Why we need a holistic approach to servicing children with ADHD in regional Australia

The NSW Government recently announced a $7.7 million boost to ADHD and behavioural support in regional NSW in their state budget, but we all know that actions speak louder than words and the implementation of this budget will be critical to determining whether it has a genuine impact on our communities.

It’s great to see the government investing in programs that will aim to provide better care for children with ADHD, particularly for families in the bush. However, we need to ensure that any investments in health care for children take a holistic approach to developing and empowering a circle of support around each child and their family.

We can’t afford to start supports too late

The government announcement highlights the importance of helping young people transition from school to tertiary education or work, which is an important start, though this part of a child’s life cannot be addressed in a silo. Allied health professionals, particularly speech pathologists and occupational therapists, can play life-changing roles in a child’s development if engaged at the right time.

It needs to start with early intervention, which is critical for children with ADHD, as experts and a recent ADHD Australia study have shown they can otherwise revert to self-medicating through drugs or alcohol when they’re older. Continued support throughout their education is important to ensuring they live fulfilling and healthy lives, with 55% of young Australians with ADHD saying they have difficulty in managing social and relationship matters. Then, as the government alludes to, it is important to support young adults’ transition into the workforce, as nearly six in 10 young Australians with ADHD reported an impact on their employment as a result of their ADHD.

If this isn’t enough to show a piecemeal approach to supporting our young people is not adequate, we need to simply look at the reams of stats now available highlighting how the pandemic has further increased the mental health challenges and levels of anxiety for all Australians. Research points to young people with ADHD also experiencing these effects, on top of their pre-existing challenges.

Introducing new programs shouldn’t involve overlooking existing professional workforces

It is important for the professional healthcare network to be addressed with a holistic approach — the government’s announcement features the involvement of medical and allied health professionals to develop a new model of care. It is promising to see the government exploring new ways to develop and implement healthcare services, though it will be just as important to assess the existing healthcare workforce for upskilling and training opportunities.

The available information and research around ADHD is constantly evolving, and speech and occupational therapists aren’t being trained to recognise and provide care for children with ADHD at the same level as, for example, children with autism. But this shouldn’t be the case when one in 20 Australians have ADHD and an increasing rate of adults with ADHD are being recognised and treated.

As highlighted by the pandemic, telehealth is a viable option for families in rural and remote Australia and the technology already exists to bridge the gap in access to health care, particularly for families waiting months or years for basic health services like speech and occupational therapy. We need to look at both existing and new care methods to ensure children with ADHD are getting the most effective treatments possible.

We cannot continue relying on ‘build it and they will come’ healthcare models

The programs and professional network are somewhat redundant if they aren’t made accessible to the children that need them. Currently, ADHD is not covered under the NDIS, unless the child has additional conditions such as an intellectual disability or global developmental delay, which may increase their likelihood of obtaining NDIS funding, although this is not guaranteed. This doesn’t make sense, as the needs of a child with ADHD are complex and our understanding of how to best provide care is constantly evolving.

Furthermore, during the pandemic, there was a boom in Australians wanting to learn about ADHD, yet the ‘booked-out and expensive mental health care system’ led to many turning to social media for information and support. With 4.7 billion TikTok videos now tagged #adhd, the government clearly has a role in bridging this gap between supply and demand for information, service delivery and adequate support.

The government needs to prioritise enabling affordable and accessible health care for all. This cannot be limited to supporting those diagnosed with ADHD at specific moments in their life, or introducing a new stream of professionals to deliver service in particular ways and locations. We need an end-to-end reassessment of how ADHD is diagnosed, how early intervention is implemented, and how all supports, professionals and knowledge about ADHD are made accessible across the country.

 Claire Salter Parry, Clinical Services Manager at Umbo.

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