Class Diagnostics

A couple of years ago I underwent a course of CBT, provided by my local NHS trust, just before I started my degree. I was sliding into a period of bad mental health and I knew that if I was going to stand a chance of getting through university, I needed help.

The sessions were thankfully what I needed and they taught me some useful ways of coping, particularly with anxiety. During one session I talked about my experiences of education in school. I went to a state school at the cusp of the era when knowledge about ADHD among young people and mental health was just beginning. Its not an exaggeration to say my school experience was a disaster and I left without qualifications. That was more or less the pattern for about 20 years. I began to suspect that something more was going on. The pattern of my school years was typical for someone with ADHD. But I didn't have ADHD.

I didn't realize at the time to be diagnosed with ADHD you needed either to know how to ask for assessments or had teachers or parents who knew how to ask for help. I just assumed I was stupid. When I compared myself to my friends, they were all just better at learning things and passing exams and they all seemed smarter than me. I could learn things, but my brain rarely settled down long enough for me to do it in a structured way. Teachers would tell me I wasn't stupid, but would label me a daydreamer or distracted. I have also been called creative and driven. But I couldn't turn any of that into formal achievements.

Friends went on to stable jobs, and academic accomplishments, while I stayed in low skill low status jobs. I did manage to pass the first year of a BSc with the Open University. That was my only academic achievement. I only managed that because my partner was doing the same course at the same time and they showed me how to study and made sure I kept up with the work. I know that without that help I would have failed to finish, because that was my second attempt, on my own the first time, I made a mess of it.

Then came the application to nursing school. My second application to nursing school. My first application was before 2004. When nursing schools rejected applications from transsexuals (the language of the time) automatically. I wrote to four different schools in London and received similar replies from each. That my transsexual status would be an issue, and that they would need to discuss it but that it would be unlikely I would be accepted. Thankfully that changed with the introduction of the gender recognition act in 2004, and the equalities act provisions in 2010. But that's another story for another time.

My therapist agreed that perhaps I maybe did have ADHD and she arranged for me to have an assessment in 2020. The year I finally began my nursing degree. At that point the waiting list, I was told, was possibly 18 – 24 months long. Since then the waiting list has stretched to infinity. I am still on the waiting list but there is now no known upper limit. It is rumoured to be more than four years at this point. The NHS service responsible for it no longer provides updates.

However, if you have a spare £800 – £1000 You can be seen in a matter of months. There are occasionally articles by journalists of my generation who pay for the assessment and suddenly discover they have ADHD. I will likely never get an assessment, and I definitely won't get one before the end of my degree. Which also means that if I do have it I won't be able to able to access the help available. There has always been a class division in healthcare, and an associated disparity.

Having money, or access to money, lets you jump the queue. The same has always been the case in transgender care as well. Money buys you whatever treatment you want if you have it. For everyone else, there is the hell of NHS gender identity services. But, again, that's a different story that other people are covering better than I can.

I think about this when I see people talking about “Neurodivergent” and “Neurotypical” people. They are unavoidably class ridden terms, because the diagnostic certainty associated with them is now mostly reserved for those with money, while everyone else languishes in the uncertain land of NHS waiting lists and self diagnosis.

I have learned that I need to live my life as if I have ADHD, because the strategies that people with ADHD use just work for me. Since doing that I have been able to manage the dysfunctional parts of my brain and get into third year. I am still not convinced I can graduate. Self assured certainty scares me. I hope I make it, I am going to continue to work my arse off towards that goal, but I know me, I know I can't afford to assume everything will be alright.