Debate contribution: ADHD Services

Debate contribution by Miss Órlaithí Flynn on 9 February 2026.

MLA

Miss Órlaithí Flynn

Party at the time

Sinn Féin

Date

9 February 2026

Type

Debate contribution

Business

Private Members' Business

Heading

ADHD Services

Assembly identifier

Official Report component 5369670

Read the official Assembly record

Text

I beg to move

Go raibh maith agat, a Phríomh-Leas-Cheann Comhairle.

I am pleased to propose the motion on commissioned attention deficit hyperactivity disorder services. ADHD is a lifelong neurodevelopmental condition that affects how people think, learn, work and relate to the world around them. It affects children and adults, families, communities, education, employment and mental health; yet, despite its prevalence and its impact, ADHD services in the North remain fragmented, inconsistent and fundamentally unfit for purpose as they stand. At the outset, it is important to be clear about the current position here. There is currently no commissioned regional ADHD service. There is no single, standardised pathway for diagnosis, treatment and ongoing support; instead, access to assessment, diagnosis and treatment depends largely on where a person lives, their age and their ability to pay privately, which has created another postcode lottery. Provision has developed in a fragmented and inconsistent way across the health and social care trusts. It is not because of a lack of need or evidence but because a regional ADHD service has not yet been commissioned. For adults, the situation is particularly stark. There is no commissioned adult ADHD service, and, in many areas, there is no clear pathway at all. Adults are often diverted into mental health services that are not designed to assess or manage ADHD, and, sometimes, people are left without support altogether. For children, ADHD assessment has largely been absorbed into an already overstretched child and adolescent mental health services (CAMHS) system. CAHMS is not an ADHD-specific service. Extremely long waiting times mean that children are waiting for years for their assessment and are losing critical opportunities for early intervention. As a result of those gaps, many people will seek private assessment out of desperation; yet, afterwards, they often discover that there is still no automatic route back into health and social care treatment, including in cases where they need prescriptions for medications. At the minute, shared care arrangements are in place, which are discretionary for GPs who can decide whether they want to prescribe for patients, but that leaves many people having to either continue to self-fund for treatment or wait in public pathways: the options are to self-fund or wait. It is not just an inconvenience; it has real and lasting consequences. I am dealing with a case in west Belfast of an adult who paid for and received a private diagnosis of ADHD. The guy is in a terrible state at the minute, as is his family, because there are issues with him continuing to get the medication on which he depends. I am sure that we all see at first hand in our offices how it impacts on children and adults. Children with an unmet ADHD need are more likely to struggle in school and to experience anxiety, exclusion and extremely low self-esteem. Adults with undiagnosed or unsupported ADHD face a higher risk of unemployment and poor mental health, and a lot of them will come into contact with crisis services at some stage. Those outcomes are not inevitable. They are the result of a system failure. I am not putting it directly onto the Minister who is with us here today and holds the portfolio. The system has failed for years, and it is failing at the moment. The situation is even more challenging for people who have ADHD alongside mental ill health or a diagnosable mental illness. The current system too often treats ADHD and mental illness in silos, leaving people to be passed from service to service, falling between thresholds and receiving no consistent care. That is why the motion specifically calls for ADHD mental health services that will recognise and respond to co-occurring conditions.

There is a clear irony here. We know that the Minister and the Department already accept most of what the motion calls for — the Minister may say that when he responds — and that it is already contained in the mental health strategy, which has a specific section that calls for early intervention, regional consistency and better support, particularly for neurodivergent people. Leaving aside the Department of Health, we know that the children and young people's emotional health and well-being framework already acknowledges the long waiting times, delayed assessments and fragmented pathways. Despite that recognition over a number of years and in different pieces of work, ADHD services remain largely uncommissioned and underdeveloped. That is not necessarily a failure of individual trusts. I spoke earlier about a postcode lottery. At a meeting last week, I discovered that the Belfast Trust is the only trust that has no services for kids over the age of 10. Gaps have developed. That is not to put the blame on the trusts, because they are also in a difficult position and cannot commission new services when they do not have the funding to do so. Nor are GPs commissioned to provide assessments, prescribe or manage people's care on an ongoing basis. Where individual GPs step in to support patients, they do so without a commissioned pathway, and shared care depends on clinical judgement rather than a consistent system. The absence of commissioned ADHD services does not save money. Where services are not available early, trusts are required to respond through mental health services, addiction services or crisis care to consequences that occur later down the line. That is cost-shifting, not cost-saving, and the impact on people's lives and futures is profound. Without timely assessment and appropriate treatment, many adults will struggle to sustain employment or maintain stability in their lives, and many children and young people will struggle to concentrate in school or to engage in learning and progress to further education or university. Those are not personal failings on the part of those individuals; they are the predictable outcomes of unmet clinical need. There is also a wider picture that cannot be ignored: evidence shows that ADHD is associated with higher risks of substance use and earlier contact with the criminal justice system. When support is delayed or absent, people are more likely to require later interventions by addiction services, policing and the courts at far greater human and financial cost. The motion does not seek to apportion blame; it seeks leadership. We call on the Health Minister to engage with the health and social care trusts to explore any regional solutions that it might be possible to put in place and any services that will encapsulate diagnosis, treatment and mental health support in a coordinated and commissioned way. Hopefully, that can be explored. We are moving towards a regional mental health service and regional crisis services. The Minister has spoken about his support for the five-trust model working as a single unit, without necessarily putting that formally in place because of constraints in money, time and all the rest. Hopefully, this can be an example of where we can make a bit of progress on that. The motion calls for:

"improved awareness of ADHD within government agencies, schools and workplaces."

Too many people with ADHD still face horrible stigma, misunderstanding and inappropriate expectations. Better awareness means earlier identification, reasonable adjustments and environments where people will thrive rather than struggle. ADHD affects families in every community; it cuts across health, education, employment and justice, and addressing it properly requires coordination, commissioning and political will. As we know, the Assembly has debated ADHD many times in recent years, and Members from all parties have raised concerns. Many of our statutory Committees have taken evidence on the issue, and we have covered it extensively in the Health Committee. Throughout that time, families have waited patiently. The time for acknowledgement has passed. What is needed now and what, hopefully, we can achieve is action. The motion does not pretend to fix everything overnight, but it does something that is essential: it puts the Assembly on record as recognising the need for commissioned, regional and integrated ADHD services. I urge Members to support the motion in order to send a clear message to all those who live with ADHD and their families that they are being heard; that their experiences matter; and that the Assembly is committed to building services that work for them and not against them.

1,372 words. Text as published by the Northern Ireland Assembly.

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