Unlocking ADHD writer Lilian Hoe finds out what are the factors to consider in deciding where to go for an ADHD assessment.
You have read about Attention Deficit Hyperactive Disorder (ADHD) or heard about a friend’s child who was diagnosed with it. The symptoms sound suspiciously like what you have experienced or may have observed in your child.
It is tempting to put a label to help us make sense of a situation, and then go on to seek confirmation to support the label. Before falling into the confirmation bias trap, make a list of the observations that led you to suspect ADHD. This will be useful to share with the professional you eventually consult.
There are generally two main routes to a diagnosis and assessment in Singapore – the subsidised route via the restructured hospitals, or the private route. There are different considerations for each route.
For Singaporeans who wish to avail themselves of subsidised fees for specialist outpatient treatment at the restructured hospitals, the polyclinic will be the first stop. Family physicians at National University Health System (NUHS), National Healthcare Group (NHG) or SingHealth are also able to refer you to a psychiatrist at the Specialist Outpatient Clinics (SOC) for assessment at subsidised rates. Do be prepared that it may take up to several weeks before you can secure an appointment.
- Affordable fees – the polyclinic fees for a family physician are usually under $20. If referred to a SOC to see a psychiatrist or psychologist, the subsidised consultation fees are about $45.
- For those who prefer to see a psychiatrist of their choice at a SOC without waiting too long, they can elect to do so as a private patient. The consultation fees would not be subsidised. The fees are about $150. This is still generally lower than the fees charged at private clinics.
- Affordable medication – there are subsidies for certain prescribed ADHD medications at the pharmacies of restructured hospitals. These include Ritalin (short acting) and recently, Medikinet.
- Access to a comprehensive team such as a psychiatrist, psychologist, occupational therapist and other professionals who work together to manage ADHD patients
- Longer wait time to see a psychiatrist – this can take several weeks to months, and may not be feasible for those who need a diagnosis and treatment in a timely manner
- Subsidised patients are not able to select the psychiatrist of their choice.
- The high volume of patients seen at the restructured hospitals also means that there is a limited time for each patient to spend consulting with the psychiatrist.
- Limited selection of medications offered at the restructured hospital pharmacies. An example is that non-stimulants may not be available for prescription
There are many mental health professionals in private practice. Thus, the quickest way to an assessment is to consult psychologists or psychiatrists in private practice directly.
- Shorter waiting time – there is generally less waiting time to see a psychologist or psychiatrist in private practice.
- Choice of seeing a psychologist first (in restructured hospitals, the psychiatrist is the first professional you will see)
- More personalised care – as the patient volume is less in private practice, there may be more time spent with each patient
- Wider choice of medications available including both stimulants and non-stimulants
- The fees at private clinics are generally higher than at restructured hospitals. For some people, this may be a deterrent to getting diagnosed and treated. Fees can start from $180 per hour onwards for psychologists, and from $250 onwards for psychiatrists.
- The medication at private clinics can also be more expensive. Since medication may be a long term possibility, this can add up to the overall costs of treatment
- It can be sometimes confusing to try to select a mental health professional to see as there are so many in private practice.
Whether one chooses to see a mental health professional at a restructured hospital or a private clinic will depend on the urgency of getting a diagnosis, one’s financial ability, and whether a certain type of expertise is available in either the private or public sector.
You may also view our ADHD Awareness Month webinars below for more in-depth information on ADHD diagnosis and management: