Do you need a diagnosis?
You don’t need a diagnosis to be neurodivergent or to ask your employer for adjustments. In many countries, equality law protects you whether or not you have one. Many people find that simply understanding themselves better is enough.
A formal diagnosis can still help. People often say it:
- explains lifelong experiences, and helps them stop blaming themselves
- opens the door to treatment, such as ADHD medication
- makes it easier to get adjustments and support at work, college or in exams
- helps them connect with others who share their experiences
It’s your choice. There’s no right or wrong answer, and you can change your mind at any time.
Before you start
Try a screening questionnaire
Our free screening questionnaires can help you put your experiences into words. They aren’t a diagnosis, and a high or low score doesn’t settle anything, but many people find them a useful first step and a good thing to take to a doctor.
Gather some notes
Assessors are interested in your whole life, not just how you are now. It helps to write down:
- examples of how your differences affect you at work, at sea, at home and in relationships
- examples from childhood, such as school reports, or memories from family
- strategies you’ve developed to cope, even ones that seem small
- anything you’ve already tried that helps, or doesn’t
How assessment usually works
The details depend on your country and health system, but adult assessments for autism and ADHD follow a similar pattern almost everywhere.
Find your route
Depending on where you live, this might be your public health service, your health insurance, or a private specialist. A family doctor or primary care doctor is often the first step.
Referral or booking
In some systems a doctor refers you to an adult autism or ADHD service. In others you can book a psychiatrist or clinical psychologist directly.
Waiting
Waits for public services can be long, sometimes years. Keep your contact details up to date so you don't lose your place.
Assessment
A specialist talks with you, and often someone who knew you as a child, about your history and current life. It may take one or several appointments, in person or by video.
Outcome
You should receive a written report. For ADHD, if you want medication, there is usually a period of adjusting the dose to find what works.
Clinicians around the world diagnose using one of two sets of criteria: the World Health Organization’s ICD-11, or the American Psychiatric Association’s DSM-5. Because of this, a diagnosis from a qualified clinician is usually recognised in other countries, although a new prescriber may want to review it before prescribing.
Examples of routes in different countries
These are only examples. Services change, so check what’s available where you live.
| Country | Usual route for adults |
|---|---|
| United Kingdom | Through a GP referral to the NHS. In England, “Right to Choose” lets you pick a provider with an NHS contract, which can be faster. Private assessment is also available. |
| Ireland | Public adult services are limited, so many people use a private psychiatrist or psychologist. |
| Canada | A family doctor can refer you to a psychiatrist, which is covered by public health insurance. Psychologist assessments are often private. |
| Australia | A GP can refer you to a psychiatrist or psychologist. Medicare covers part of the cost of some appointments. |
| United States | Book a psychiatrist or psychologist, often through your health insurance. How much is covered varies by plan. |
| Elsewhere | Ask a primary care doctor or psychiatrist. National autism, ADHD and dyslexia associations can usually point you to services. |
Private assessment
Private assessments can be much faster, but costs vary widely. Before you book, check:
Check
- The clinician’s qualifications and professional registration
- Whether your regular doctor or health service will accept the diagnosis
- For ADHD: who will prescribe and monitor medication in the long term
- What the fee includes
- Whether the report can be provided in English
Why it matters
- Assessments should use recognised criteria (ICD-11 or DSM-5) and be done by qualified specialists
- Your medical record and future care depend on it
- Without an ongoing prescriber, you may have to pay privately for prescriptions
- Reports, follow-ups and medication reviews can cost extra
- Medical examiners, employers and prescribers abroad may need to read it
Dyslexia and other specific learning differences
Assessments for dyslexia and other specific learning differences are usually done by educational psychologists or specialist assessors, not doctors.
- Your employer, college or training provider may pay for one.
- Some countries fund workplace support or assessments. See our guide to funding for support at work.
- Dyspraxia (DCD) in adults may be assessed by an occupational therapist, physiotherapist or psychologist.
Working at sea while you wait
Long contracts at sea can make appointments hard.
- Tell the service about your working pattern when you’re referred or book.
- Ask whether video appointments are possible, and whether they can work around your trips. Some clinicians can only see patients who are in the same country, so check before you sail.
- Make sure the service has up-to-date contact details, including email.
- If you miss a letter while at sea, contact the service as soon as you’re home. Don’t assume you’ve lost your place.
- Keep copies of every report, ideally in English, so you can share them with medical examiners, employers and prescribers in other countries.