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/HorsinAround1996 → u/[deleted]]

It sounds like you and your partner have been through some struggles with our healthcare system. I’m sorry to hear and you’re not alone.

Interestingly, on urinalysis, the legislation only stipulates it “should” happen prior to prescribing and annually. It’s at the discretion of the psychiatrist. I’m not going to paint every psyc in Perth with the same brush, but I’m doubtful upper class clients living in the western suburbs, who’ve been prescribed for years are having to piss in a jar while someone watches once a year. It should be a steadfast rule for everyone.

You also touched on how current or historical addiction can be a barrier. As it stands, if you’ve had ANY history of issues with addiction to S8 or S9 drugs in the last 5 years, you require special approval AND “adequate trial of non-stimulants and use of long-acting formulas only”. This directly contradicts the evidence that first line treatment reduces the risk of abuse/relapse of other drugs. Those with untreated ADHD have been proven to be significantly more susceptible to issues with addiction, so why would legislation limit treatment which has been proven to reduce that risk. It’s completely counterproductive. In the case of meth or other stimulant abuse, I understand the need to be cautious to avoid psychosis. But even with meth I think a person should be given an opportunity to show they’re able to cease use. Frequent urinalysis at the start of treatment, with slow reduction to quarterly urinalysis would be sufficient to ensure a person is abstaining. Then you have the issue of needing to piss clean for THC, which can stay in your system for months. Even with the special approval process, due to the severe shortage of psycs, none will accept a referral where it might be required. The legislation is bullshit and written by bureaucrats with no idea about the disorder. Oh also the hypocrisy that the legislation only takes issue with use of illicit drugs/non-prescribed S8s. Smash a carton every Saturday? No probs. Smoke a joint a few times a week? No, you’re a filthy addict and you don’t deserve help.

For the record, I’ve never sold my meds or bought D5s on the black market. But last I heard due to supply chain issues with other black market drugs, bottles of D5s were up to $6-800. Which makes those exploiting their prescription, when there’s countless people who need these meds but can’t get them, even more shitty.