Earlier quoted context omitted.
This was daunting for me too. I had a series of private evaluations in London, and the proxy I used was to seek a consultant psychiatrist (just about as senior as they come) who had a longstanding relationship with his local NHS trust (hadn't jumped from one area to another), looked him up on the GMC (registry of doctors in the UK which would report malpractice or other issues), and asked for a telephone consultation…
hi george thank you for your response here and elsewhere in the comments. i have found them very helpful. i did indeed just reach out to a friend who recommended i talk to my primary care provider (PCP) and go from there. now that i'm looking into all this, mental health is a luxury in america. sessions are approx $200/visit here in san francisco.
Here is what I might do if I wanted to cap at $400 (assume $400 is two hours) before finding out whether I need to do any more.
Before I book the appointment:
1. Find the most commonly used clinical assessment tool[1] and commit to undertaking it, with a specific emphasis on any corroborative components (i.e. friends and family who have known you for years helping to share experiences of you in childhood)
2. Research qualitatively: e.g. read essays from people who have had diagnoses and treatment and see how much of it chimes with you.
3. A useful experiment I did was to go to the ADHD subreddit and, ignoring the ebullient teenage blogger-type posts, make a list of posts and experiences which closely correlated to my own.
4. Write down your own summary of your experience and why you're seeking some help. Not necessary ADHD-specific, but what are the things you're aware of that you want to improve on in your life? What are the consequences you experience from those areas?
At the appointment:
1. Explain that you are aware diagnosis of most conditions requires a multi-stage evaluation from a psychiatrist, and that you am committed to taking the process seriously but have concerns about both the cost (hence doing a lot of research and being very organised, which runs contrary to some people's expectations of ADHD!), and the risk of getting a doctor who simply writes prescriptions without a second thought.
2. Tell the psychiatrist that you would like a preliminary recommendation from them on whether it's worth continuing with assessment and/or treatment after two sessions, and you'd appreciate it if they could do their work as methodically as possible but sensitively to the fact that you don't want to initially deploy more than $400 to the task.
3. Share with them that you have researched DIVA or another clinical assessment for ADHD because it feels like the symptoms of that chime with you, and you wanted to be sure it was worth your time coming in at all.
4. Tell them you're giving them this information because you don't want them to think you're doing stage management or trying to score some drugs, and commit to letting them run the session from there.
5. They will likely ask you to explain what has motivated you to attend in the first place. What 'thing' happened to get you off your ass and into their office?
I think it's very probable that you can find someone who understands that this is a debilitating condition in many people and which also needs a sympathetic approach to diagnosis.
The other thing to remember is that there are multiple clinical assessments because many people have comorbidities and it requires unpicking. If that isn't the case for you then you don't need hours and hours of assessments.
Feel free to reach out on my email (in profile) if you have Q's or I can be helpful.
[1] E.g. in the UK it's DIVA https://www.advancedassessments.co.uk/resources/ADHD-Screeni...