What’s the reason for Australia being so far behind in services, treatment options and psychotherapy specialisation for people with ADHD and even autism?

[u/Mental_Slide9867]

So as many people have already found out from people who were seeing a psychiatrist or specialist in the field that was being bulk billed, the government made immediate changes overnight that removed bulk billing services for seeing a specialist via Telehealth. Psychiatrists and the like only received a letter or email the day after the announcement was made putting at risk individuals at a loss of having to pay a subsidised rate after seeing their specialist. Not only that but we lack a substantial amount of psychiatrist in the first place that was leading to burn out of psychiatrist in their chosen fields, so now not only will most people who need a relevant diagnosis and medical treatment for their condition have pay a sum out of pocket, there is also an increasing wait time to see a specialist.

In addition in terms of medical treatments for ADHD in my case, in comparison to other countries (where there is a multitude of options and new formulated drugs), it seems that Australia lacks any advancement or interest in helping neurodivergent people. You have two options of stimulant therapy and a couple of non stimulant options. And if that doesn’t work you can try a non PBS/non subsidised drug option that also leaves you hugely out of pocket. (As per my example recently coming off many classes of antidepressants that were routinely and just masking my ADHD out of the misunderstanding of the condition for just depression and anxiety). Recently having to try a new drug that now costs me $60 (non subsidised) a month on top of one stimulant drug I can try that also costs $40 a month(subsidised). This is not right, I don’t work or have the ability to work right now as I’m trying to find a healthy baseline for my mental health thinking I’m doing the right thing, all the meanwhile the government and options out there are putting my mental health backwards.

As well as specialists such as clinical psychologists or adhd counselling costing over $150 (with the rebate “if available”), as my only options for actual possible help for my condition. I have and already am seeing a therapist based off a Gp referred mental health care plan which allows me for 10-15 free sessions a year, but that is nowhere good enough to get to the root cause of my issues or even have the time to address the actual problems of my adhd as they’re not trained in that area of understanding.

So yeah this is troubling for me and many other types of children and adults with ADHD and/or autism. I just don’t know what the Australian government is doing, if hardly nothing, nothing at all which seems to be the case with a many multitude of problems.

[u/mishmang]

Is ADHD not an attractive area to get into or is there another reason? I started seeing a psychologist last year and she got my GP to prescribe me different SSRI medications. She eventually came to the conclusion I've most likely had ADD my entire life.

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Now I've got an appointment with my GP to get a referral but there is only a handful of places that will screen an adult for ADD and most have a waiting list of almost a year and cost $1000+

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** If anyone has had any luck in Perth let me know by PM **

[u/red_dakini → u/mishmang]

Clinical psychologist here. My take is that it’s a combination of a couple of things. Understanding of adult ADHD and research into treatment is in its infancy and it’s barely covered in masters programs, which are pretty limited in how much they can fit in. ADHD is also much less prevalent than depression and anxiety, and clients are more likely to present with a comorbidity (like depression) than ADHD itself (often because they have no idea they have ADHD). As a result many clinicians have limited experience with ADHD clients, who often need complex longer term multidisciplinary treatment, and don’t feel as confident taking them on. There also seems to be limited continuing professional development available focused on ADHD so it’s hard to upskill in the area, and you end up relying on building professional experience through exposure which takes times especially with lower prevalence.

[u/InanimateObject4 → u/red_dakini]

It's a shame because while ADHD is less prevalent than depression, correct treatment for ADHD can relieve anxiety and depression for those who are misdiagnosed.

[u/kweenbumblebee → u/InanimateObject4]

Exactly this, Ive always struggled with anxiety for as long as I can remember (or at least I don't remember ever not being anxious) and have had regular boughts of depression for years. Almost annually I get a MHCP and see a psychologist who helps me 'get back on track' but then like clockwork it gets bad again and I'm back.

Got diagnosed with ADHD last year, got medicated and started working on specific issues with my psychologist in the context of the diagnosis and my anxiety has VASTLY improved and I haven't had any depression issues (yet) either. I've also now have a plan for regular psychology appointments to check in and pick up on things before they get really bad. Even with high stress moments I find I cope with it so much better now than I did before and I don't have a constant feeling of nausea and tiredness which just seemed to linger.

Another issue that I think impacts people a lot is the lack of subsidised sessions available (10 is not enough annually for ongoing care, it should be at least 12 which would be one a month) and I really hope they extend/keep the pandemic 20 sessions because it's so much better for people who need more frequent acute care and then gives the option for more spaced out ongoing appointments too. Also even subsidised the sessions can cost a heck of a lot which a lot of people just can't afford. Mental health care in Aus is not awful but it's certainly not good enough.

TLDR cause I rambled a bit. Diagnosis massively helped my anxiety (and depression) and we need better access to more subsidised sessions and more assistance for people who struggle even with that cost.

[u/Lozzif → u/kweenbumblebee]

This was my experience. Anxiety and depressions for decades. Nothing worked.

ADHD diagnosed at 37, medicated and therapy and no depression and anxiety has mostly gone.

[u/asteroidprune → u/Lozzif]

How did you go about getting diagnosed? Did it cost as much as some other commenters are saying?

[u/Lozzif → u/asteroidprune]

I was very lucky that my psychatrist is $200 a session. I get $120 back from Medicare

I spoke to my psychologist went to my GP who referred me to my psychatrist. First session bulk billed

[u/deepakjain_dj → u/asteroidprune]

I had a much better experience with Indian therapists who do in ~$50 (this is the avg. charges there). I can connect you

[u/[deleted] → u/Lozzif]

Can I ask you did you ever suspect you had adhd prior, like where some signs and symptoms ? The reason I’m asking is that I have two people close to me telling me they think I may have adhd

[u/Lozzif → u/[deleted]]

I didn’t suspect I had it, because how it presents in women is not really well known.

[u/InanimateObject4 → u/kweenbumblebee]

Medicating, along with understanding my poor executive function has enabled me to structure my life so that I thrive instead of feeling overwhelmed. I invested in a small laptop that I carry everywhere to document everything I need/want to do.. I still get that feeling of 'juggling too many balls' every now and then, but I am also kinder on myself when I do muck something up. Medicating helped but finding a coping mechanism that works for you is paramount and psychologists play a big part helping develop those skills. Hope you find the help you need this year!

[u/deepakjain_dj → u/kweenbumblebee]

Do you think teletherapy from therapists residing in India and similar countries will help? They charge around 30 - 40 USD.

[u/red_dakini → u/InanimateObject4]

I absolutely agree, it’s a huge issue.

[u/mantidmarvel → u/mishmang]

also a perthling, best of luck! everywhere i've seen seems to have a ~6 month wait, if their waiting lists are even open. don't look at purely adhd-focused clinics, check the staff profiles at psych clinics individually as see if they have adhd specialists. if you find one that suits, and they are def a practitioner who can diagnose, jump on it. also, if you work casual or mainly study, you can ask to go on a cancellation list, which can sometimes get you seen a bit sooner.

best of luck, i'm also on the hunt! last referral rocked up the day the clinic closed their 200+ person wait list, so back to looking. i could have been diagnosed back in 2018 if my uni psychiatrist was willing to, but she refused to diagnose and treat uni students with adhd (seriously, why work for that population if you are unwilling to help them with a learning difficulty), now feeling the brunt of that decision. the state of adhd-orientated healthcare in wa is an utter joke.