Tasmanian general practitioners should be able to play a greater role in the diagnosis of attention deficit hyperactivity disorder amid a shortage of specialists and prolonged waiting times for assessment, the state branch of the Australian Medical Association says.
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State president John Saul has said there was a serious lack of child and adolescent psychiatrists and paediatrician appointments were in short supply.
"Only paediatricians and child and adolescent psychiatrists can assess and initiate treatment for ADHD in Tasmania and child and adolescent psychiatrists are on the critically endangered list in Tasmania," he said.
Dr Saul said diagnosed children must be seen twice a year to make dose adjustments simply for growth or to trial withdrawing from medication.
He said both tasks could be managed by a general practitioner.
Unlike Tasmania, GPs in Queensland can assess and initiate treatment for ADHD, and in NSW, diagnosed children can be discharged to a GP for ongoing care.
A senate committee was tasked earlier this year to look into the barriers to consistent, timely and best practice assessment of attention deficit hyperactivity disorder
Premier Jeremy Rockliff in a submission to the committee said the state government had increased the number of paediatricians and child health medical specialists employed in our public health system by 32 per cent over five years to 2021.
"Despite these efforts, Tasmania is experiencing significant challenges with meeting the rapidly increasing demand for specialist assessment of children with behavioural and developmental management issues, including for diagnosis and management of autism and ADHD," he said.
"To reduce the waiting times for paediatric appointments specifically, the Tasmanian Health Service is working to recruit additional specialists and exploring contemporary models of care."
Mr Rockliff said this included the use of general practitioners in special clinics.
Dr Saul said there had been a significantly increased demand for ADHD assessment in Tasmania, which did not come as a big surprise as the condition had been under-recognised and under-treated in the state.
"The consequence of undiagnosed and untreated ADHD comes at great individual costs including the risks of failing education, incarceration, poor job and housing security, relationship issues, economic costs and worsening mental health and illicit drug use," he said.
Dr Saul said girls and women were often given less attention due ADHD being less prevalent in females.
"They may present as simply inattentive and not cause much trouble although their educational attainment falls short of their actual capacity, limiting their future options significantly," he said.
Cornerstone Youth Services in a submission to the committee said the financial cost of private assessments could be prohibitive for young people
It said costs could vary from $200 to $800 for private psychiatric assessment and fees of between $1000 and $3000 can be charged by clinical psychologists in private practice.
The organisation said for adults, diagnosis and management plans from a psychiatrist as a bulk-billing or low-cost psychiatric services was largely impossible to obtain.
Tasmanian Adult ADHD Support Group in their submission said there were very few private psychiatrists and psychologists who would treat adults for ADHD in Tasmania and those who would had closed books or long waiting lists.
It said the four-step process for assessment, diagnosis, treatment plan and condition management was complicated, expensive, time consuming and could involve four different health professionals in four different places.
The group said there should be provision in the public health system for treating adults with ADHD, ideally at a specialist clinics within hospitals staffed by psychiatrists, psychologists and GPs and where assessment, diagnosis, treatment plans and applications to prescribe could be done in an integrated manner and bulk billed.
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Political reporter for Australian Community Media, based in Hobart.
Political reporter for Australian Community Media, based in Hobart.
