A “system-wide” crisis in support for autistic people and those with ADHD and autism requires a nationwide response from across health and social care services, Scotland’s psychiatrists have warned.

The Royal College of Psychiatrists (RCPsych) in Scotland says continuing with the current approach to assessment and support for ADHD and autism is ‘not sustainable’ and ‘a fundamentally different, society-wide response’ is now needed.

RCPsych in Scotland has this week launched a plan to better meet the needs of the 65,000 people currently waiting for a neurodevelopmental assessment.

The report includes calls for the introduction a new four-tiered pathway, which would allow people with and without a formal neurodevelopmental diagnosis to access the support they need when and where they need it.

RCPsych Scotland says this must recognise that much of this support will fall into primary care and public mental health, rather than highly specialised acute psychiatry.

The report also recommends the introduction of national standards for assessments, which focus on holistic, mental health rather than single conditions, as well as dedicated funding for cross-societal approaches within public mental health and primary prevention.

Dr Pavan Srireddy, vice-chair of RCPsych Scotland, said:

“We’re at breaking point because the scale of the problem now goes beyond what any mental health system in the world could deliver. 

“It’s a public health emergency which is leaving thousands with neurodevelopmental conditions on waiting lists with their difficulties worsening, while those with more serious conditions can’t get the help they need.

“The stakes are high. People with ADHD are up to five times more likely to die by suicide, while those with autism are nine times at greater risk. Left untreated ADHD can also reduce life expectancy by up to nine years.

“But through our 10-point plan we can change this, and we can be world-leading. We know the right support, offered early on in people’s journey can be life-changing and that rather than getting stuck, people can move on in their lives and flourish.”

Demand for neurodevelopmental assessments has risen by more than 2,000% in some areas in Scotland, with some facing years for waits.

Some areas have no pathway at all, which autistic advocates told MSPs earlier this week is driving many people into crisis.

The report warns that, with ‘no dedicated services’ in place, autistic people and those with ADHD are being pushed into general mental health services – placing ‘unsustainable pressure’ on a system not designed with these needs in mind.

This leaves ADHD and autism patients with ‘nowhere else to go’ and creates dangerous delays for all patients stuck on waiting lists for mental health support.

The report also highlights the wider economic impact, estimating the cost of autism to the UK to be more than £4bn a year, while untreated ADHD costs around £17bn annually through lost productivity, unemployment and pressure on health and justice services.

Carol Stobie in East Lothian explains shediscovered her ADHD at 60 years old and is on a 10-year waiting list for diagnosis.

She told RCPsych Scotland that she received support and now works for a non-profit ADHD organisation, but that change is drastically needed to recognise the intersecting problems those with ADHD face:

“The need for psychosocial education, peer support and one-to-one coaching is becoming more urgent and we’re always full because people can often not afford private ADHD coaching or diagnoses.

“New thinking is needed all round on how we manage the increase in those coming forward.

“People with ADHD are more likely to experience things like addiction and depression and as someone with lived experience of the condition, I know this is something decision-makers must sort out.”

Read more: All public bodies must focus on health, urges charity; Call for ‘urgent' review of ADHD and autism services; Scotland’s ‘invisible’ patients and carers; Watchdog criticises homelessness service cuts; NHS saves £82m a year through outdoor spaces; Psychiatrists in ‘disbelief’ over cut funding; The in-between: what's happened to social care reform?; Partnership urges action over Scotland's mental health

Sign up to our bulletin for key health & social care updates straight to your inbox.