P-50 Innovating access to adult attention deficit hyperactivity disorder care in the Caribbean: early experience from an online Specialist mental health service

Methods: A retrospective descriptive case series was conducted using anonymised routinely collected clinical data from an online specialist mental health clinic operating across Caribbean territories via telehealth. All adults contacting the clinic between 1 September 2024 and 30 September 2025 were included in a service access cohort. Detailed clinical data were extracted for individuals completing an assessment and analysed descriptively using counts and proportions.

Results: Twenty-one adults contacted the clinic during the study period. The majority (n=16, 76%) were women and resident in Barbados, with additional representation from other Caribbean territories. Most individuals self-referred (n=17, 81%). Thirteen individuals completed an assessment, with Attention Deficit Hyperactivity Disorder confirmed in twelve cases, predominantly inattentive or combined presentations. Several individuals had prior diagnoses of anxiety or depressive disorders, and autistic traits were identified in 5 individuals (38%) who scored above cut-off thresholds on autism screening questionnaires. Most individuals with confirmed diagnoses were initiated on evidence-based pharmacological treatment, and the majority entered ongoing care and attended follow-up.

Conclusion: This early case series demonstrates the feasibility of an innovative online specialist service model for improving access to adult ADHD care in the Caribbean. Research is needed to establish the prevalence of ADHD and other forms of neurodivergence in adults in the region. However, these preliminary findings highlight a potential unmet need and support the role of service innovation in strengthening regional mental health systems and informing future service development.