Mr. Ken Kilbride:

Regarding adults with ADHD, using internationally accepted figures, there are at least 110,000 such adults in Ireland today. There are no exact figures on how many of these are getting a formal diagnosis and support, but we expect it is less than 10%. ADHD is now known to persist into adulthood, with approximately 65% of children continuing to have features, with 15% meeting the full diagnostic criteria. It is also known that adults have higher rates of marital breakdown, unemployment, substance misuse, anxiety and depression and lower life expectancy, which can be up to five years.

Recently, ADHD Ireland did groundbreaking research that was funded by the National Office of Suicide Prevention, NOSP. It was conducted in partnership with University College Dublin, UCD and the HSE. It showed that in terms of suicide risk, 20% of all adults with ADHD have attempted suicide in their lives; 50% have self-harmed in the past; and 10% consider suicide as an option going forward. These results are in line with international studies that have shown that ADHD has elevated risks for suicidal behaviour.

Apart from the impact on families and lives, there is an ongoing cost to Irish society in general. Research shows that the socioeconomic cost to Ireland each year for adults with ADHD is €1.8 billion. Reasonable estimates show that 15% of adults getting treated by the HSE for mental health conditions will have undiagnosed ADHD. We as a society are overpaying for ignoring this condition and we will continue to pay €1.8 billion each year until we do pay attention to it.

ADHD Ireland works as hard as it can to support adults with the condition and we work closely with both UCD and the HSE to develop what can be seen as world-leading initiatives. For instance, in November 2022, the Minister of State at the Department of Health, Deputy Mary Butler, launched our new adult ADHD app. This already has 10,000 downloads. It is one of the few evidence-based apps worldwide and was delivered as a true partnership between ourselves, UCD and the HSE.

We recently launched the understanding and managing adult ADHD programme. This is a six-week workshop series, combining psychoeducation on adult ADHD with acceptance therapy. It has been developed to address the lack of services available for adults with ADHD in Ireland and as an early intervention within the stepped care model. Again, it is a collaboration between ADHD Ireland, UCD and the HSE's national clinical programme for adults with ADHD.

We run what we like to call the world's largest support group for adults with ADHD every second Tuesday. We will continue to do so and continue to call it that until someone proves differently. We also run webinars, social activities and much more for adults.

Purely anecdotally, we have seen a wide range of personnel in the HSE and the community mental health services being overwhelmed by adults looking for ADHD assessment and treatment. We are hearing that some clinics are reporting that up to a third of new referrals are now for ADHD. Although those waitlists are likely to have been screened previously by mental health services, having oversubscribed adult mental health teams serving as a gateway for this service is unsustainable. Getting a diagnosis privately, even if one can afford it, is also onerous, particularly if medication is required here in Ireland.

I will summarise with some key takeaways. ADHD is a serious condition, and without assessment and treatment it can have serious lifelong consequences. However, when it is picked up and treated earlier, outcomes are generally good.

The prevalence rate for ADHD is 5%, which equates to one child in every classroom. The socioeconomic cost of adult ADHD is €1.8 billion per annum. There are very limited assessment and treatment routes for adults in Ireland. The CAMHS system needs to be overhauled for all children with mental health conditions, with consideration given to the removal of ADHD from CAMHS and the establishment of specialist teams for ADHD in Ireland or neurodivergent teams. We must develop national protocols for the assessment of ADHD and guidelines for ADHD intervention in Ireland. Private assessment must be regulated. ADHD Ireland looks forward to working with this committee, relevant Ministers, and all Members of the Dáil to ensure that services are adequately resourced, that they are rebuilt as required and that each person with ADHD in Irish society can live meaningful, happy, productive lives. Gabhaim buíochas.