A diagnosis may take years. Support should not.
The current waiting times for ADHD assessments in England are deeply concerning. NHS England’s independent ADHD Taskforce reported that some people are waiting more than two years for an assessment, with waits of between 10 and 15 years reported in some areas. While these figures vary considerably depending on where someone lives and which service they have been referred to, the reality is that many people are now facing years of waiting after finally reaching out for help.
For women, this can come after an already very long journey. ADHD has historically been less readily recognised in women and girls, and many women reach adulthood having spent years trying to understand why they struggle with things that appear to come far more easily to others. By the time they finally begin to consider ADHD, they may already have spent decades finding ways to compensate, pushing themselves harder and blaming themselves when those strategies stop working.
We must never assume that somebody is doing well simply because they are seemingly managing to work, study, look after their children or generally keep their life going. So many undiagnosed individuals struggle enormously behind the scenes. Being able to function does not necessarily mean that someone is coping well, and this is particularly important when we consider what it actually means to place somebody on an assessment waiting list for several years.
What happens while somebody waits?
This is the part I think we need to talk about much more. What happens during that wait? The difficulties that led somebody to seek an assessment do not simply disappear because a referral has been made. They may still be struggling at work, becoming overwhelmed by everyday demands, finding it difficult to manage appointments, paperwork or finances, or simply becoming increasingly exhausted by the amount of effort it takes to keep everything together.
Support and diagnosis are not the same thing
And this is where I think we need to make an important distinction between support and diagnosis.
A diagnosis matters enormously. I have written before about how life-changing receiving the right diagnosis can be, particularly for somebody who has spent years struggling without understanding why. It can lead to the right support and treatment, including medication where appropriate, and give somebody an understanding of themselves that they may never have had before.
But believing strongly in the importance of diagnosis does not mean that we should offer people nothing while they wait for one.
In fact, NHS England’s own ADHD Taskforce recommends that people should have access to information, help and support while they are waiting, and that support based on somebody’s needs should not necessarily depend on whether they already have a diagnosis.
I think this is incredibly important, because support before diagnosis does not have to mean assuming that somebody definitely has ADHD. Nor should it ever become an alternative to assessment. It simply means recognising that somebody can be struggling now and may benefit from practical help now, rather than being expected to wait several years before that need is taken seriously.
And this is where I do have a concern about some of the thinking around future ADHD services. The Taskforce proposes a more stepped approach, with those experiencing severe ADHD, or whose functioning does not improve with first-line non-pharmacological support, being fast-tracked for clinical diagnostic assessment and medication.
There may be very good reasons for prioritising people who are struggling most severely, particularly when services are under such enormous pressure. But I would be deeply concerned if a move towards needs-based support ever resulted in formal diagnosis becoming something effectively reserved for only the most severe cases.
Support cannot replace diagnosis
Someone may benefit enormously from practical support and still have every right to understand whether ADHD is actually behind the difficulties she has experienced throughout her life. A person should not have to reach crisis point, lose a job, become unable to function or fail to respond to other support before their need for a proper assessment is considered significant enough.
Why this matters particularly for women
This feels particularly important for women, precisely because so many have spent years appearing to cope while struggling enormously underneath. If access to diagnosis becomes too closely tied to visible severity, there is a very real risk that some of the same women who have historically been overlooked could continue to be overlooked.
Someone who is completely overwhelmed by work does not need to wait for an assessment before she can be helped to think about what is making her workload so difficult to manage. Somebody who is stuck in a cycle of procrastination, unable to start an important task or completely paralysed by a decision can still be supported with what she is experiencing, without anyone attempting to diagnose her.
There is a very significant difference between helping somebody with the difficulties she is experiencing and telling her what condition she has.
I also think this becomes particularly important when we consider the stage of life at which many women are now seeking an ADHD assessment. Some are reaching their thirties, forties and fifties before ADHD is even considered, often at a time when life itself may have become considerably more demanding. Careers, children, caring responsibilities, relationships, ageing parents and financial pressures can all be competing for the same limited amount of energy and attention.
For some women, this may also coincide with perimenopause or menopause. There is growing interest in the relationship between hormonal changes and ADHD, but the research is still developing and we need to be very careful about making sweeping claims that the evidence simply cannot yet support. What we can say is that perimenopause and menopause can bring significant changes of their own, and for some women this may be part of the wider context in which they begin questioning why they are finding certain areas of life increasingly difficult to manage.
Whatever somebody’s individual circumstances, several years is a very long time to be left trying to work everything out alone.
Support while people wait
None of this removes the urgent need to improve access to ADHD assessment. If anything, I think the two issues need to be discussed together. People should not have to wait years for a diagnosis, but while those waits exist, we also cannot pretend that the only options are immediate assessment or no support at all.
There has to be something in between.
Why we are building Instant Relief
This is also one of the reasons my husband Alex and I are building Instant Relief.
Instant Relief is currently in development in the UK for women with ADHD and AuDHD, including women navigating perimenopause and menopause. We are deliberately keeping most of what we are building private at this stage, but it has grown from something we both feel very strongly about: the difficult moments in somebody’s life do not wait until an appointment finally comes through.
Instant Relief is not intended to replace diagnosis, treatment or medical care, and it cannot shorten an NHS waiting list. But the wider principle behind what we are building matters to me enormously.
We need to become much better at recognising that support and diagnosis are not the same thing, and that providing one does not diminish the importance of the other.
People deserve timely access to proper ADHD assessment. They deserve access to appropriate treatment and support after diagnosis. But they should also not be expected to spend the years in between simply trying to cope as best they can.
A diagnosis may take years. Support should not.
Instant Relief is currently in development in the UK.
If you would like to be told when applications for our closed beta open, you can join the waitlist at www.getinstantrelief.com.
Joining the waitlist is not an application and does not guarantee a place.
Instant Relief is not therapy, diagnosis, medical care or crisis support.
Sources
NHS England — Independent ADHD Taskforce final report: plain English summary, 9 December 2025
NHS England — Report of the Independent ADHD Taskforce: Part 1, 20 June 2025
NHS — Attention deficit hyperactivity disorder (ADHD) in adults, reviewed 19 March 2025
Osianlis et al. — ADHD and Sex Hormones in Females: A Systematic Review, Journal of Attention Disorders, 2025
