Accessibility of ADHD Assessments in Australia: A Secret Shopper Study.

AIM This study aimed to provide a representative indication of the accessibility of both adult and child ADHD assessments in Australia for psychologists, psychiatrists, and paediatricians. Accessibility was considered in terms of clinician availability, wait times for an initial session, initial session costs, and total assessment costs across Australian states and territories, remoteness areas, and socioeconomic ranges.

METHODS Using a secret shopper design, researchers posed as potential consumers seeking an ADHD assessment for themselves and/or their child. A total of 736 clinicians were contacted via telephone between May and August 2024.

RESULTS Fifty-nine percent of clinicians responded, and 49.8% of respondents were available to book an ADHD assessment. The average wait times for psychologists, psychiatrists, and paediatricians were 7, 16, and 31 weeks, respectively (Mdn = 3, 15, and 26; IQR = 7, 16, and 31). The average initial session costs and estimated total assessment costs were $266 and $1,622 for psychologists (Mdn = 250 and 1,625; IQR = 57 and 929), $748 and $1,163 for psychiatrists (Mdn = 750 and 1,086; IQR = 340 and 555), and $500 and $598 for paediatricians (Mdn = 495 and 585; IQR = 123 and 739).

CONCLUSION This study identified substantial barriers to ADHD assessment accessibility in Australia. Low clinician availability, long wait times, and high costs for assessments are all factors contributing to healthcare access inequality. Policy changes and investment, as well as further research into contributing factors, are needed to improve availability and accessibility.