Making clinical care more accessible is a step in the right direction.
According to new health economics research, attention deficit hyperactivity disorder (ADHD) is costing Australia $18 billion a year.
Associate Professor Emma Sciberras – a researcher from Deakin University’s School of Psychology and the Murdoch Children’s Research Institute (MCRI) – said this figure was calculated from the combined costs of lost productivity, expenses from the health and criminal justice systems, and the reduced quality of life and premature deaths linked to ADHD.
Barriers to diagnosis
It’s estimated that one in 20 Australian children live with ADHD. But Associate Professor Sciberras says that many affected children can miss out on a diagnosis during their early years, despite displaying ADHD-related symptoms.
“Fitting the criteria for ADHD doesn’t always lead to diagnosis,” she says. “Only one in every five children meeting criteria for ADHD at age 7 already has a diagnosis.”
It’s unclear why this is the case. It could be because a diagnosis relies on identify impairing levels of inattention and hyperactivity, which can be difficult to measure in children. Stigma and negative community attitudes towards ADHD may also act as a barrier.
The longer that ADHD is left undiagnosed and untreated, the more likely it can lead to serious challenges for the child. For instance, children with ADHD are more likely to fall behind academically, and to develop mental health conditions like depression and anxiety.
“Many parents and teachers may watch and wait to see whether symptoms improve,” Associate Professor Sciberras says. “However, difficulties can become more obvious when the demands of their child’s schoolwork increases.”
But waiting too long to seek out a diagnosis means that the child could miss out on early support.
It’s important that children with ADHD are supported in their early years of school. They spend a great deal of their time there, and students, parents and teachers all stand to benefit if symptoms of ADHD can be recognised early.
Parents might seek out clinical help much earlier than they otherwise would have, and teachers can help students with ADHD learn in a way that works best for them.
Investing in clinical care to improve accessibility
Diagnosing ADHD during early childhood has the potential to improve a child’s experiences in the classroom. But it also means they can seek out other treatments and supports as soon as possible.
Associate Professor Sciberras says that ADHD-related services can be difficult to access.
“Many have long waiting times and out of pocket costs, which can be a problem,” she says. “Some children might not be eligible for public care, meaning many families will have to turn to the private sector.
“And there’s a huge system challenge for older adolescents in accessing new treatment services when they have previously seen a paediatrician – who specialises in children’s health – and they need access to a psychiatrist instead.”
These challenges are further complicated if the person with ADHD was diagnosed later in life.
“It can be hard for adults with ADHD to secure an appointment to discuss diagnosis and ongoing treatments due to a lack of available health professionals working in the area of adult ADHD,” Associate Professor Sciberras says.
It’s important to remember that not every person with ADHD gets diagnosed during their childhood. Services need to be increased to meet the need to support adults with ADHD.
Associate Professor Sciberras says that many people realise that something is amiss after they leave school.
“When they add study obligations, work and home responsibilities and family stresses on top of just living, it can make ADHD related difficulties more noticeable,” she says. “They might realise how much effort they’ve been putting into keeping things afloat.”
The research undertaken by Associate Professor Sciberras and her peers emphasises the importance of investing in clinical care for people with ADHD – from young children through to adulthood.
She says that the considerable socioeconomic impact of ADHD should drive investment and policy decisions to improve its identification and treatment.
“A lot of the costs that we estimated are about lost productivity in adulthood, but when we provide earlier diagnosis and treatment, it may lead to better outcomes,” she says. “We’re currently working with Deakin’s health economics team on further research to establish the economic and social burden of ADHD in Australia.”
Curious? Check out Insight’s episode on adult ADHD at SBS On Demand.