Basel: ADHD assessments delegated to trainees for years

The University Psychiatric Clinics of Basel (UPK) delegated assessments for attention deficit hyperactivity disorder largely to students for years. The report comes from the "NZZ am Sonntag". The clinics replied on Sunday that they are aware of no case in which this arrangement led to a mistaken diagnosis, and stated that psychology trainees are involved in standardised diagnostic procedures as part of their training.

The newspaper quotes former trainees who say they in part carried out the ADHD assessments practically on their own and drew up proposed diagnoses. Formal responsibility for the diagnosis was then taken by a psychologist who had not seen the patients in person.

The UPK said they are reviewing how those procedures were actually organised and how they were professionally supervised. The findings will be assessed, and the clinics promised to report transparently on any measures taken.

The billing question

A second chapter concerns costs. The health insurers' association Prioswiss regards billing to basic insurance as inadmissible where the services were provided by students. On this point too the UPK have announced enquiries.

The clinics say they had already begun making improvements before the article appeared. Professional supervision of students has been stepped up and case discussions are now led by the new joint psychological management. A further strengthening of specialist psychological and medical resources is also planned.

For those affected the question is not a minor one. An ADHD diagnosis can create an entitlement to compensatory measures during training or study, and it often leads to medication over many years. Between 2020 and 2024 prescriptions of ADHD drugs in Switzerland almost doubled. The medicines, however, are prescribed by doctors, not by psychologists.