ADHD diagnoses are on the rise in Australia, yet a critical cohort is being overlooked. While more than 800,000 Australians are now diagnosed with ADHD, the process of getting assessed remains so complex and costly that it often excludes those most in need of support. This development follows a growing awareness of ADHD, which was once primarily associated with “naughty little boys” but is now recognized across a broader demographic, including adults well into midlife.
Mick Owar, 42, was diagnosed with ADHD during his primary school years. Known for his energetic and restless nature, Owar was labeled a “problem child.” He recalls that his initial assessment was relatively straightforward, leading to a prescription that he eventually abandoned. As an adult, Owar found himself struggling with focus and organization, prompting him to revisit his diagnosis. However, he encountered a labyrinthine system filled with waiting lists and high costs.
The Complex Path to Diagnosis
Most ADHD diagnoses and treatments in Australia occur within the private healthcare system. Patients typically receive referrals from their general practitioners to specialists such as psychiatrists, psychologists, or paediatricians. However, the journey to a specialist is fraught with long waiting times and significant out-of-pocket expenses, often reaching around $2000.
According to psychiatrist Dr. Rich Bradlow, the high cost of ADHD assessments is perplexing, given that the procedures are no more complex than other mental health evaluations. The system’s complexity raises concerns among experts who fear that individuals lacking financial resources or organizational skills may be overlooked.
“One of the main things doctors look for when diagnosing ADHD is impaired functioning,” says Bradlow. “But there are no standardized definitions of ‘functional impairment’.”
Bradlow highlights the variability in diagnoses, often influenced by patients’ expectations after enduring lengthy waits and incurring substantial costs. This variability can lead to misdiagnoses, particularly when other psychosocial factors like anxiety or depression are not thoroughly explored.
Personal Journeys and Systemic Challenges
Caroline Beresford, who suspected she might have ADHD after assisting a family member, experienced a relatively smooth diagnostic process. After a shortened wait due to a cancellation, Beresford discovered she had ADHD at age 47. The diagnosis provided her with profound insight into her life’s challenges, fostering a newfound sense of self-acceptance.
Now an ADHD coach, Beresford recognizes her experience as atypical. “People that can afford the private system pathway have a much simpler and faster experience,” she notes. Her case underscores the disparities in access to ADHD diagnosis and treatment, with those able to navigate the private system facing fewer obstacles.
Medication and Beyond: Comprehensive Treatment
Stimulant medication is often the first-line treatment for ADHD in Australia, with prescriptions rising by nearly 300% to 470,000 Australians over the past decade. However, psychologist Cameron Brown emphasizes the importance of integrating skill development and therapy into ADHD management.
“Medication can help with motivation and execution, but it can’t address an entrenched belief system of ‘I always fail’ or ‘I will never follow through,'” Brown explains.
Brown also points out that individuals with inattentive ADHD, often diagnosed later in life, may be overlooked due to the absence of hyperactive symptoms.
Rethinking ADHD Care: Towards Equitable Solutions
The increasing demand for ADHD diagnoses has spurred the growth of single-session online clinics, which offer quicker assessments but may lack comprehensive treatment options. Dr. Bradlow expresses concern that these clinics might not provide sufficient non-pharmacological treatments, which are crucial for effective ADHD management.
To improve access and equity, Bradlow advocates for a greater focus on functional impairment in diagnoses and the expansion of public healthcare options. Some states are already reforming pathways, with Queensland set to allow specially trained GPs to assess and treat ADHD by December 2025, followed by other states in early 2026.
“GPs diagnosing and treating ADHD could be great if done well,” Bradlow says. “It could increase access to treatment and bring equity.”
However, he cautions against potential pitfalls, such as limited GP availability leading to high charges or misdiagnoses due to a narrow focus on ADHD symptoms.
As Australia navigates these changes, the challenge remains to create a system that is accessible, affordable, and comprehensive, ensuring that all individuals with ADHD receive the care they need.
