One person who’s been doing amazing work to address some of these issues for people with ADHD in Australia—especially for kids—is Zac Altman. He’s the founder of Kantoko, a subscription-based telehealth platform providing accessible ADHD assessment and care. His inspiration comes from his own journey through the long and confusing diagnosis process. The platform’s goal is to make accessing ADHD support as easy as possible—which can be an uphill battle for many Australians.
ADHD diagnosis rates in Australia are in line with worldwide figures. It is thought to impact around 2—6 percent of the general population. Those same people struggling to access care find themselves with months-long waits to see a specialist. On average, these delays stretch from six to 18 months. The current lack of mental health professionals only exacerbates this delay. They just don’t have the capacity to reach the growing demand in ADHD services.
Altman’s personal experience, while not his main focus, is emblematic of the more systemic problems plaguing our healthcare system. Upon returning to Australia, he was forced to pay nearly $1,500 out of pocket for the same diagnosis. That included an upfront fee of $1,000 just to get an appointment with a psychiatrist in New South Wales. His experience provides a window into the frustrations most Americans face when trying to make their way through our current healthcare system.
Providers play a key role Specialists first take the lead in managing the initial diagnosis and stabilization of ADHD. From there, they start transitioning care to general practitioners (GPs) through a co-prescribing model. This patchwork system creates issues for patients, especially those moving across state lines. Not only do they have to adapt to various rules, but they might have to find new experts on the fly.
The differences in the rates of adult ADHD medication prescriptions between Australian states make it all the more confusing. Only Western Australia and the Australian Capital Territory (ACT) have worse prescribing rates. These rates are higher than the rates of any other states – even the Northern Territory. South Australia, Tasmania, Victoria and the Northern Territory lag behind the national average for timely diagnosis. They fail to ensure that we have the best possible treatment options.
“It seems somewhat unreasonable to expect every psychiatrist to know every quirk across the country … which is why I would argue we should have some sort of national standard around this stuff.” – Zac Altman
Dr Alison Poulton, senior lecturer in pediatrics at The University of Sydney, highlights fostering a continuity of care and solid, long-term relationships between GPs and their patients. These connections are essential for effective management of ADHD.
She hopes that increasingly deepening these relationships will help her to reduce risks associated with ADHD treatment. Even more importantly, it will promote a much-needed, more holistic approach to patient care.
“Decisions should be made between the GP and patient, not based on a letter written five years ago.” – Dr. Alison Poulton
The current Australian government appears to recognize that yearning for reform. They aren’t stopping there — they’re dedicated to making ADHD prescribing rules uniform and nationally consistent. NSW, ACT, South Australia, and Western Australia plan to allow specially trained GPs to prescribe ADHD medications independently by 2025 and 2026. Meanwhile, Queensland has already implemented measures allowing GPs to prescribe certain ADHD medications for children without prior approval since 2017.
Despite these positives, there is still a lot of unanswered questions about how these reforms will affect access in rural vs urban areas. Roger Paterson, an Aboriginal psychiatrist who works in Western Australia, has spoken out about the dangers of “postcode privilege” in healthcare access.
While some areas are moving in the right direction, he acknowledges that many others still haven’t figured that out.
“There would be less concern about lower GP numbers who are highly trained, and more concern about higher GP numbers who are less trained.” – Dr. Roger Paterson
The disparities in treatment availability have led many to worry about negative impacts on patients’ lives. Dr Paterson expresses concerns that we don’t want to end up in a situation where access to stimulant medication was similar to that for cannabis via medicinal cannabis clinics.
“No-one really knows why [some states lag], beyond the NT not having many specialists — paediatricians or psychiatrists. But they are all gradually catching up to the ADHD prevalence rates.” – Dr. Roger Paterson
It’s easy to see why Altman founded Kantoko out of frustration with the current system. His goal is to make ADHD support more accessible and affordable to everyone affected by this condition.
“The worst-case scenario is that stimulant medication becomes as accessible as cannabis from the medicinal cannabis clinics.” – Dr. Roger Paterson
Altman’s establishment of Kantoko reflects his frustration with the current system and his desire to create a more accessible and affordable means of support for individuals grappling with ADHD.
“Kantoko wouldn’t exist if Australia had nailed it. I wouldn’t have gotten so frustrated that I started this business and embarked on this journey if it were easy-to-access and affordable.” – Zac Altman
