As five-year-old Ayla anxiously awaits beginning kindergarten next fall, her path has been paved with unexpected twists and turns. Like many from the newer generation of ingredient label readers, Sarah Jackson, Ayla’s mom, fears that her daughter may be developing ADD. This condition has recently impacted Ayla’s older sister. These fears are compounded by what many have called a crumbling mental health system in Western Australia. An enormous backlog in diagnoses leaves an estimated 17,000 families awaiting the results of their tests in limbo.
Now, Ayla would not be able to get an ADHD diagnosis from her GP because of her age. In Western Australia, GPs are not able to diagnose ADHD in children under the age of 10. This limitation increases the burden on families such as Ayla’s, who are already experiencing challenges in finding care when they need it most. Sarah Jackson testified to her annoyance that there wasn’t a guaranteed time to wait before being seen by a specialist. She stressed that the large waiting lists maintained for health professionals are damaging society as a whole.
As Ayla’s mother Sarah Jackson noted, it’s never too early for an accurate diagnosis to be life-changing. She believes that understanding Ayla’s potential challenges will allow both the family and the school to provide the necessary support for her development. It would enable me and the school to better meet the needs of her support. With this support, she won’t get too far behind.
A Growing Crisis in Mental Health Services
The public waiting list for new pediatricians in Western Australia has recently reached over 12,000 children. This alarming number is only the tip of the iceberg that reflects the systemic inequities and injustices pervading the healthcare system. Families are forced to leave their children in unmet needs while waiting without an appointment date for a possible appointment. Jackson stressed that “it’s undervalued, the impact that that wait list is having on our society. Families need more support.”
Other Australian states such as Queensland have enjoyed a more laissez faire approach. Yet they don’t stop there – they have set up GPs to diagnose and prescribe ADHD medication for children as young as four. This has led to calls for similar policies in Western Australia to help alleviate the strain on families awaiting diagnoses. Niroshini Kennedy emphatically asserted that in order to accurately diagnose and treat ADHD, general practitioners must adopt a multipronged approach. She urged increasing the capacity and confidence of healthcare providers.
Families such as Ayla’s are doing so every day. They tend to bear added emotional burdens that exacerbate anxiety, stress, and fears over their children’s futures. Jackson admitted, “I don’t know what the future holds for Ayla and that’s … scary.”
The Impact on Early Education
Ayla’s difficulties with transitions in her first year of school emphasize that immediately diagnosing and treating these issues is vital from the very beginning. Without appropriate and timely support, children with ADHD are frequently mischaracterized. When teachers call them “hard to handle” or “troubled,” it can lead to their education being compromised. Jackson stressed that just having the knowledge that she has ADHD disarms the teacher’s implicit bias. Not only does this knowledge foster a more compassionate learning culture for her,
Dr. Peter Jones, a pediatrician intimately familiar with this issue, emphasized the increasing cadre of geriatric general pediatricians. He stressed the dire requirement for systemic changes in order to meet this challenge. The average age of general pediatricians is increasing. What we should do about that … we’ve got to work our way through that,” he said. As the future demand for services continues to grow, we need to be proactive so that children like Ayla can get the care they need when they need it.
These early years are critical for developing children’s skills, and subsequent delays in diagnosis can have long-term consequences. Jackson explained that with no right diagnosis kids end up in this like in between world of “limbo land.” As she said, “By the time she eventually gets to decision between a GP and the paediatrician, it’s going to be too late for her.”
A Call for Change
The chaos surrounding ADHD diagnosis in Western Australia is symptomatic of a much larger problem plaguing the healthcare system at its core. Families are waiting months on end and being denied access to critical specialists. Sadly, this is the new reality, and it makes the case for improved service more critical than ever.
Families and healthcare providers alike understand the need for reform. Sean Stevens, who trains GPs on ADHD diagnosis, said, “For now we think it’s appropriate that we just target children as young as 10 and over. Unfortunately, this marks a growing trend since it’s becoming harder to fund developmentally appropriate options for younger kids.
Advocates have been working around the clock to change policies, increase access and break stigma surrounding mental health. Families like Ayla’s can only dream of a future where faster diagnoses allow children to really flourish in their educational settings. The ongoing discussions around recruitment of more GPs and pediatricians in regions like Tasmania may offer a glimpse into potential solutions for Western Australia.
