The federal government has responded to the national ADHD inquiry, adopting one of its 15 recommendations and providing in principle support for 9 others. The inquiry held a year ago, highlighted difficulties patients face in receiving ADHD diagnosis and care including high costs and long wait times.
Category
📺
TVTranscript
00:00At the moment, most people who want an ADHD diagnosis go to their GP and ask for a referral
00:09to a specialist, which for children is usually a paediatrician and for adults is an adult
00:15psychiatrist. Now, the specialist model of care, which says that once a specialist has
00:20diagnosed someone with ADHD, they should go on treating that person for as long as they
00:26need treatment. And so, of course, over time, all that specialist's consultation time is
00:34taken up with follow-up patients. So in the end, they can't take on any new patients.
00:39And this is where the waiting lists blow out and people get desperate and it just really
00:45doesn't work. And what we are hoping for in the government response to the report of the
00:52Senate inquiry is solutions. And I can't see any solutions in their response.
00:59And so, yeah, just with the current system, what negative outcomes does that lead to for
01:04people out there with ADHD?
01:07Well, there's a number of outcomes. First, they don't get that diagnosis and treatment
01:15that they need. And for some people, given, oh, there's also a lot of misunderstanding
01:25about ADHD and even a lot of professionals in allied health who we would hope during
01:32that training would have covered ADHD. They have had very little education about it. So
01:40you get people turning up to either a GP or a psychiatrist or some, maybe a counsellor,
01:52and they don't recognise the ADHD. So they come with symptoms of anxiety, depression,
01:59and the ADHD, which they've had all their life and it's been missed, it doesn't get diagnosed.
02:07So they end up perhaps with a diagnosis of treatment-resistant depression because
02:12the depression doesn't improve unless the ADHD is addressed.
02:17Yeah, and so that can lead to all sorts of ongoing challenges for that person. So you
02:21mentioned that there's been this Senate inquiry and so there would have been a lot of hopes out
02:25of this Senate inquiry. The government has given in-principle support to, as this Senate
02:31committee recommendation, to provide a review into the Medicare benefit schedule to improve
02:36accessibility to ADHD-related assessment, diagnosis and support services. So does that
02:43give you any optimism that things might change?
02:47Well, I'll wait until I see what that actually amounts to. But I think where Medicare falls
02:55down most badly is in the remuneration that GPs get, because I think that most people with ADHD
03:06could be well managed in general practice if they had a GP who was trained in understanding
03:12and knowing how to manage ADHD. But at the moment, the Medicare item numbers just don't,
03:23they're just not adequate. And so if we want GPs to take on more responsibility in prescribing and
03:32diagnosing ADHD, I think the funding arrangements really have to be looked at.
03:40And what's the evidence that that model actually works?
03:45Okay. So in Nepean Blue Mountains local health district, we've got an ADHD clinic where we're
03:54trialling a new model of care. And so I'm training GPs in the clinic. So they each attend the clinic
04:02on 12 separate days. And they also have some formal teaching and case review. And at the end
04:09of that, they have an assessment of competence. And then they can enter the study as study
04:15investigators, and they can recruit study participants who are their own patients in
04:20their practices with ADHD, and they diagnose and treat them. And we're collecting the results of
04:27this and hoping to publish it. But in the long term, I think this is a very good line of care
04:37to be looking at, because it costs, well, obviously, we have to pay the GPs when they're
04:44attending the clinic, but having paid them for those 12 clinics, then they in principle, could
04:52be able to diagnose and treat ADHD for the rest of their professional lives. And so that works out
04:59as an incredibly cost efficient way of expanding the resources, expanding the number of doctors
05:08available for treating ADHD. And so were you hoping something like you've just said out
05:14there was going to be adopted by the government out of this Senate committee?
05:19I'm still hoping, but not from the Senate. Yes, I mean, I've been hoping that this model of care
05:25could be adopted, because I think that models of care do need to be considered. And the New South
05:33Wales Ministry of Health are funding models of care which are happening in Western New South
05:39Wales and Hunter, New England. But I think we need proper economic modelling of those models of care
05:45plus others that are being trialled around the state and obviously in other parts of Australia,
05:52and just looking to see which is going to provide the services within a reasonable budget.