Single Point of Access - ADHD Template

Clinician Specialty: Support Manager Presenting Concerns Patient presents with significant difficulties maintaining focus at work, frequent task incompletion, and challenges with emotional regulation, particularly irritability. They report a lifelong pattern of impulsivity, disorganisation, and difficulty prioritising tasks, which has led to recent performance issues and increased stress. The patient is seeking an assessment for possible Attention-Deficit/Hyperactivity Disorder (ADHD) and support in managing these symptoms. Pre-12 / School History Prior to age 12, the patient exhibited significant academic difficulties, particularly in subjects requiring sustained attention. Teachers frequently noted restlessness and difficulty following instructions. Socially, they experienced challenges with peer relationships due to impulsivity and occasional outbursts. Behaviourally, there were reports of being easily distracted and often 'daydreaming' in class, leading to inconsistent performance and several detentions for disruptive behaviour. Substance Use History Alcohol Use Patient reports occasional alcohol consumption, typically 1-2 units once or twice a month, primarily in social settings. They deny any history of heavy drinking, binge drinking, or alcohol-related concerns. They state alcohol use does not impact daily functioning or responsibilities. Tobacco Use Patient ceased tobacco use five years ago. Previously smoked 5-10 cigarettes per day for approximately 10 years. Reports no current cravings or desire to resume smoking. Cannabis Use Patient reports no current cannabis use. Historically, they used cannabis recreationally during their late teens and early twenties, approximately once a week. They ceased use due to concerns about its impact on memory and motivation. Other Substance Use Patient denies any other substance use, illicit or otherwise, and has no history of substance misuse or dependency beyond the past recreational cannabis use. Risk Assessment Self-Harm and Harm to Others Patient denies any current or historical self-harm ideation, suicidal ideation, or intent. They report no history of attempts. There are no current concerns regarding harm to others. Protective Factors Identified protective factors include a strong supportive partner, a desire to improve work performance, good insight into their difficulties, and a proactive approach to seeking help. They also report having a creative outlet in painting, which helps manage stress. Historical Violence or Threats Patient denies any history of violence, threats, or aggression towards others. There are no reported incidents of physical or verbal aggression. Safety Concerns No current safety concerns identified during the assessment, either to self or others. Safety Strategies Not applicable, as no immediate safety concerns were identified requiring specific strategies. Other Services Involved No other services are currently involved in the patient's care.