'Absolute explosion' in number of adults with ADHD amid acute crisis in Cork/Kerry

Severe staff shortages leading to 'huge' waiting lists for treatment, HSE expert says

There has been an explosion of referrals for ADHD post-pandemic. File picture: PA

There has been “an absolute explosion” in numbers of adults with suspected ADHD, but none of the teams to treat them are fully staffed, the HSE national clinical lead has warned.

While the crisis is acute in Kerry and Cork, investment is urgently required nationally, said Dr Margo Wrigley, HSE clinical lead for the Adult ADHD National Clinical Programme.

This comes in the wake of a shock decision in these counties to stop accepting GP referrals to adult community mental health teams for ADHD assessment and treatment to tackle waiting lists.

“If you look at referrals for ADHD, you will see there has been an absolute explosion post-pandemic,” Dr Wrigley said.

They are seeing patients who really struggled without work or education structures.

“That was then coupled with an increased public awareness of ADHD and specifically that it doesn’t just go away when you are aged 18,” she said.

This is leading to “huge” waiting lists for the relatively new adult service, she warned.

"I was concerned about the fact there are now no permanent staff working in the service in Kerry/West Cork,” she said.

A second service, covering Cork City and North Cork, is down a psychologist, she added.

“The prime example of [shortages] is Kerry, West Cork, but for all the services I would say recruitment is the number one priority for them,” she said.

Hiring is challenging, as effectively she feels “there was a recruitment embargo put in place in December”, with some regions without a team so far.

“We’ve been unable to recruit into posts when they become vacant or if there’s new posts that haven’t been filled we weren’t able to recruit into them,” she said.

So of the 37 posts we should have across the country, 12 of them are vacant at the moment. And there isn’t a single service that has its full complement at the moment.

Cork/Kerry are accepting older teenagers referred from children’s mental health services, but she raised concerns about the adults.

“You are disadvantaging women in particular,” she said.

“We find if you’re looking at the male/female ratio, it’s five boys to one girl being diagnosed, but within our adult services where we have established them, the ratio is more one woman to every man. It does reflect the fact that more women are coming forward.” 

She said in Kerry/West Cork, additional staff were not hired despite promises in 2022 after the scathing report by Dr Seán Maskey on children’s mental health services in South Kerry.

“There are difficulties with that. I’ve brought that up as well and said really they need to look at that, because the Maskey report does mean there is an additional requirement for service to meet the needs of the young people,” she said.

“Not surprisingly, some of them have family members who think they have ADHD and are looking for an assessment as well.” 

Budget 2025 included an announcement of funding for four new adult ADHD teams by Mental Health Minister Mary Butler, which Dr Wrigley welcomed.