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Abstract
Attention deficit hyperactivity disorder (ADHD) is the commonest disorder presenting to Child and Adolescent Mental Health Services in Ireland. This article considers the impact of the Covid-19 pandemic on the provision of mental health services for young people with ADHD with specific reference to the difficulties that have been experienced in ADMiRE, a specialist ADHD service in Dublin, since the outbreak of Covid-19 in Ireland. Current guidelines and alternative ways of ensuring adequate service provision are discussed. Restrictions to mitigate the spread of Covid-19 are likely to continue for many months, and child and adolescent mental health services need to find new ways to provide a sustainable service to young people in Ireland. There is a growing evidence base for the use of telepsychiatry in the assessment and management of ADHD. Factors that should be considered when developing a telepsychiatry service for children and adolescents with ADHD are highlighted.
Highlights
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by inattention, hyperactivity and impulsivity that is developmentally inappropriate and causes significant functional impairment (Thapar & Cooper, 2016)
In Ireland, ADHD is the commonest presentation to Child and Adolescent Mental Health services (CAMHS); approximately one-third of children in Irish CAMHS have a diagnosis of ADHD (Health Service Executive (HSE), 2014)
Guidelines for use of protective equipment (PPE) for face-to-face appointments in ADMiRE were altered in recognition of the emerging data, and adequate PPE has been made available for clinicians carrying out physical monitoring in young people with ADHD
Summary
In September 2018, ADMiRE, a tertiary-level specialist ADHD pathway, was introduced in South Dublin Linn Dara CAMHS in order to provide early access to evidence-based assessment, diagnosis and intervention for children who are referred with primary presenting difficulties suggestive of ADHD. ADMiRE has implemented an evidence-based standardised model of care for assessment and intervention for ADHD that is based on the Dundee Clinical Care Pathway (Coghill & Seth, 2015) This Clinical Care Pathway has demonstrated that a careful standardised titration of medication including guideline-based management of adverse effects makes a significant difference in terms of sustained improvement of measured ADHD outcomes when compared to a less-structured approach (Coghill & Seth, 2015).
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