College & graduate students
They said they don’t do ADHD evaluations. Nobody said what to do instead.
A student books an appointment at the campus health center, describes years of trouble finishing work that everyone else seems to finish, and is told the clinic does not do ADHD evaluations. Sometimes a printed list of community providers comes with it. Often the appointment ends there, with fifteen minutes used and nothing resolved.
That is not a brush-off. It is not a judgment about whether the concern is real. It is a scope decision, and most universities put it in writing. What nobody explains is the next step, what it involves, and the one question that decides whether the money is well spent.
Why campus clinics say no
University health services are built to treat, at volume, the conditions that bring students in most often. Many of them will manage anxiety and depression, run short-term counseling, and continue an ADHD prescription that a previous clinician started and documented. What a great many of them will not do is perform the initial diagnostic evaluation.
This is published policy at institution after institution, not an informal preference. Written ADHD policies from university health services across the country say the same thing in different words: the service does not conduct initial assessments, and students who arrive without adequate documentation are referred to community providers. A student who runs into this in Michigan is running into a national norm, not local bad luck.
The reasons are practical. A proper diagnostic evaluation takes hours across more than one appointment, requires history from someone who knew the person as a child, and involves a differential that has to rule several other things in or out. That does not fit a clinic built around fifteen and thirty minute slots. Controlled substance stewardship plays a part too, and so does the fact that a diagnosis made carelessly at nineteen follows someone into graduate admissions, licensure and employment.
The question to settle before paying anyone
This is the part that costs students real money when they get it wrong.
Schools generally apply two different documentation standards, and they are not the same. One is what the disability or accessibility office needs in order to grant accommodations. The other is what the campus health service needs in order to take over prescribing. The second is frequently stricter, and at some institutions it is substantially stricter.
Published policies vary more than most people expect.
Accessibility offices are usually the easier bar. Many accept a letter or report from a licensed clinician on letterhead that states the diagnosis and describes its functional impact. A structured psychiatric evaluation with standardized rating scales and collateral typically meets that standard.
Campus health services, when they take over prescribing, are often the harder bar. Some state outright that they will not accept a diagnosis based only on clinical interview, symptom checklists, or response to medication. Others recommend formal testing and reserve the right to require it. Those policies ask for psychological, neuropsychological or psychoeducational testing covering intellectual functioning, memory, attention, executive functioning and processing speed. That is a different service, delivered by a different profession, at a different price.
And some university health services describe a proper evaluation in terms that match a psychiatric one exactly: a comprehensive interview, information from parents, teachers and school records, and testing only sometimes. The bar is set by the institution, not by the condition, which is why the written policy is the only thing worth trusting.
So before booking anything, find the written policy. It is usually published on the health service or accessibility office website. Read what it requires, and read whether the requirement is different for accommodations than for prescribing. Then ask any prospective evaluator directly whether what they provide meets that written standard.
An evaluator who cannot answer that question clearly is not the right evaluator.
What an outside evaluation involves
A structured psychiatric evaluation for attention concerns is not a test and it is not a questionnaire. Done properly it involves:
- A long clinical interview covering development, school history, work history, sleep, mood, substance use and family history
- Standardized rating scales, scored rather than eyeballed, completed by the person and often by someone else who knows them well
- Collateral information from a parent, an older sibling, an old report card, or anyone who can speak to what childhood looked like, because the diagnostic criteria require evidence that difficulties began early
- A differential, which is the part that matters most. Anxiety, depression, chronic sleep deprivation, trauma, learning disability and autism all produce attention problems that look similar from the outside and respond to completely different treatment
- A written report that states a conclusion plainly and ties specific findings to specific functional impacts
At this practice that runs across two appointments and produces a written report, and the all-inclusive price for a new patient is on the fees page at $750. Market prices in the region vary widely, and psychological or neuropsychological testing batteries typically cost several times more than a psychiatric evaluation because they involve many hours of standardized test administration and scoring.
Psychiatric evaluation and psychological testing are not the same product
The words get used interchangeably in conversation and they should not be.
A psychiatric evaluation is a diagnostic assessment by a psychiatric clinician. It uses history, examination, standardized rating scales and collateral. It results in a diagnosis, a treatment plan and, where appropriate, prescribing. For most adults seeking an answer about attention, this is the appropriate service.
Psychological and neuropsychological testing is a psychologist’s service. It uses standardized instruments to measure cognitive domains directly, and it is the right tool when there is a suspected learning disability, a complex or contradictory picture, a history of head injury, or a documentation standard that specifically demands it.
Neither is a lesser version of the other. They answer different questions. Paying for the wrong one is the most common expensive mistake in this whole process.
What happens after the report exists
The report goes where it is needed, and where that is depends on the goal.
If the goal is accommodations, it goes to the accessibility or disability office, which makes its own determination. Note that accommodations are generally not retroactive, that many schools require a request each term rather than once, and that some set a recency limit on documentation.
If the goal is treatment, the report supports ongoing care. Whether the campus clinic will take over prescribing depends on the policy discussed above. Where they will not, ongoing care continues with a community prescriber. That prescriber has to be licensed in the state where the patient is physically located at the time of the appointment, which becomes a real scheduling question over summers and study-abroad terms.
If a student is reading this in the middle of a bad semester
An evaluation is a diagnostic answer. It is not, by itself, a fix for a semester that is already going badly, and it will not resolve in time to rescue a deadline that is next week. What it can do is end the guessing, and open the accommodations and treatment paths that are closed without it.
The accessibility office is worth contacting regardless of where the evaluation happens, because they can explain their own standard, and that conversation is free.
FirstLight Mental Health opens in Ann Arbor on November 1, 2026, and offers structured psychiatric evaluations with standardized rating scales and collateral for adolescents and adults. Free 20-minute calls can be booked on our Patient Portal page.
Related reading: You did fine in school. That doesn’t rule out ADHD. and What an ADHD evaluation costs in Michigan, and why the range is so wide
Sources
- Examples of published university health service ADHD policies, cited as public documents and not as a comment on any institution’s services or wait times: Case Western Reserve University, University of Southern California, University of Oregon.
- Diagnostic framework and onset criteria: American Psychiatric Association, DSM-5-TR.