The death of a brilliant young man has exposed profound failures in a flagship NHS policy designed to speed up access to mental health diagnoses. Ryan White, described by his sister as "super bright, witty, personable, generous and kind", took his own life on 12 May 2024 after being failed by a system that left him trapped in administrative limbo.
A System in Crisis: The 'Wild West' of ADHD Assessments
Ryan's story is a stark illustration of the dangers within the NHS's 'right to choose' pathway for neurodevelopmental conditions like Attention Deficit Hyperactivity Disorder (ADHD). Introduced in 2018 to tackle waiting lists of up to a decade, the policy allows patients to select a private provider for assessment and initial treatment, funded by the NHS. However, experts have branded the current landscape a "wild west" of poor regulation and inadequate training.
Like many others, Ryan was referred by his GP for an ADHD assessment with the private firm Psychiatry UK in September 2022. He received a diagnosis five months later. Yet his path to treatment was blocked by a critical flaw: the shared care agreement. This is the mechanism where a patient's NHS GP agrees to take over prescribing and monitoring after private diagnosis. It is entirely voluntary, and not all GPs consent, often rejecting private diagnoses as not meeting their standards.
"Ryan tried so hard to get help. He was brilliant, but he was left to fall through every crack," said his sister, Leigh White. "He was fighting a system that demands stability from people who are already in crisis."
Administrative Limbo and a Fatal Breakdown in Care
Ryan's case was further complicated by a history of bipolar disorder, which meant he needed a community mental health review before starting ADHD medication. "Nobody chased anything, or took responsibility," Leigh stated. His situation deteriorated rapidly in June 2023 when his housing became unstable. In a devastating twist, he was deregistered by his GP practice after expressing frustration at the delays.
Stranded without a GP and increasingly isolated, Ryan's pleas for help went unanswered. He sent messages to Psychiatry UK explaining he did not know where to turn; one was never replied to. Shockingly, the provider continued to send messages about changing his medication for over a month after his death, only learning of the tragedy months later.
A subsequent report into Ryan's case by Psychiatry UK highlighted the need for better communication with GPs and mental health teams. The firm's medical director, Dr Joanne Farrow, apologised for any part it played in Ryan not getting help and outlined improvements, including a new contact centre.
Call for Urgent Reform and Standardisation
Consultant psychiatrist Marios Adamou, founder of the UK Adult ADHD Network (UKAAN), argues the right to choose policy was rolled out prematurely. "There was no standard in what good assessment looks like and there's still no standard for what a qualified assessor would look like," he said. He urged the NHS to halt "uncontrolled" spending through the scheme and divert funds to NHS pathways with specific quality standards.
The problems are compounded by vague assessment guidelines from the National Institute for Health and Care Excellence (NICE) and a lack of a national framework for diagnostician qualifications. Dr Jaime Craig of the Association of Clinical Psychologists said he regularly hears concerns about the rigour and quality of private assessments, warning that patients risk being misdiagnosed and medicated for conditions they do not have.
Andrew Jay, director of North East ADHD, pointed to NHS pressure to drive down prices, leading some private providers to offer a "very basic level of care" and pressuring clinicians to be brief. Meanwhile, Danielle Henry of the Independent Healthcare Providers Network defended the sector's role, stating private providers now deliver over half of all NHS-funded ADHD assessments and are regulated by the Care Quality Commission.
Ryan White's tragedy, borne from immense personal loss including the death of both parents, underscores a system failing at its core. It highlights an urgent need for robust regulation, clear standards, and seamless communication to prevent other vulnerable patients from falling through the cracks.
