ADHD at University – diagnosis is the key to success

ADHD at university: Why diagnosis, treatment and greater inclusivity is so important, says Priory expert.

ADHD Awareness Month occurs annually throughout October and is dedicated to raising awareness of and educating the public about Attention Deficit Hyperactivity Disorder.

• An estimated 2.6million people in the UK are living with ADHD, with official figures giving a childhood incidence rate of 5% and an adult incidence rate of 3-4%
• People with ADHD show a persistent pattern of inattention and /or impulsivity that interferes with day-to-day functioning and development
• New published research calls for more personalised intervention and support to help students with ADHD – and highlights significant delays experienced by students in accessing professional assessment and treatment
• ADHD is a “Protected Characteristic” as defined in the 2010 Equalities Act, which mandates universities to make reasonable adjustments for students with ADHD
• Leading Priory expert warns that waiting for a diagnosis until starting at university can contribute to ‘drop-out rate
• ADHD Awareness Month October 2022 explores the issue of greater inclusivity and “Understanding a Shared Experience”

Many students who find themselves struggling at university may in fact be experiencing undiagnosed ADHD – or suffering from a lack of support if they had already been diagnosed, claims leading expert from Priory.

Dr Leon Rozewicz, consultant psychiatrist at Priory Hospital North London, says that early intervention in terms of assessment and treatment – followed up with personalised support – is vital as “it can mean the difference between dropping out and getting a First”.

This is reflected in recent research compiled by the UK Adult ADHD Network which concludes that “there is a need to move away from prevailing notions within higher education about ADHD being a specific learning difficulty and attend to the urgent need for all university students with ADHD to have timely access to treatment and support”.

ADHD is a neuro-developmental condition which affects cognitive function. It is frequently characterised by impulsivity, inattention and hyperactivity; 70% of people living with ADHD may have a co-existing condition which might include anxiety, depression, eating disorders or being on the autistic spectrum. In the case of anxiety and depression, this might be caused by undiagnosed ADHD. The condition can also often be connected with specific learning difficulties (dyslexia, dysgraphia, or dyscalculia).

While attending university is generally an opportunity for personal and academic growth, it’s widely understood that students with ADHD can find the experience overwhelming, and in some cases will quit without the right support.

There is also a recognised failure in identifying ADHD in particularly gifted students who are adept at masking their challenges – or in missing the diagnosis in those suffering from anxiety, depression or an eating disorder.

So, should universities now screen for ADHD in students who have specific learning difficulties?

Mental health is now at the top of the agenda for many universities and higher education institutions, but those with ADHD may need far more specialised support – and fast access to a diagnosis – to help them cope with new responsibilities, academic and personal.

Dr Rozewicz says: “ADHD can often ‘first manifest’ at university. A highly structured school and home can allow people with ADHD to do very well, achieving As and A*s at ‘A’ level, and 8s and 9s at GCSE. Young people with ADHD can compensate for their symptoms with a good structure at home and at school. The increasing need to be focused and organised at university can prevent them from going on to fulfil their potential. So, when students arrive at university, there is much less structure, parents don’t supervise independent work and there may be very few hours of face-to-face lectures, with an expectation for self-directed study. In addition, there are many other distractions, partying, new relationships, alcohol – basically ‘burning the candle at both ends’. So, when a student finds themselves unable to cope – and the ‘scaffolding’ which was provided by the school and the parents is taken away – ADHD can come to the fore and appear for the first time.

“These factors can all lead to a ‘perfect storm’ which can certainly contribute to the dropout rate.”

Dr Rozewicz adds; “Many university student counselling and student health services are aware of this trend and are starting to establish links with ADHD clinics. Students should feel comfortable and encouraged to approach their university counselling service, student health service or GP.”

Around 80% of those with ADHD will improve with medication – e.g.stimulants such as methylphenidate / dexamfetamine and non-stimulants such as atomoxetine.

Dr Rozewicz says “There are enormous benefits of appropriate drug therapies, which can in some cases can make all the difference between leaving university early and successfully completing their studies.

“Experienced psychiatrists and therapists, including my colleagues at Priory, can devise bespoke ADHD treatment tailored to individual diagnosis, with the aim of reducing associated symptoms through a variety of evidence-based treatment methods.

Non-medication approaches might include, group therapy, family therapy and cognitive behavioural therapy (CBT) which can help to ‘re-programme’ patterns of negative thinking that are associated with the disorder, leading to better management of symptoms. We can also refer patients for specialist ADHD “coaching” which can be highly effective.”

ADHD is a Protected Characteristic as defined in 2010 Equalities Act. Universities must make reasonable adjustments for students with ADHD.

These adjustments are usually:

• 25% additional time in examinations (to give a 10-minute rest break for every 40 minutes work), this helps with concentration.
• Allowing students to take exams in a small room with few other students (to minimise distractions)
• Study mentor – they can help with essays/projects/assignments. A mentor will help a student break down complex tasks with long term deadlines into a series of small tasks with short term deadlines. This helps with procrastination
• Students are eligible for the Disabled Student Allowance (DSA). Universities should help them apply. This financial help can be used to pay for the study mentor and for computer equipment (to record and transcribe lectures).