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Mental Health and Wellbeing – ADHD Support

Dr Rosalie Woodruff MP

Dr Rosalie Woodruff MP  -  Tuesday, 24 November 2020

Tags: Health, Mental Health, Disability

Dr WOODRUFF - Minister, just a change of topic. I want to raise an issue which has been raised with me by a number of constituents in relation to Attention Deficit Hyperactivity Disorder (ADHD). It is the most prevalent childhood neurodevelopmental disorder and the estimates range but it's around 4 per cent. ADHD is estimated to affect 21 000 Tasmanians - most of them are adults and it reflects the persistence of ADHD into adulthood and the lifelong impact of ADHD. This has come to be understood only relatively recently and there is a perception amongst the community and also amongst GPs that it is something that children grow of it. That is not the case. Deloitte did a study on it last year showing it has substantial social and economic impacts. The good news is that there is internationally-recognised robust evidence-based diagnostic criteria. Treatment is available and service delivery models have been defined internationally.

Australia hasn't yet adopted a universal set of treatment standards although a consensus document between states is in an advanced stage of development. There are no treatment services in Tasmania and there is no non-medical support. Non-medical support groups are effectively non-existent for people living with ADHD and their families.

Whether you are aware of it or not, the evidence is that Tasmanian adults living with ADHD currently face inadequate diagnosis and poor access to treatment and to services, particularly in regional Tasmania. We have a situation which is poorly understood and is reflected by the inaccessibility essentially for most adult Tasmanians, the estimated 21 000, who can only access treatment if they go to private treatment, mostly Hobart or Launceston. It is something that the Tasmanian Department of Health and you as Mental Health minister, need to investigate.

Mr ROCKLIFF - Can I be so bold to ask you what you are quoting from?

Dr WOODRUFF - Thank you for asking. I thought you might have a copy of this. It is addressed as a proposal to seek cross-party support. It is called, 'A case for resourcing the Tasmanian Health Service to meet developing national standards for the treatment of ADHD'. This is an initial briefing draft, so maybe you have not been sent a copy of it yet.

Mr ROCKLIFF - I will check my records but it sounds very interesting.

Dr WOODRUFF - It is something that does not require a substantial amount of investment from the Government. It does require some Tasmanian support to develop whole of national government guidelines, which are in an advanced stage. Tasmanian academics at UTAS happen to have a particular expertise in this area and they can and are already doing that work.

Mr ROCKLIFF - We need to examine that further and we are happy to do so. I will have the draft, I am not sure if it arrived on your desk -

Mr WEBSTER - Through you, minister, the Chief Psychiatrist is vaguely aware of the report you are referring to and advises that we do need to examine the report. It is new information out. This is an area that Australia-wide not many resources have been put into it, so it is something we would need to examine over time. The short answer is it is not something we have looked at to this point.

Dr WOODRUFF - That is great news and I will make sure I pass this on to your office. The important thing is that is not only about ADHD, but about the co-morbidities with other disorders like bipolar disorder and major depressive disorders and the fact that people can make fairly simple changes through treatment that can make huge differences to their quality of life and engagement with society. Thank you, I will pass that on.

Mr ROCKLIFF - Thank you for bringing it to our attention. It will probably come to me in some form.

Dr WOODRUFF - I was only approached fairly recently about this.

Mr ROCKLIFF - I will take that on notice and with great interest, I will read it.


Dr WOODRUFF - Minister, for a while I have been in touch with a grandmother who lives in southern rural Tasmania. She has a 29-year-old grandson who she is responsible for caring for who has battled for many years with alcohol and drug addiction and mental health issues and homelessness. In the last couple of months, he has been hospitalised with an overdose at least four times, three times in the week before she contacted me in October. He has had many traumatic episodes in his life including being bashed up multiple times, raped, put into the boot of a car, coerced into stealing to feed his addiction. She is very clear that he is no saint but he is a good person who has a terrible disease and is not, she feels, treasured appropriately in the state. He has been diagnosed with ADHD and anxiety, continuing on with the adult ADHD issue I was talking about before.

This person needs a lot of things and there's not one single fix but she is really clear that something that has never been available is specialist trauma counselling. Where would someone who lives in rural southern Tasmania with no money for private medical treatment be able to access specialist trauma counselling for her grandson?

Mr ROCKLIFF - I will seek some advice on that. I wouldn't like to advise and not get that right. I am happy to take this offline and talk about your constituent. We might have some information from our chief psychiatrist if he is still online to provide you with some answers on early intervention. We covered that extensively in our Education Estimates this morning about trauma-informed practice and the initiative of $14 million over four years for our young people in our schools to reduce all those barriers to education. Trauma is a significant one.

Part of our bilateral agreement with the federal government is to invest. We've chosen disability and trauma as two areas where we're investing some of the growth funding. I'm hoping that level of funding in the early intervention space can prevent circumstances such as the example that you've used. I am not sure of the individual's exact circumstance but early intervention in that sense will be key for our education provision. Mr Webster do you have anything?

Mr WEBSTER - Obviously with fairly complex co-morbidity issues it is important for us to get more detail than we have just in a brief question. The starting point for anyone in Tasmania is the Mental Health Helpline which actually triages and can direct to other services. It is important that given the level of co-morbidities we do not give advice other than contact the helpline. We need to work through the particular case.

Dr WOODRUFF - I'm not asking for a number. I am asking is there publicly funded specialist trauma counselling that this woman would be able to - she's rung hotlines many times of course. This has been going on for a long time. She is just very desperate and sad about the fact that it seems very difficult to get traction on an intervention. It needs deep-seated trauma counselling, she feels. I am not prescribing but that is what she has asked.

Mr WEBSTER - It does depend on the type of trauma. You described their sexual assault. There is good trauma counselling through the Sexual Assault Support Service which is funded. Given the level of co-morbidities we'd be reluctant to say, there's the referral. We would need to get more details to see the type of trauma and where the referral should be to.

Dr WOODRUFF - Okay, so you'd recommend that people like that go to the hotline or maybe I could approach you, minister, with some details. Which would you recommend?

Mr ROCKLIFF - I recommend you approach me and give me some details.

Dr WOODRUFF - Okay, I'll do that.