Moves to expand the involvement of general practitioners (GPs) in identifying and treating Attention Deficit Hyperactivity Disorder (ADHD) may have unintended consequences and exacerbate inequalities, according to researcher Max Loomes. He urges healthcare policymakers to consider health equity when implementing new policies.
Over the past year, state health departments in Australia have initiated reforms enabling GPs to receive specialized training in diagnosing and treating ADHD. This initiative has been celebrated by individuals awaiting diagnosis and the Royal Australian College of General Practitioners (RACGP), the accrediting body. Since mid-2025, Western Australia, South Australia, New South Wales, and Victoria have all announced funding for GPs who opt for this training.
For those experiencing ADHD, this development may provide reassurance and a belief in greater access to both medical and non-medical treatments for this often-debilitating condition. However, from a public health perspective, this shift may further entrench inequality, where access to healthcare is driven by postcodes and socio-economic status.
Understanding ADHD and Current Treatment Trends
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental condition characterized by difficulties with attention, hyperactivity, or both. Individuals diagnosed with ADHD often struggle with everyday activities such as organization and sustained focus on tasks, along with feelings of restlessness or impulsivity. Currently, ADHD is recognized under the broader umbrella of neurodivergence, an approach that highlights the strengths of individuals with this condition.
Despite this recognition, moderate to severe ADHD can significantly affect social and emotional well-being through increased rejection sensitivity and lower emotion regulation. Untreated ADHD can lead to other concerns, including a tendency toward reward-seeking behaviors, potentially resulting in dangerous activities and addiction, as well as higher incarceration rates compared to those without a diagnosis and treatment.
In recent years, ADHD has been in the spotlight due to a substantial increase in diagnosis rates and the expansion of private services offering fast-track diagnoses. Media outlets such as the Financial Review and 9 News have argued that this focus has led to an ‘overdiagnosis’ of young people. However, the increased recognition of ADHD may be attributed to evolving diagnostic criteria that now consider gender and age differences, representing an overcorrection.
“For many, this has provided access to life-altering medications, like lisdexamphetamine and dexamphetamines, which have significantly improved their quality of life.”
Addressing Postcode Inequality in Healthcare Access
While improved access to medical treatment is generally beneficial for health equity, the increase in GPs undertaking ADHD diagnosis might fail to address structural inequity. A recent study has identified a growing ‘postcode inequality’ pattern in how psychiatric medications on the Pharmaceutical Benefits Scheme (PBS) are prescribed, including ADHD medications. In wealthier areas of Australia, medication prescriptions for ADHD have increased tenfold, possibly due to better access to healthcare for affluent families, while there has been a relative reduction for lower-income families.
This disparity is also linked to the gradual privatization of psychiatrists within the healthcare system, driven by perceived underpayments and the rising cost of psychiatric appointments, historically essential for ADHD diagnosis and treatment. Initial consultations can cost upwards of $800, creating financial barriers for those with limited resources.
Even with some GPs able to prescribe and treat ADHD, the financial constraints of repeated medical visits ultimately preclude people with limited financial resources, allowing only those who can afford it the means to support their children. Additionally, with some ADHD medications in short supply globally, individuals in regional and remote areas of Australia face challenges in filling prescriptions due to limited pharmacy access, regardless of GP availability.
The Role of GPs in ADHD Diagnosis and Treatment
The reforms allowing GPs, with appropriate training, to diagnose and treat ADHD exemplify task sharing, where healthcare actions are redistributed to other professionals to increase accessibility and address resource shortages. Many within the sector have applauded this move, given that GPs already serve as gatekeepers to psychiatric care and often maintain long-term relationships with their patients. General practitioners play a crucial role in addressing the shortage of psychiatrists and financial constraints.
However, the issue of postcode inequity persists. Geospatial differences not only affect access to medication but also impact GPs’ work conditions. GPs in rural or lower socio-economic status (SES) areas are typically overworked, underfunded, and more likely to bulk-bill. These doctors are less likely to find time for training, especially if they work on a pay-per-visit contract. While these doctors would benefit the most from the training, it is more likely that GPs in higher SES areas will have the capacity to undertake it, funneling healthcare benefits back to wealthier suburbs.
“I implore healthcare policymakers and executives rolling out these initiatives to consider a health equity approach. Under-serviced communities, both rural and metropolitan, should be directly provided with this kind of targeted funding instead of it being offered equally around the states.”
Implications and Recommendations for Policymakers
To achieve equity and act as a preventative measure for broader psychosocial issues such as incarceration, drug and alcohol use, and accidental injury, funding must be prioritized for under-serviced areas. Additional support for these doctors should include paid compensation or flexible training options. By addressing these disparities, the healthcare system can ensure that all individuals, regardless of their socio-economic status or location, have equitable access to ADHD diagnosis and treatment.
Max Loomes, a clinical psychologist registrar, researcher, and PhD Candidate at the University of Technology Sydney, has worked in psychological and mental health research for over eight years at several institutions, including the University of Sydney, UNSW, and St Vincent’s Hospital.
