Adult ADHD Treatment in Copenhagen, Denmark - Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup The organization of adult ADHD treatment in Copenhagen, Denmark Bolette S ndergaard Chief Physician Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup Curriculum vitae Psychiatrist and chief of psychoterapeutic clinic in Glostrup, Copenhagen (diagnosis and treatment of non-psychotic disorders with psychoterapy/medication) 2018: Chief of ADHD and autism team (merged with psychoterapeutic clinic) 2017: Chief of Glostrup and Hvidovre psychterapeutic clinic (merged) 2013: Chief Physician and head of the psychoterapeutic clinic in Hvidovre 2012: Specialist in psychiatry 2 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup Background The capital of Copenhagen is the biggest region in Denmark and is home to around 1,9 million citizens Our outpatient clinic is the only clinic in the capital s public hospital psychiatry that diagnoses and treats adults with ADHD Our clinic is the only clinic in Denmark with a team that specializes only in ADHD and autism We recieve the most complicated patients and there is a high comorbidity between autism and ADHD (around 80 percent of all patients referred to us) The majority of uncomplicated ADHD treatment takes place in the primary sector by privately practicing psyhiatrists 3 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup Organisation The ADHD/autism team: 1 team leader 3 senior doctors 3 younger doctors 13 psychologists 9 nurses 4 secretaries 4 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup We recieve patients from General practitioners Private practicing psychiatrists Other psychiatric outpatients clinics Psychiatric wards in Copenhagen All referrals are sent to a Central visitation: Health professionals will read the referral and medical record and decide whether the patient meets the criteria for an examination in our clinic They sometimes examine unclear patients first, before they refer them to us They have a gatekeeper function 5 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup Complicated/less complicated patients The patients we recieve are divided into two categories Less complicated patients Complicated patients little comorbidity comorbidity (somatic/psychiatric) higher function low functional level no abuse some abuse Treatment package of 9 hours Treatment package of 20 hours All patients recieve approxemately the same number of hours of treatment in the package 6 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup 7 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup The ADHD team was established in 2015 In the beginning it was a team mostly for less complicated ADHD The team recieved around 200 ADHD patients a year In 2017 the team started to recieve complicated ADHD patients and autism patients too We got every year more patients, but mostly autism referrals Until suddenly in 2020: The ADHD referrals increased massively And we got more than 800 ADHD patients in 2022 We have over period of 5 years grown from a small team to a big team with more than 29 therapists 8 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup Referrals for the last 7 years to ADHD and autism team Referrals pr. year 2015-2022 600 500 400 300 200 100 0 2015 2016 2017 2018 2019 2020 2021 2022 HF-ADHD HF-Autisme RF-ADHD RF-Autismeudredning 9 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup 2023 In 2023 we were supposed to recieve 1500 patients with ADHD and/or autism BUT The waiting list was getting longer and longer (6 months or more to the first visit) Our therapists were burning out due to large patient caseload The patients referred to us came more often from other departments in hospital psychiatry and were considerably more complex than before Therefore we were given permission to close for internal referrals for 9 months Other psychiatric departments had to diagnose and treat ADHD patients themselves 10 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup 2024 what have we done so far? We have opened for internal referrals again, but we have tightened the visitation criteria We have educated other hospitals psychiatry departments and general practitioners We are still recieving referrals from the primary sector We have multidisciplinary team conferences to support other psychiatrists with very complicated patients We have telephone hours, so we can supervise other therapists We have therapists within the organisation on focused days in our clinic 11 Psykiatrisk Center Glostrup

New visitation criteria 2024 External referrals (from primary sector): We recieve only non-diagnosed ADHD patients (if less complicated) We recieve complicated ADHD patients, if they are too complicated for other psychiatric clinics and private psychiatrists Internal referrals (other psychiatric clinics in hospital) We recieve only complicated ADHD patients, if they are so complicated for other psychiatric clinics that it is not enough to give them advice and supervision 12

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup What have we been working on in the team? We have developed a management system - overview of all our patient processes and we maintain tight control, e.g: Caseload for each therapist Length of treatment Patient absences We scan all referrals in order to get the right patients We have training and supervision for our therapists All new therapists have a mentor 13 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup Conclusion and perspective Our organization of adult ADHD treatment is not perfect We still struggle with patients on waiting lists versus resources There is a massive need from our surroundings to get advice and teaching from us But: ADHD has become a recognized diagnosis in adult psychiatry All psychatrists must to be able to diagnose and treat this disorder 14 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup We still need specialized clinics Diagnose and treatment of the most complicated patients Teaching and supervising other health workers Scientific research Important to have a team for both ADHD and autism Gather experts in the same place to become even better Develop and implement the latest guidelines 15 Psykiatrisk Center Glostrup

Region Hovedstadens Psykiatri Psykiatrisk Center Glostrup Thank you for listening! Psykiatrisk Center Glostrup