The challenge of improving assessment and treatment for attention-deficit/hyperactivity disorder in Australia.

Abstract

Australia's mental health system is under increasing pressure as demand for the assessment and treatment of attention-deficit/hyperactivity disorder grows. Many people face long wait times, high out-of-pocket costs and limited specialist capacity. This encourages faster assessments, increasing the risk of misdiagnosis and avoidable downstream demand. The policy response has been to improve access and relieve specialist bottlenecks by expanding the role of general practitioners. Assessment for attention-deficit/hyperactivity disorder requires time-intensive clinical evaluation, including careful consideration of developmental history, collateral information and differential diagnoses. Making an attention-deficit/hyperactivity disorder diagnosis in adulthood adds complexity given the need for retrospective assessment to support childhood onset, limitations in the availability of collateral information and the impact of life events on executive functioning. Without dedicated time and training, general practitioners may struggle to maintain consistent diagnostic quality and appropriate prescribing at scale. There is already limited delivery of guideline-recommended multimodal care for Australians experiencing attention-deficit/hyperactivity disorder. Medications reduce core symptoms for many people, but sustained functional improvement typically requires psychoeducation, skill-based therapies, coaching and family, school or workplace interventions. Reform should pursue both access and quality by clarifying guideline advice for difficult adult diagnoses, introducing higher Medicare rebates for longer assessment appointments, linking any general practitioner role expansion to structured training and shared-care support, and funding scalable multimodal attention-deficit/hyperactivity disorder care through multidisciplinary clinics, group-based programmes, workforce upskilling, and national digital psychoeducation and self-management supports.