How GPs could ease ‘bottlenecks’ for specialist ADHD care

More than 480,000 Victorians may be living with ADHD, but ballooning waitlists have left them without diagnosis or treatment. General practitioners could be the key to fixing the backlog.

Victorian GPs are calling for the right to diagnose ADHD and prescribe medication for the disorder. Picture: iStock

Victorian general practitioners are calling for the right to diagnose ADHD and prescribe medication for the disorder, in line with other states.

The peak body for GPs is pushing for change, warning months-long waitlists to see a psychiatrist or pediatrician – on top of high out of pocket cost – is leaving patients without care.

Royal Australian College of General Practitioners Victorian chair Dr Anita Muñoz said some Victorian clinics charged up to $2000 for a comprehensive ADHD assessment.

“Up to 163,000 Victorian children and 320,000 adults may be living with ADHD in Victoria,” she said.

“But many of these patients can’t access an assessment.

“Enabling GPs in Victoria to diagnose, initiate and manage psychostimulants for ADHD will reduce specialist bottlenecks, improve timely access to treatment and reduce costs for patients, while easing pressure on public hospital outpatient waiting lists.”

New South Wales announced reforms to let GPs diagnose and prescribe for ADHD last month, with the Western Australian making a similar commitment in February.

Queensland has allowed GPs to do so for children since 2017.

But Victorian GPs cannot diagnose patients or start them on psychostimulants.

They can only prescribe ADHD medications under a shared care arrangement with a pediatrician or psychiatrist and must get a patient-specific permit.

Victorian GPs are calling for the right to diagnose ADHD and prescribe medication for the disorder. Picture: iStock

GPs including Dr Muñoz will attend state parliament on Wednesday to call for reforms, but the peak psychiatry body has raised concerns and argued “expanding GP roles without the necessary support won’t solve the access crisis”.

Royal Australian and New Zealand College of Psychiatrists Victorian Branch Chair Associate Professor Simon Stafrace said “at present”, GPs were not “adequately supported” to take on the responsibility of managing ADHD “alone”.

“In Victoria, there are almost no publicly funded services offering specialist training, and access to psychiatrists, whether in a public or private setting, is severely limited,” he said.

“This is a significant cause of concern for us.

“ADHD is a complex condition that often co-occurs with anxiety, depression, trauma, or learning difficulties.”

But Dr Muñoz said Queensland GPs had been successfully managing children with ADHD “without issues” for eight years and the college offered training.

“This change is past due,” she said.

“Early intervention for children with ADHD is vital. It sets them up to thrive,” she said.

“For adult patients, a diagnosis and access to treatment can be life-changing.”

The debate comes at a time of increasing diagnosis rates, which most experts attribute to a correction of a previously under-diagnosed condition.

The number of Australians prescribed ADHD medication per 1000 people increased 11-fold between 2004-5 and 2023-24, according to the latest Australian Institute of Health and Welfare data.

Originally published as How GPs could ease ‘bottlenecks’ for specialist ADHD care