questionnaires, or help filling them in
- a support person with you
- a phone appointment if video is difficult
- a written summary of what was said and agreed
How might you feel afterwards?
An assessment asks you to go over your whole life, including hard memories, so you may feel tired or unsettled for a day or two. A diagnosis can bring relief, or a sense that things finally make sense. It can also bring sadness or anger about the past, or doubt. If ADHD isn’t diagnosed, you may feel disappointed or confused, even if the explanation makes sense.
- Keep the rest of the day free if you can
- Talk it through with someone you trust
- Write down questions as they come up, and ask them when you get your report
- You don’t have to tell anyone about the outcome until you’re ready
If you feel very low or unsafe at any point, get help now: see our urgent help page.
If you’re assessed with ADHD Health
Your assessment is with Dr Helen Carter, Consultant Psychiatrist, by secure video. Before the appointment you complete online questionnaires: screening and rating scales and, where possible, input from someone who knew you as a child. Then you have a 60-minute one-to-one video assessment. Your written report and treatment plan follow within 48 hours of the assessment. The fee is £289, the same whatever the outcome. Appointments are usually available within days. If you’d like any of the adjustments above, tell us when you book. See how it works.
Next step
Ready for an adult ADHD assessment?
A 60-minute assessment by secure video with a consultant psychiatrist, after short online questionnaires. You get a written report and plan within 48 hours. No GP referral needed. It costs £289.
Common questions
Do I need a GP referral for an adult ADHD assessment?
Not for a private assessment: you can usually book directly. For an NHS assessment you need a referral, usually from your GP. In England, you may be able to choose an NHS-funded provider under Right to Choose, though some areas now limit these assessments. Compare Right to Choose and a private assessment.
Should I mention alcohol or drug use?
Yes. Be as honest as you can. Alcohol, cannabis and other drugs can affect attention, sleep and mood, so the specialist needs to know in order to judge your symptoms fairly. It matters for safety too, if you go on to consider treatment. Mentioning it doesn’t stop you being assessed.
Can I be assessed if I’m being treated for anxiety or depression?
Yes. Tell the specialist about any diagnosis and treatment, and bring a list of your medicines. Anxiety and depression can look like ADHD, and they can also come alongside it, so the specialist looks at how they fit together. Sometimes they’ll suggest treating another condition first, then reviewing ADHD.
I was diagnosed years ago or abroad. Do I need a new assessment?
Not always. A specialist can often review your existing report and records instead of starting again. Read transferring ADHD care or reviewing an older or overseas diagnosis.
Can I get a diagnosis on the same day?
Sometimes. If the specialist has all the evidence they need, they may tell you the outcome at the end of the appointment, with the written report following later. If something is missing, such as your informant’s view, they’ll wait until they have it rather than rush a decision.
Sources
- NICE. Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations 1.3 (diagnosis) and 1.5 to 1.7 (treatment). Last updated 2025.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). 2013; text revision 2022.
- World Health Organization. ICD-11: 6A05 Attention deficit hyperactivity disorder. 2024 release.
- DIVA Foundation. DIVA-5: Diagnostic Interview for ADHD in adults. 2019.
- NHS. ADHD: diagnosis. Page reviewed 19 March 2025.
- GOV.UK. The NHS Choice Framework: what choices are available to me in the NHS? Updated 23 October 2024.
