Victoria's Reforms for ADHD Care
Victoria is set to implement reforms allowing general practitioners (GPs) to diagnose and treat Attention-Deficit/Hyperactivity Disorder (ADHD), with 150 GPs expected to complete accredited training by September. These changes, supported by a $750,000 government investment, aim to reduce current specialist waiting times and assessment costs, which can exceed $2,000. The initiative aligns Victoria with similar reforms undertaken by several other Australian states and territories.
Expanding Access to ADHD Care in Victoria
The Victorian government is implementing legislative changes this year to authorize GPs to diagnose and treat ADHD in individuals aged six and older. This expansion of practice is intended to address wait times for specialist assessments, which currently range from six to 12 months.
Mental Health Minister Ingrid Stitt stated that these changes are designed to provide more opportunities for Victorians affected by undiagnosed or untreated ADHD.
Premier Jacinta Allan noted the goal is to make ADHD care more accessible and affordable for families and to alleviate pressure on existing specialist services.
Under the new framework, 150 GPs will undergo accredited training, with initial accreditation expected from September and training anticipated to be completed before the end of the year. Health Minister Mary-Anne Thomas confirmed a focus on geographic distribution for training, prioritizing GPs in rural, remote, and outer-suburban areas.
Currently, ADHD diagnosis and management in Victoria primarily require specialists, with adults typically needing a psychiatrist and children requiring a paediatrician or psychiatrist. The reforms will allow trained GPs to also consider non-medical treatments, including lifestyle strategies and referrals for behavioral therapy, psychology, and educational support. Mental Health Minister Ingrid Stitt indicated future expansion of the program, following consultation with the healthcare sector.
A Look at the National Landscape
Victoria's reforms follow similar initiatives in Queensland, New South Wales, South Australia, Western Australia, and the Australian Capital Territory.
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Queensland allows all fully qualified GPs to diagnose adult ADHD without further training and permits them to diagnose and treat children. One source indicates this change for adults commenced in December.
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New South Wales previously trained over 800 GPs to issue repeat ADHD medication prescriptions, an initiative that has supported over 5,000 patients and resulted in over 18,000 scripts filled since September 1 (of a recent year). A new phase of training, commencing in March, has seen nearly 600 GPs express interest in learning to diagnose and initiate treatment for ADHD. This training prioritizes GPs in regional, rural, and remote areas. NSW Health covers training costs and provides a remuneration package for completing GPs.
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The Australian Capital Territory has authorized GPs who complete approved training to prescribe ADHD medication for eligible patients aged six years or older who are stable on existing medication and have a specialist diagnosis. These GPs no longer require repeated specialist reviews or Chief Health Officer (CHO) approval for continued prescribing. Conversely, psychiatrists, paediatricians, and neurologists are now required to obtain CHO approval for prescribing ADHD medications within defined dosage ranges. Further reforms are anticipated later this year to allow GPs with additional training to diagnose ADHD and initiate medication.
Perspectives and Key Considerations
The Royal Australian College of General Practitioners (RACGP) has advocated for these diagnostic changes, citing the complexity and cost of the current process as barriers to care. Dr. Anita Muñoz, Victorian Chair of RACGP, highlighted the importance of early intervention for children and the potential impact for adult patients.
The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has raised concerns about potential misdiagnosis and emphasized the need for specialist training and oversight for GPs, suggesting a shared care model after initial specialist diagnosis.
Some clinicians have questioned the concept of ADHD as an independent neurodevelopmental disorder treatable by specific medications, raising concerns about overdiagnosis and overmedication.
The RACGP has also highlighted that national prescription rates for ADHD medication are more than double in Australia's most advantaged areas compared to the most disadvantaged, advocating for nationally consistent rules across states and territories.
Prevalence and Medication Trends
Nationally, over 800,000 Australians have been diagnosed with ADHD, with some estimates suggesting the number could be as high as 1 million. ADHD is estimated to affect 6-10% of children and adolescents and 2-10% of adults. In Victoria, the RACGP estimates approximately 163,000 children and 320,000 adults may be living with ADHD.
Pharmaceutical Benefits Scheme data from 2024 indicated a 450% increase in adult ADHD medication use between 2012-13 and 2022-23.