Summary of narrative review
The NICE ADHD guideline recommends that health professionals, with training and expertise in ADHD, should be involved in the diagnosis, assessment and ongoing treatment and support of children, adolescents and adults with ADHD as well as overseeing continuity of care (NICE, 2018). Communication and ongoing feedback between health professionals and education and social care providers is also highlighted. The importance of psychological services for people with ADHD as well as programs that provide group and individual parenting interventions as well as support groups for people with ADHD and websites are also noted.
Equity in the delivery of services for people with ADHD remains a major issue in Australia, with the majority of public health services electing not to diagnose and treat ADHD, especially in adults. This leads to the majority of people on low incomes, adults especially, not being able to access essential services.
Improvements are being made to the equitable provision of medications for ADHD, but some medications are still not available on the PBS for adults who have not been diagnosed in childhood. ADHD is not on the list of eligible conditions for entry to the NDIS. Although this does not exclude those with significant impairment from accessing the scheme, it has meant that no meaningful communication has been possible to educate the NDIS in the needs of those who are disabled by ADHD.
Service configuration recommendations within the NICE guideline (NICE, 2018) highlight the importance of giving the person with ADHD and/or their carer the option of being involved in treatment decisions and planning. Shared care protocols for medication monitoring between primary and secondary health care professionals are also recommended. Integration and better organisation between child health services and mental health services with the formation of multidisciplinary specialist ADHD teams is a further recommendation.
In addition, local multi-agency teams with representatives from paediatrics, mental health, education, social, forensic services and parent groups are needed as well as provide training and a directory of information regarding ADHD services. There is a need for models of care within the Australian context, particularly shared care.