Moves to expand the involvement of general practitioners in identifying and treating Attention Deficit Hyperactivity Disorder (ADHD) may have unintended consequences and exacerbate inequalities, according to researcher Max Loomes. Loomes urges healthcare policymakers to consider health equity when rolling out new policies.
Over the past year, state health departments have initiated reforms to enable general practitioners (GPs) to receive specialized training in diagnosing and treating ADHD. Celebrated by those awaiting diagnosis and the Royal Australian College of General Practitioners (RACGP), this reform aims to improve access to care. Since mid-2025, states like Western Australia, South Australia, New South Wales, and Victoria have announced funding for GPs who opt for this training.
For individuals experiencing ADHD, this development may offer reassurance and a belief in greater access to medical and non-medical treatments for this often-debilitating condition. However, from a public health perspective, this shift may inadvertently entrench inequality, where healthcare access is influenced by geographical and socio-economic factors.
Understanding ADHD and Treatment Trends
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental condition characterized by difficulties with attention, hyperactivity, or both. People diagnosed with ADHD often struggle with organization, sustained focus on tasks, and feelings of restlessness or impulsivity. Currently, ADHD is recognized under the umbrella of neurodivergence, which highlights the strengths of individuals with this condition.
Despite this positive framing, moderate to severe ADHD can significantly impact social and emotional wellbeing, leading to increased rejection sensitivity and lower emotion regulation. Untreated ADHD can also result in reward-seeking behaviors, potentially leading to 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 like the Financial Review and 9 News have suggested this focus has led to an ‘overdiagnosis’ of young people. However, many argue that increased recognition reflects evolved diagnostic criteria that now consider gender and age differences, representing an overcorrection.
“For many, this recognition has provided access to life-altering medications, like lisdexamphetamine and dexamphetamines, which have significantly improved their quality of life.”
Addressing Postcode Inequality
While improved access to medical treatment is generally beneficial for health equity, the increase in GPs diagnosing ADHD may fail to address structural inequity. A recent study identified a growing ‘postcode inequality’ in how psychiatric medications, including ADHD medications, are prescribed under the Pharmaceutical Benefits Scheme (PBS). In wealthier areas of Australia, ADHD medication prescriptions have increased tenfold, possibly due to better healthcare access for affluent families, while there’s been a relative reduction for lower-income families.
This disparity is partly attributable to the gradual privatization of psychiatrists within the healthcare system, driven by perceived underpayments and the high cost of psychiatric appointments. These appointments, historically essential for ADHD diagnosis and treatment, can cost upwards of $800 for an initial consultation. Even with some GPs able to prescribe and treat ADHD, financial constraints prevent those with limited resources from accessing necessary support.
“With some ADHD medications in short supply globally, those in regional and remote areas of Australia face additional challenges in filling prescriptions, regardless of access to a prescribing GP.”
The Role of General Practitioners
The reforms allowing GPs to diagnose and treat ADHD, with appropriate training, exemplify task sharing—redistributing healthcare system activities to increase accessibility or navigate resource shortages. Many within the sector have applauded this move, given that GPs already act as gatekeepers to psychiatric care and often maintain long-term relationships with patients. General practitioners play a crucial role in addressing psychiatrist shortages and financial constraints.
However, the issue of postcode inequity persists. Geographical differences not only affect medication access 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, who would benefit most from the training, often lack the time to pursue it, especially if they work on a pay-per-visit contract. Consequently, GPs in higher SES areas are more likely to receive training, funneling healthcare benefits back to wealthier suburbs and those who can afford it.
Policy Implications and Recommendations
Max Loomes implores healthcare policymakers and executives to adopt a health equity approach when rolling out these initiatives. Under-serviced communities, both rural and metropolitan, should receive targeted funding instead of equal distribution across states. Additional support for these doctors, such as paid compensation or flexible training options, is essential.
Prioritizing funding for these areas could achieve equity and serve as a preventative measure against broader psychosocial issues, such as incarceration, substance abuse, and accidental injury.
Max Loomes is a clinical psychologist registrar, researcher, and PhD Candidate at the University of Technology Sydney. With over eight years of experience in psychological and mental health research, Loomes has worked at several institutions, including the University of Sydney, UNSW, and St Vincent’s Hospital.
