When ADHD Meds Run Out

Fighting the national ADHD medication shortage

“A lot of people don't believe that ADHD is a thing, still,” Alison Clink told me. Thirteen years ago, Clink’s son was diagnosed, but she couldn’t find enough information about how to live with the condition. So, she founded the Dundee and Angus ADHD Support Group. Today, she runs another ADHD support group in St Andrews with Lisa Cathro, founder of Zest Cafe. 

Thirteen years down the line, Clink and Cathro’s work is especially important — since September 2023, there’s been a national shortage of ADHD medication due to global supply bottlenecks. Last week, Health Secretary Wes Streeting added that overdiagnosis was central to the problem. How are St Andreans coping with the shortage? I asked Cathro how the local community is stepping in to counter the shortcomings of the British government.

For patients with ADHD, receiving a diagnosis from their local GP is often a process of waiting “years and years”, Cathro explained. If you get diagnosed by a private doctor, even from a qualified psychologist, you’re still not guaranteed NHS prescriptions. A lot of people who get private diagnoses have to pay for their own medication, with no guarantee that the GP will provide any care or support. “It’s a postcode and GP practice lottery,” Cathro said.

Cathro believes that the problem is more about misdiagnosis than overdiagnosis. “A lot of people who have ADHD have been diagnosed with anxiety and depression and been medicated for the wrong thing,” Cathro said. As a result, patients are often prescribed the wrong medications — when that fails to get results, patients are simply moved off one medication and onto the next, which often just makes things worse.

Cathro saw a need for support beyond the scope of medication particularly in Northeast Fife. “Northeast Fife tends to get left out a lot because everyone assumes that it's a more affluent area.” This is often tied to the assumption that people can afford to pay for their own services. If you’re looking to find a support group you often have to travel long distances, an hour on average. “If you already struggle with public transport and things like that, it's just not that doable. Especially for something you may be anxious about already.”

To respond to this need, Cathro started the Zest support group. “We were really keen to use the cafe space because it’s a lot less formal,” she said.  She tries to make the support group a safe space for neurodivergent people and people with disabilities. “Walking into a big empty room doesn't quite have the same relaxed vibe. I wanted to make sure that there were drinks and wee snacks,” Cathro said. The refreshments give attendees a chance to chat and connect, to take a break from the workshop. 

Their sessions begin with a presentation, then a break with coffee and cookies, and then a chance to discuss with the group. Dr Maggie Ellis, a lecturer at the School of Psychology and Neuroscience, led the first workshop. Ellis was diagnosed with ADHD late in her career — it was “fantastic” to have her, Cathro told me. “That was someone who had lived their whole life and their whole professional academic career struggling with ADHD.”  

With attendees ranging from ages twenty to 65 and a mix of both students and professionals, Cathro finds perspectives like Ellis’s particularly valuable. Joining local attendees from St Andrews, the group also saw people coming in from Leven, Dunfermline, and Glenrothes — a testament to the lack of local avenues for support. This demographic also further highlights the lack of local provision. 

Cathro also provided her own expertise to the support group. She presented to the group on the topic of employability along with a representative from the Fife Council Support Employment Service. “A lot of people don't understand the Equalities Act,” Cathro said. If you don't declare your disability, you're not covered by the Equalities Act and can get fired because of your disability. Under the Act, disclosing your disability to your employer offers protection from being fired on the grounds of disability. Cathro helped the group discuss how to have this conversation with an employer: “If you go and say to somebody, ‘I've got this disability,’ and that's all you say and an employer doesn't know anything about it, they’re gonna panic and say, [...] ‘I can't support this person.’”

Cathro encourages workshop attendees to be direct. “Say, ‘I've got this disability or I have ADHD, this is how it impacts me, this is what you can do to support that.’”  People should also be clear about the “benefits” of ADHD too. For Cathro the value of the session was also tied to the exchange that came after her presentation. Attendees discussed what they'd tried, what worked for them, and what hadn't worked. “That was a really good knowledge share.”

The primary challenge for the group is funding. Over the years, sourcing funds has become more difficult with a rise in the number and range of charities running. Zest also works under the legal structure of a business rather than a charity. Cathro explains that while they run as a social enterprise, running as a profit-making business is important to being able to secure the jobs of her staff. However, this prevents them from being eligible for the grants and funds that sustain most charities. 

Cathro is optimistic, though. To her it’s been a continuous journey of learning and community. “A lot of employers panic about employing disabled people because they feel like they have to know everything about disability to be able to support the person,” she explained. “I know I'm never gonna know everything about it in the way a person with a disability does. If someone has a disability, they've lived with it mostly their whole life.They're an expert on what works for them and what doesn’t.” Her ideas and projects like the ADHD support group are centred around conversations she has with her staff to understand them. 

“People get so terrified of legislation and, you know, getting it wrong, that I think they forget to just be human and speak to people. ”

Illustration by Isabella Abbott