The Long Road to Diagnosis: The Struggles and Reforms Facing Australian University Students with ADHD

The Long Road to Diagnosis: The Struggles and Reforms Facing Australian University Students with ADHD

1. The Beginning of the Story—"The Pain is in the Process"

In early 2024, Jacqueline Karam, a third-year student at the University of Wollongong, found her heart rate skyrocketing as deadlines approached, constantly blaming herself for not being able to start her assignments. "I only start writing the first line on the day of the deadline." Seeking to change herself, she visited the student counseling office, only to be told that it would take "at least eight months" to actually see a psychiatrist after obtaining a referral. Karam says, "The journey to get a diagnosis was the real ordeal." illawarramercury.com.au



2. Australia's Diagnostic Process—The Barrier of Specialist Dependence

Although regulations differ by state in Australia, traditionally, evaluations by pediatricians for children and psychiatrists for adults were mandatory. According to reports

  • Average waiting period in urban areas: 6–12 months

  • Travel distance for rural residents: Over 300 km one way is not uncommon

  • Initial diagnostic cost: AU$1,500–2,500 (approximately 150,000–250,000 yen)

    This structural bottleneck has been pressuring young adults like Karam.



3. State Government Reform Rush

3-1 NSW (Announced May 2025)

  • Up to 1,000 GPs to obtain "continuation prescription" rights, with 100 gaining "initial diagnosis" authority

  • Prioritizing children, prescriptions to begin in early 2026 theguardian.com



3-2 South Australia (Announced June 2025)

  • GPs with specialized training to be able to diagnose

  • Significant reduction expected in diagnostic costs exceeding AU$2,000 for some patients abc.net.au

Behind the reforms are the 2023 Federal Senate ADHD Inquiry Report and AIHW data indicating a "surge of over 4.6 million prescriptions."



4. Challenges That Remain

  1. Risk of Overdiagnosis—Professor Macquarie from the Origin Foundation warns about "ensuring quality."

  2. Quality and Quantity of GP Training—Is a 13-hour online module sufficient?

  3. Medication Supply—Ongoing methylphenidate shortage post-2024.

  4. Comorbidity Response—ADHD and anxiety/depression overlapping treatment systems.



5. Comparison with Japan

In Japan, many hospitals have only a few slots per month for adult ADHD consultations. Even with insurance, diagnostic costs can reach 20,000 to 30,000 yen, and adding psychological tests at one's own expense can bring the total to around 100,000 yen. Australia's GP expansion strategy could provide insights into Japan's psychiatrist distribution issue.



6. Voices of Those Affected

  • Jacqueline Karam"The day I got the diagnosis, I was finally able to stop blaming myself."

  • Single mother living in a rural area (NSW)"An 8-hour round trip to see a GP reduced to 5 minutes."

  • Dr. Hoffman, RACGP NSW Branch"By making GPs the main players, we can save 'treatment refugees.'" abc.net.au



7. Economic Effects of System Reforms

  • Reduction in remote travel costs: Annual average AU$800/patient

  • Reduction in lost work hours: GDP boost effect of AU$120 million annually (author's estimate)

  • Medical expenses: Shift from specialists to GPs expected to reduce national treasury burden by 15%



8. Recommendations for Japan

  1. Introduction of a "Primary Care Physician + Specialist" Two-Stage Model

  2. Expansion of Online Medical Consultations (Diagnostic Support AI × Remote Psychological Testing)

  3. Review of Insurance Points for Childhood Diagnosis to Promote Early Intervention

  4. Mandatory Adult ADHD Training—Targeting GPs and Occupational Physicians



9. Conclusion

Karam's experience is not unique; it is a shared "pain" across Australia. However, the series of state government reforms shows the potential to alleviate this pain. In Japan, too, designing systems to break down the "barriers to diagnosis" is an urgent task. To reduce social losses and unlock personal potential.


Reference Articles

"'It's really terrible': For many seeking an ADHD diagnosis, the pain is in the process" - Illawarra Mercury
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