In brief
Australia’s first clinical guideline for ADHD arrived in 2022. This piece for the MJA’s InSight+ sets out why it will be hard to put into practice: ADHD costs the country an estimated $20 billion a year, yet there are too few clinicians to assess and treat everyone who needs it, and the cost to families of getting a diagnosis presents a significant barrier.
In more detail
What the piece is about
Australia’s first evidence-based clinical guideline for ADHD was published in 2022 by the Australian ADHD Professionals Association. It sets out the best model of care: medication together with non-medical support such as counselling, mindfulness or anger management, or life-skills coaching. This essay, written after the 2022 AADPA conference, asks why that model will be so hard to deliver — and lets the ADHD community answer.
The scale of the problem
Modelling by Deloitte puts the social and economic cost of ADHD in Australia at about $20 billion a year: roughly $13 billion in economic costs, including $800 million to the health system, and $7.5 billion in lost wellbeing. Treatment works — people with ADHD report better functioning at home, at school and at work once they are treated — yet in Australia most stimulant prescribing is done by paediatricians and psychiatrists, under rules that differ from state to state.
What the community said
The conference brought representatives of seven Australian ADHD community organisations together with clinicians and researchers, and their concerns were gathered in writing and at a plenary session. Six themes came through. There are too few specialists authorised to diagnose and treat ADHD, so waiting lists are long and a diagnosis is expensive; adult ADHD in particular is still treated politically as a childhood problem. Professionals get too little training in ADHD — the community wants it covered in every medical, psychology, occupational therapy, speech pathology and nursing course. Schools do not understand it: in one survey nine in ten parents said their child was not getting enough support, and more than half of teachers surveyed were not confident managing ADHD in the classroom. Public services are thin and private care is costly, the NDIS does not recognise ADHD as a disability, and the move from a paediatrician to a psychiatrist in the late teens can price a young person out of treatment altogether. The community lacks a single national body to speak to governments. And the wider public still misunderstands the condition, so families face stigma and a confusing flood of online information.
What would have to change
The essay’s conclusion is that the guideline’s promise depends on affordable care from properly trained professionals — the same finding as the 2019 Henry Review of paediatric services in New South Wales, which called ADHD services inadequate and asked for new models of care that include GP prescribing. It argues for organised advocacy: investment in training, more public-sector services, and looser prescribing rules so that upskilled GPs and qualified nurse practitioners can treat ADHD. It ends with a plea for empathy towards people and families living with the condition.