Simon Behrakis MP
19 June 2024
Mr BEHRAKIS (Clark) - Honourable Speaker, I move -
That the House:
(1) Notes:
(a) that according to a Deloitte report, "The Social and Economic Costs of ADHD in Australia," it is estimated that approximately 4% of Australians have ADHD. The report states that in 2019, the total social and economic costs of untreated ADHD were $20.42 billion. Per person, this amounts to $25,071. These costs encompass health system costs, productivity losses, education, and even crime and justice system expenses;
(b) the Rockliff Liberal Government’s commitments to employ new General Practitioners with special interests in this area and make regulatory changes to allow GPs with special interests to prescribe appropriate medications; and
(c) more work is required to ensure that Tasmanians with ADHD have the best possible access to diagnosis and treatments.
(2) Refers the following reference to Government Administration Committee B to inquire into and report upon the availability and efficiency of the assessment and treatment of Attention Deficit Hyperactivity Disorder (ADHD) and support services for people with ADHD in Tasmania, with the following Terms of Reference:
(a) adequacy of access to ADHD diagnosis;
(b) adequacy of access to supports after an ADHD assessment;
(c) the availability, training and attitudes of treating practitioners, including workforce development options for increasing access to ADHD assessment and support services;
(d) regulations regarding access to ADHD medications, including the Tasmanian Poisons Act 1971and related regulations, and administration by the Pharmaceutical ServicesBranch (PSB), including options to improve access to ADHD medications;
(e) the adequacy of, and interaction between the State Government and Commonwealth services to meet the needs of people with ADHD at all life stages;
(f) the social and economic cost of failing to provide adequate and appropriate ADHD services;
(g) another related matters; and (h) that the Committee report by 31 March 2025.
In my Address-in-Reply, I said I had more to say about the matter of Attention Deficit Hyperactivity Disorder (ADHD). In early 2023, I was diagnosed with ADHD, or Attention Deficit Hyperactivity Disorder. This is not something I have spoken openly about before, initially due to worry or concerns about whether doing so would be self‑damaging or career limiting, and I suppose time will tell.
I do not say this now for my own benefit, but to acknowledge the experiences faced by neurodiverse Tasmanians and the work needed to improve the way they are supported. I would like to acknowledge the inaugural speech of the member for Lyons, Andrew Jenner, last week and his courage and openness outlining his experiences with ADHD as well as dyslexia and the need to reduce stigma and normalise talking openly about this subject.
When I say I was diagnosed in 2023, it would be more correct to call it re‑diagnosed. I was told that I had ADHD as a child. I was that typical story of the kid who was told he was bright, but only if he applied himself more in school, otherwise you would never get anywhere in life. I was often disruptive in class. At the time, the conventional wisdom was that children would 'grow out of it'. This belief, coupled with the many sensational stories in A Current Affair and Today Tonight and those sort of shows about how ADHD medications like Ritalin were going to turn your kids into zombies, the result was me discontinuing treatment past high school.
As we now know, children with ADHD do not grow out of it, it just presents itself differently in adulthood. As I grew a found myself struggling with various aspects of my life that seemed inexplicably challenging. In 2022, a severe case of burnout gave me calls to reflect on my childhood diagnosis. I Spoke to a GP to begin the process of being re‑diagnosed. The process, I must say, was arduous and seemed challenging for people with ADHD, a condition which when untreated is often presented by chronic procrastination and bad organisation. The first General Practitioner I spoke to was very cynical from the outset of the idea of me having the condition, suggesting instead that I possibly had an iron deficiency. They eventually agreed to provide me with a referral and referred me to a psychologist, who told me that they were more than happy to provide me with therapy. I had no idea why I was referred to them because they could not diagnose nor prescribe, as that was the job for a psychiatrist. I then went back to a General Practitioner and had to start that whole process again from scratch.
When I finally sat down with a psychiatrist who was able to diagnose and prescribe treatment, it was almost 10 months later, a timeline that would have been much longer if a cancellation had not opened up an earlier appointment for me. That period of uncertainty and limbo was a hard time, feeling burnt-out and wondering when I would be able to stop treading water and move forward with my life.
Gratefully, my story does have a happy ending. The good news is in the majority of cases, ADHD is very treatable and treatment is often literally life-changing. Talking to other people with lived experiences online on Facebook and other groups it was made apparent to me that my circumstances were almost a best-case scenario. There were many people waiting much longer and people facing prohibitive costs to access treatments, and other roadblocks.
When I said that my diagnosis was a re‑diagnosis, it is an important point to make because going through this process from the beginning, I knew fora fact what was wrong with me and I knew what diagnosis and treatment was needed. For someone who is not aware of what their condition is, confused as to why they are the way they are, burnt-out or frustrated at their inability to get their life together or to stop getting in the way of their own success, they would have and do have an even harder time getting to where they need to be or get the care that they need. Waiting lists across the country are such that clinics have popped up offering ADHD diagnosis at a completely unreasonable cost, sometimes as much as $3000 to allow people to jump the queue.
Not only is this undeniably price-gouging vulnerable people. It turns the process of medical care into a transaction. People will go there and spend hard‑earned money to get a diagnosis. When you are spending $3000 for a diagnosis, you expect one, even though for some people that might not be the right thing.
The current regulatory framework in this space further limits the already limited capacity to treat the condition in Tasmania. I had long considered whether to publicly speak about my experiences. Like many in similar positions, I worried that talking about it might hurt my career or lead people to not take me seriously.
However, prior to the election, I had a conversation with the CEO of a local advocacy group who mentioned that they also had ADHD, and stated that I was the first person in the professional world that they had met who had the condition. I promised them that was definitely not the case. I was just the first person to speak about it to them.
They expressed to me how powerful it would be for someone in my position to speak openly about their experiences, to help normalise the condition for those that are struggling with themselves, to help them feel less stigma and to help them feel more empowered to seek help.
They were right, as was the honourable member Mr Jenner with his comments. There are people with ADHD who are doing it tough. They are doing their best and they need support. However, appropriately treated and managed, people with the condition can be found among successful parliamentarians, world leaders, CEOs, celebrities, elite athletes, businessowners and more.
As someone privileged enough to stand in this place, I feel a responsibility to not only speak about this, but to work to improve the processes and outcomes for people with ADHD in our state. These systems need to be streamlined to ensure that individuals can access the care they need without unnecessary delays.
Deloitte's report titled 'The Social and Economic Costs of ADHD' in Australia estimates that approximately four per cent of Australians have ADHD. The report stated that in 2019, the total social and economic costs of ADHD were$20.4 billion, which amounts to approximately $25,000 per capita.
These costs encompass health system costs, productivity losses, education, and even crime and justice system expenses. These figures highlight the significant impact ADHD has on our society and underscores the need for effective management and support systems.
There are very few psychiatrists that are equipped to treat Tasmanians with this issue and their books are almost always full. Existing protocols and regulations make it harder for individuals to access psychiatrists and medication. For those of us with ADHD, the journey to diagnosis and treatment can be fraught with obstacles.
We need to address these issues comprehensively. We need to increase the availability of specialists, reduce waiting times, and ensure that the process for obtaining medication is as straightforward and easy as possible.
Having spoken to medical professionals in the field, one of the issues that I have been able to identify amongst the many issues is that Tasmania does not currently allow co‑prescribing between a specialist psychiatrist and a nominated GP. This means that the limited number of psychiatrists in Tasmania who treat the condition have their books full of patients like myself who are on stable treatment and who need to attend twice a year to get their scripts renewed. This is something that can and should be able to be carried out by a patient's GP, as occurs in other states, freeing uptime for psychiatrists to see new patients. Treatment by way of stimulants currently ceases after 70 years of age, a regulation that is not supported by healthcare professionals and for which there is little justifiable evidence. The prescription of stimulant medication is effective in decreasing the use of illegal drugs. Regulations that make access to such medication more difficult for people with a history of drug use risk being counterproductive to this intention, and results in those who need assistance to get their lives on track finding it harder to access that very assistance.
These are just a handful of the many suggestions that have been raised with me. While I fully appreciate the need for regulations to ensure people are kept safe, it is imperative that we look into this issue to see if there is a better way to ensure that those with this condition can be diagnosed and access treatment in the most effective and efficient way possible.
I have been meeting over the last few months with psychiatrists, GPs, members of the AMA and other subject matter experts. What I have learned is that while I have some lived experience regarding this condition, the issues and solutions are both numerous and complex, and well outside my expertise. It requires a larger effort to identify these issues and solutions with the input of a broad range of medical professionals and those with lived experiences who can engage with and understand this issue in the Tasmanian context.
I acknowledge the fantastic work that was undertaken by the Senate inquiry into assessment and support services for people with ADHD, brought on by the Greens, which brought much‑needed attention to the issue and identified a range of broad issues and solutions in the national context. It identified this as an issue across the nation, requiring increased funding, resources and regulatory change at the national level. I am not aware of what progress has happened federally since that time. The inquiry did note a lack of services, stating:
· Lack of services, limited availability and long wait times for healthcare professionals to diagnose and provide medication and other supports to people with ADHD.
· Lack of services in the public health system, especially for adults with ADHD, and insufficient services in rural, regional and remote areas.
· High cost of services, including insufficient coverage under Medicare, the Pharmaceutical Benefits Scheme, and the National Insurance Disability Scheme.
· Poor consumer experiences caused by a lack of reliable information about ADHD, overly bureaucratic processes, fragmented care, inconsistent prescribing regulations, and stigma and variable quality of healthcare associated with ADHD, as well as the use of stimulants.
· Lack of supports in schools, out‑of‑home care and correctional facilities.
· Specific challenges for key groups including girls, women, and gender diverse people, First Nations people, and people from culturally and linguistically diverse backgrounds.
Particularly of relevance in Tasmania was the acknowledgement of the disconnect and inconsistent rules and regulations between the Commonwealth and the states, and the issues that require action at the state level.
This inquiry is intended to complement, rather than duplicate, the work of the Senate inquiry, and identify what we can and need to do in Tasmania in the Tasmanian context. For anyone who has watched me in this place or during my time on council and wondered about my mad fidgeting or my shifting around like a maniac, this may play some part in providing an explanation - and I promise I am paying attention. This is just one of the many ways ADHD manifests in everyday life, and it is important to understand that these behaviours are not signs of disinterest or distraction. It is an example of why it is important to improve understanding in this space and address stigma.
I have had a number of comments made about me in that regard, including a video that was made up of clips of me fidgeting in this place during the election put up as a reason not to vote for me. I have a pretty thick skin - which I personally believe is necessary in politics - however, the message that that sends to others living with the condition, wondering if they should be open to their friends or employers, or suffering from impostor syndrome, is that they do not belong or that they have not got what it takes.
That lack of understanding of the condition is a large factor in the stigma surrounding it. Many say it is little more than hyperactive kids who need more discipline. As someone who grew up in a traditional Greek household, I can say I received plenty of discipline, and I can tell you now that it is not a cure.
During the election, I shared on social media an announcement under our 2030 Strong Plan to employ new general practitioners with special interest in this area and make regulatory changes to allow GPs with special interests to prescribe appropriate medications, which is a great step forward. However, to say that some of the comments online and on other candidates' posts on the matter were ignorant is an understatement. They are largely summed up by one comment, which read:
ADHD is just kids who didn't get enough discipline. Isn't it funny how ADHD didn't seem to exist before the 90s and now suddenly everybody seems to have it?
ADHD did not exist before the 90s in the same way that gravity did not exist before Isaac Newton discovered it.
ADHD, especially in adults, is often very different to the stereotype. It is not bouncing off the walls and getting distracted by anything and everything. It is often exhaustion caused by not being able to slow down your brain from running at a million miles an hour. It is chronic procrastination, despite every intention to do what you should or need to be doing. It is forgetting to respond to messages that you promised yourself you would do later - until you have left it so long you feel too awkward or ashamed to act on them.
It is not paying bills, not because you do not have the money to do so, but because you said you would do it later. It is rocking up to appointments late on a regular basis, always with an excuse. It is routine burnout, impostor syndrome. It is anxiety and being mad at yourself for not being able to get your act together, even though you promised you would.
Once again, in the vast majority of cases, these symptoms are very treatable. Treatment is well understood and effective, which is why it is so important that those who need it are able to access it and are able to be appropriately diagnosed and treated.
Em Rusciano, a notable Australian with ADHD, has described her experience as feeling like she was from another planet and struggling to fit in. She highlighted the relief, grief and eventual acceptance that comes with a late diagnosis, and how understanding her condition has profoundly changed her self‑perception. This resonates with me and underscores the importance of understanding and support for those with ADHD. We need to shift our perspective from viewing the condition as a deficit to recognising the unique strengths and perspectives that individuals with ADHD can bring to our society.
I have raised these issues with both the Premier and the Health Minister, both of whom have been very receptive, supportive, and eager to work on improving the systems of diagnosis and treatment for Tasmanians with the condition. The Tasmanian government has increased the number of paediatricians and child health medical specialists employed in our public system by 32 per cent. The Tasmanian government also directly employs school psychologists who undertake assessments and provide interventions to support learning, engagement, and positive student outcomes.
It is crucial that we continue to take concrete steps to address the systematic barriers that prevent individuals from accessing the timely and effective care that they need. We need to invest in training for healthcare providers, improve public awareness, and create a more empathetic environment for those living with ADHD.
The Senate inquiry into ADHD has provided valuable insights and recommendations from a federal perspective. It emphasised the need for a standardised approach to ADHD diagnosis and treatment, which includes developing consistent prescribing rules and improving the Medicare Benefit Schedule and Pharmaceutical Benefits Scheme.
The inquiry highlighted significant barriers individuals face, such as lengthy wait times, high costs and fragmented care. These findings underscore the necessity for states, including Tasmania, to implement improvements in their own systems to better support individuals with ADHD.
I want to share some specific stories of Tasmanians with the condition who have spoken out about their difficulties. One mentioned:
Receiving an ADHD diagnosis has been life‑changing. However, it has also made me reflect on the missed opportunities and how different my life could have been if I had received a diagnosis and treatment as a teenager.
This highlights the critical importance of early diagnosis and support. Another Tasmanian expressed frustration with the current system, saying the lack of information and qualified professionals who could diagnose and treat ADHD has reached a crisis point. As I said, my story has a happy ending. I am successfully receiving treatment, but others are struggling. Through an inquiry, we can work together, drawing on the expertise of medical professionals and the lived experiences of individuals with ADHD to help create a more accessible and supportive system. It will provide an avenue for the thousands of other Tasmanians who have had similar experiences and are struggling with navigating the status quo to contribute and have their stories heard.
We must ensure that the right supports are received at the right time, from educational support to individual and family support, or medication if that is required.
Thank you to members for their discussion on this motion over the past day. I understand the Greens have a minor amendment to tighten up some of the language in the terms of reference, and we are happy to accept that.
Thank you, Deputy Speaker, and thank you to everyone in this place for their indulgence on this issue.
Members - Hear, hear.
Ms HADDAD (Clark) - Deputy Speaker, I start by giving a huge thank you to my colleague, the member for Clark, Mr Behrakis for speaking so personally and so passionately from his own experience. I was not aware of his adult diagnosis of ADHD, and it is a very generous thing for the member for Clark to have shared his own personal story and his diagnosis pathway with the Chamber and with the Tasmanian public tonight.
He has not only shared his experience of ADHD, but he has put forward a really practical motion to refer to Committee B an investigation into ADHD treatment and the availability of treatments and so on in Tasmania. It is an extremely practical thing to put forward out of his own experience, recognising that his experience reflects the experience of thousands of Tasmanians. I want to put on the record that I think it is great that you have done this, Simon, it is really generous of you to share your story.
The kinds of things that he shared are the things that my friends with ADHD, particularly those who have been diagnosed as adults, have shared with me as well. There is incredible stigma and discrimination around neurodiversity generally, but particularly ADHD. I have heard some of those similar things that Mr Behrakis shared: 'It did not exist before the 90s', and 'How come all these kids are being diagnosed with ADHD now and it did not happen back in my day?'; or 'It is just kids being naughty'.
We all know that that is wrong, but unfortunately that kind of stigma and discrimination still does perpetuate in our community. It is really sad that it does. It does so through lots of misunderstandings and misconceptions around what ADHD is and misunderstandings around what we thought it looked like back in the 80s when I was going through school. There was an assumption that ADHD presented in one particular way, usually in young boys. We know now that that kind of hyperactive behaviour - that is not the terminology used in the diagnosis anymore - but that expression or that demonstration of ADHD is not the only way that ADHD presents.
This is particularly the case when it comes to girls, and girls have been massively under‑diagnosed with ADHD. It often presents very differently in girls and in gender‑diverse people than it does in boys and men, but it can equally present in different ways in boys and men as well. There is an increased understanding of ADHD around the country. I hope that what that leads to in the future is a reduction in the discrimination and stigma that is felt by people. An increase in diagnosis does not mean an increase in prevalence, it means an increase in understanding, and an increase in the ability for people to deal with neurodiversity, in particular, ADHD.
I appreciated what Mr Behrakis said around treatment. It is really important that people are able to seek treatment and seek the advice that they need to support their lives. I also want to reference the work of the Senate committee. Today, I spent some time reading some of the Tasmanian submissions to the Senate inquiry that concluded its work last year, because they really do demonstrate just how difficult things are for Tasmanians who are investigating a diagnosis of ADHD. How long the wait times are, how hard it is to get in to see, first of all, a psychologist for a referral, then either a paediatrician or a psychiatrist, depending on your age, then the wait time to see the psychiatrist or the paediatrician, then the long discussion about trialling medications.
One mum, a friend of mine who has a teenager with ADHD, described the medication process - once you get through all of those wait times and are facing the chance to finally trial different medications - as like tuning a radio. You might try one medication and it is completely wrong for you. It might be the right medication but the wrong dosage. It might be the wrong medication, and it can take months or years to get that right.
Once somebody is on a stable medication, it is not right that they are still facing barriers, as the mover described, like having to go back to a psychiatrist or paediatrician for treatment more regularly than is needed for someone who has a stable diagnosis. That is a massive barrier for those people who are managing their ADHD, but also for others who are waiting on those invariably long waitlists, or waiting to see, as we know, many private clinicians whose books are closed altogether.
The AMA in their submission to the Senate inquiry talked about the fact that ADHD is the most prevalent neurodevelopmental disorder in Australia, affecting about 8.2 per cent of the population nationally. It also referenced the Deloitte report that Mr Behrakis spoke about regarding the social and economic cost of ADHD, which is estimated to be huge, about$20.4 billion. That equates to $25,000 per person, not to mention the kind of social impacts that lack of access to treatment has on people who have ADHD.
They talked specifically about some of the barriers to treatment in Tasmania. They said private paediatricians did not regularly take new referrals in southern Tasmania at the time that they were writing, and not much has changed since then. This puts greater burden for assessment and treatment onto the public system, and the wait times in the public system are very long. They mentioned that school support funding is dependent on a diagnosis, as is NDIS funding, although NDIS funding is not available for ADHD alone; there needs to be comorbidities. They talk about the delays in assessment meaning that delays in getting support affect people, particularly in crucial early learning years.
They talked about access to private psychologists, psychiatrists and paediatricians being expensive and said there are prolonged wait times. They noted Tasmania has the poorest and most distributed population, making access to services for large rural or semi-rural populations even harder. They said that some patients would travel interstate for care, but then you run into the issue around prescriptions. Anyone who has been down this pathway will understand how frustrating it is waiting on those waitlists for referrals and then diagnoses, then finding out you can access telehealth services in another state or territory. However, if you do go down that pathway and you end up with a prescription that cannot be filled in Tasmania, you have to go back onto the Tasmanian waitlist until a Tasmanian prescriber can prescribe whatever medication is recommended for you to trial.
It is a national issue, but it is something this committee will be able to look at and make recommendations on. It is an incredible frustration. Part of it, to my mind, is a misunderstanding, an assumption that people have around the use of amphetamine or stimulant‑based medications. People unfairly assume that there is an intention to misuse. The same is true of opioid pain relief, but that is not relevant to this debate today. I think that is a real shame. It is handled differently in different states. The Australian Medical Association went to that a little in its submission, saying:
In Tasmania it seems that fear of medication diversion and fear of increased substance abuse in those treated with stimulants seems to be a prominent driver for assessment and treatment barriers, including the recent extremely unhelpful tightening of guidelines on a single prescriber that's not backed by research.
The AMA said it found no indication of increased risk of substance abuse among individuals prescribed with stimulant ADHD medication. If anything, the data suggested a long-term protective effect on substance abuse. In the history of drug-taking, even though we know those with untreated ADHD are more likely to seek illicit drugs, it is viewed as a reason not to treat, even if it is quite distant, which is really unfair and leads to enormous suffering.
The AMA noted that some children, particularly in lower socioeconomic status families, have a draconian pick‑up restriction imposed on their prescription and their families. Even when there has been no suggestion of drug diversion, they are put on daily pick‑up routines. That is discriminatory, stigmatising and imposes a significant burden, and it makes holidays or travel problematic. It is unfair that Tasmanian ADHD patients are treated this way. It is not the case in other states and territories, where prescribing is much fairer and more streamlined. The AMA notes that every state and territory has different guidelines for treatment and called fora unified, countrywide, evidence-based provision of these essential services.
The mover also mentioned, and this was news to me when I read the AMA submission to the Senate inquiry, that there is an upper age limit for stimulant use of 70 years, which seems incredible. As the AMA and the mover said, it is not backed up by any evidence at all. With the increase in adult diagnosis of ADHD, it would be extremely distressing to maybe finally get to the bottom of what might have been a longstanding issue for you only to find that, at 70, you need to find some other way to treat something that, as the mover said, can be quite simple to treat. They note that that is a very unfair and discriminatory practice.
They also talked about the lack of child and adolescent psychiatrists in Tasmania, and it is likely that this is an area of training bottleneck. They said those that are here are faced with an overwhelming burden of work and clients. Paediatrician appointments are in short supply, yet stable diagnosed children must be seen twice a year to make dose adjustments simply for growth, or possibly to have a trial or withdrawing medication. Both tasks could be met by general practitioners.
Universally, GP capacity to share in the management of ADHD is underestimated, even though GPs routinely manage far more complex scenarios with much more dangerous drugs and drug interactions in older patients with multiple diagnoses. They said there is no need for any kind of turf war because there is such a huge, unmet need. Meanwhile, GPs are left holding children they have referred to specialists for help but who cannot get an appointment. This is stressful for the patient, their family, and the referring GP.
I am a big fan of extending scopes of practice, and the psychiatrists, psychologists and paediatricians I have spoken to about this issue share that view. They understand the demand for their part in the process of diagnosing and treating ADHD. They want to be able to do that in partnership with GPs in a multidisciplinary, patient‑focused way that makes sure any risks are mitigated and means that the patient is going to get better care and more access to services. The AMA certainly called for that and said managing ADHD patients in general practice should be supported by case‑conferencing, note‑sharing systems so that patients can be seen together with a GP, a specialist and possibly other team members, including pharmacists, speech or occupational therapists, social workers, and so on. There is an appetite for that from professionals working in this space to be able to work more collaboratively to the benefit of their patients. Unfortunately, the systems and regulations in place are massive barriers to people getting the treatment they need.
I have permission to share a submission made to the Senate inquiry by a friend of mine and his mum. Sam Mitchell was diagnosed with ADHD at age 10. He is an adult now. I would not be so rude as to record Sam's age into Hansard. He and his mum wrote a submission to the Senate inquiry and I will read their cover page. His mum, Anne, said she is:
a support teacher who has taught young people with ADHD since the 1980s, when there was widespread discussion as to whether the condition actually existed. Even now, the condition is often treated with scepticism and/or denied by some clinicians and members of the public, especially with regard to adults. This is an existential crisis for those living with ADHD and can impact the ability of an individual to succeed in all aspects of their life.
She started a Facebook group community with her son, Sam, my friend, who was diagnosed with ADHD at 10 in 2003. He was treated by a paediatrician until he was 18 and then, when he moved to Melbourne to study, he was treated by a psychiatrist in Melbourne. When he returned to Hobart after completing his studies, he could not find a psychiatrist in Hobart to take over his treatment. Several stated that they did not treat or prescribe stimulant medication for adults with ADHD. Some said their books were closed, some just refused for no stated reason. Sam continued on with his psychiatrist in Melbourne, eventually being able to apply for a Tasmanian prescription through the psychiatrist he was seeing in Hobart for a different health matter. Comorbid conditions are often experienced by those with ADHD. It took seven months to get this approval and he is currently only able to access limited dosage, having to attend the pharmacy three to four times a week.
There is a lack of consistency and integration of services, and a complete lack of public health provision for adults. This process includes the very high cost involved in accessing private treatment, with one single‑parent family having spent $10,000 on three family members and the process is still not completed, and the very small number of private providers in Tasmania who are willing to treat the condition. Many doctors have books completely closed with not even access to a waiting list or waits of over one year. One GP commented to a member of the group that he did not believe in the condition, but would complete the application as he was required to do.
This stigma and disbelief still pervade the clinical and community spaces in Tasmania, which is a real shame. It is good that the Senate was able to elicit submissions like those and thousands of others from around the country when they did their work last year. I absolutely see value in the Tasmanian Parliament similarly having the opportunity to look at specifically at what is happening here because, I dare say, all of us have had an experience with people waiting for treatment, with people being disbelieved, with people being denigrated and discriminated against and misunderstood.
Honestly, I understand how important it is that people are able to find the treatment they need but my personal view is that ADHD is a bit of a superpower. The people I know who live very healthily with ADHD, and there area lot of them, think remarkably differently. I think that is a real benefit. Medication and treatment, of course, is needed so that we can operate in a world that is not designed for people with neurodiversity, where we need to fit into particular boxes in the education system or in the world of work or study. The world is not built for neurodiversity. It is a shame that it is not, because we would all benefit in different ways if it were.
I am pleased to provide support for this motion on behalf of the Labor Party, which will refer the reference to Government Administration Committee B to inquire and report on the availability and efficiency of assessment and treatment for ADHD support services for people in Tasmania. I look forward to hopefully having a chance to participate in the committee.
Ms ROSOL (Bass) - Honourable Speaker, I thank the member for Clark, Mr Behrakis, for bringing this motion today, for sharing his personal story but also for speaking up for many people around Tasmania who have ADHD.
I echo the words that have already been spoken this evening, because there are many people who have spoken to me about their experiences with ADHD, people in my family, friends, colleagues, and professionals who are working with people with ADHD. I have heard about it many times and of many oft he difficulties that people are experiencing, including parents who are struggling to have their children assessed with current waits of up to two years within Tasmania.
When those children are unable to be assessed and receive the early intervention that they need prior to commencing school this impacts on their ability to engage with school and learn, and affects their whole future potential. I have heard from adults who have been unable to access treatment even though they were diagnosed as children, from adults who have attempted to access assessment and diagnosis, and the whole lengthy, expensive process they have had to go through to be diagnosed with ADHD. Then I have heard from adults who have difficulty with medication, accessing medication, and the obstructions they experience in accessing the medication they need. We know that stimulant medication is highly effective in managing the ADHD symptoms and helps them to function better in society and in their daily life. There are many difficulties faced by people with ADHD across the lifespan. As Ms Haddad said earlier, these were highlighted by the Senate inquiry into ADHD last year.
This motion specifically refers to many of these difficulties and highlights aspects of the lived experience of ADHD. I want to highlight one aspect, which was the reference to crime and justice system expenses that are some of the costs that people and society experience as a result of ADHD.
People with ADHD faced an increased risk of disruptive behaviour disorders and incarceration. This motion states that 4 per cent of Australians have ADHD. Where research has been conducted on rates of ADHD in prison, it was found that at least 25 per cent of people in prison have ADHD. Given the government's emphasis on hardline responses to crime, it is interesting to read in this motion an acknowledgement that ADHD contributes to crime for some people. It is beyond time that we moved away from punitive approaches to crime when we know factors such as an ADHD diagnosis can contribute to the reasons people commit crimes.
In relation to paragraph(1)(b), we acknowledge the Liberal government's commitments to employing new general practitioners with special interests. I note that two positions have been planned and are in the process of being created, which are insufficient given the size of the need in Tasmania and those issues we have heard about already in this discussion about the difficulty in accessing assessment and accessing someone who can prescribe medication for them.
We certainly agree with paragraph (1)(c) where more work is required to ensure that Tasmanians with ADHD have the best possible access to diagnosis and treatments.
The Greens support this referral to Committee B to inquire into and report upon the availability and efficiency of the assessment and treatment of Attention Deficit Hyperactivity Disorder, and note the many different aspects of ADHD that would be inquired into and reported on in this motion.
I would like to move one minor amendment to the motion. I move-
That the motion be amended by omitting from paragraph (2) 'people' and substituting 'adults and children'.
To clarify, that is the main part of paragraph (2) where it says 'support services for people with ADHD in Tasmania', omit the word 'people' and substitute 'adults and children'.
The SPEAKER - Do you have a copy to circulate?
Ms ROSOL - I have circulated it. I do not know if anybody else that wants copies.
The SPEAKER - You are moving that amendment now?
Ms ROSOL - Yes.
The SPEAKER - We are now speaking on the amendment.
Ms ROSOL - This seems like a minor amendment seeing as the word 'people' covers 'adults and children', but I think that what we know about ADHD and the experiences of people trying to access assessments, whether they are children or adults, that process is quite different for both, and there are different aspects of issues within the systems that affect adults and children. By substituting these words, it makes it explicit that we are aware of the issues for adults and children and can specifically look into both of those.
I do note that in paragraph (2)(e), it again refers to 'people' there, but it says 'people with ADHD at all life stages', which covers that. I felt that would be a doubling up to add it there, so we have only moved it for the main part of paragraph (2).
I move that the motion be amended.
Mr SPEAKER - Have you finished your contribution on the amendment?
Ms ROSOL - I have finished my contribution on the amendment. Yes.
Mr BARNETT (Lyons - Minister for Health, Mental Health and Wellbeing) - Honourable Speaker, I congratulate the member for Clark, Simon Behrakis, for coming forward with this motion, sharing his lived experience, family members and loved ones here as well and acknowledge his heartfelt contribution today, likewise his courage in stepping forward and sharing a personal story. It is a powerful message. It has been demonstrated inthis Chamber and I say congratulations, well done, to Simon Behrakis.
It is leadership in action when you can be at the beginning of this law reform measure and put together a terms of reference, which is very comprehensive and very well written. I wanted to pass that on.
I also acknowledge the other contributors to the motion tonight, Ella Haddad and Cecily Rosol. Thank you so much for that contribution.
While I am on my feet, I acknowledge the earlier contribution from Miriam Beswick, JLN, north‑west coast, Braddon, for her earlier motion as well. I paid that tribute to Miriam publicly on radio just in the last hour or so.
It is a powerful thing when members of parliament - that is the beauty of democracy, diversity in the Chamber. We can all come to this place in our own shoes. We do not have to fill the shoes of others. We are coming to this place from our own personal point of view and in terms of the level of professionalism and effort to pull this motion together, I say 10 out of 10.
The member for Clark - we have had a good deal of discussion. I know he has talked to the Premier as well. He has talked to me in my office, and that is greatly appreciated. For and on behalf of the government, we will be supporting the motion.
Likewise, I will respond to the member for Bass, Cecily Rosol, Greens member for Bass, for that amendment. It is a minor amendment. On behalf of the government, we will support the amendment. I can see where you are coming from, removing the word 'people' and inserting the words 'adults and children'. I believe people can understand where you are coming from and it is supported. So, thank you. The spirit of collaboration is working very positively in this Chamber.
I am pleased to acknowledge that, as a government, the matters that have been brought to our attention in this motion and in the Deloitte's report that Simon Behrakis has referred to in paragraph (1) that approximately 4 per cent of Australians have ADHD. As the member for Clark, Simon Behrakis, was sharing the importance of reducing stigma and raising awareness on this important topic, it made me reflect on Type 1 diabetes, which I was diagnosed with on 15 January 1997, my wife's birthday. That was a big shock for me, and for my wife and my family, my dear mother, at the time.
I did not really know what it meant, what the future would be. Josie Okey [TBC] was the diabetes educator and was wonderful and caring at the time. For me at the time - that is back in 1997, 27‑plus years ago - it was very much kept under the carpet. People did not like to talk about it. They did not disclose their condition at that time and in the decades prior. I revealed myself in due course, got involved with Diabetes Tasmania. I wrote a letter to the editor and made it clear that yes, I did have Type 1 diabetes. One thing led to another and I had the privilege of being an ambassador for Diabetes Australia for a number of decades and advocating for people with diabetes and their families. I feel this lived experience, bringing that to the Chamber, bringing that to this place where we can then produce and deliver really good law reform, really good healthcare services to support Tasmanians, adults and children alike.
I am so pleased that this motion has come forward. It has my full support on behalf of the government. I am also pleased with the committee report of 31 March next year. Committee B has a lot on its plate but it is entirely appropriate that the Government Administration Committee B inquire into this and report upon the availability and efficiency of the assessment and treatment of ADHD and support services for people with ADHD in Tasmania. The terms of reference are set out in the motion.
In the few moments I have available - I want to leave enough time for the member for Clark to wrap up and share some final thoughts on the contributions - I indicate that Mr Behrakis has made reference to the Senate inquiry. What we will do hopefully will complement the Senate inquiry. As a former senator, I know that they are very comprehensive. They do a great job. The research is very thorough. We can learn from their report and their inquiry. Hopefully, they can learn from us and what we are doing in Tasmania. We can complement one another. We can work together across the various parties and crossbenchers at the federal level and, likewise, at the state level. That is a really good thing.
I acknowledge our 2030 Strong Plan for Tasmania's future. I was with the Premier when we announced this. It was at the Moreton Medical Centre at the New Norfolk Community House. We announced this commitment to deliver and employ two new general practitioners with special interests in ADHD to work in the public outpatient clinics across the state. I am pleased and proud of that commitment. Yes, you can say it is not enough, but it is better than zero. We thought about this carefully and responded and delivered that as part of our 2030 Strong Plan. It will certainly boost services in the north and the south, and that is dearly needed, and I acknowledge that.
We are also making regulatory changes to allow GPs with special interest to prescribe appropriate medications, which the member for Clark has noted. That is a positive step. Speaking more broadly, in terms of reducing waiting times and waiting lists, and paediatricians, we are providing an additional$20 million over the next two years, with respect to last year's budget, and that will help paediatricians in this space and that will help reduce the time Tasmanians are waiting for their appointments. That is through the Outpatient Transformation Strategy.
I am also advised that demand for prescriptions has significantly increased, with data from the Pharmaceutical Benefits Scheme showing prescriptions for the two most used ADHD medications, Ritalin and Dexamphetamine, are doubling in a decade and continuing to grow rapidly. Infact, between 2015 and 2022, I am advised there has been a threefold increase in the number of Tasmanians prescribed Schedule 8 psychostimulants.
You can see there is a demand and it has been growing. Listening to the member for Clark you can see why this is an important step forward in delivering a better healthcare outcome for the Tasmanians who deserve it.
I want to leave enough time for the member to share some sum-up remarks, but I say congratulations, well done. This is exactly the way the Parliament of Tasmania can and should operate in a collaborative way, in the spirit of goodwill where we can deliver better healthcare outcomes and better outcomes for Tasmanians more generally.
For and on behalf of the government we will be supporting the motion and the amendment that has been put by Cecily Rosol on behalf of the Greens.
The SPEAKER - There being no further speakers, we are on the amendment, but I will allow Mr Behrakis to both respond to the amendment and to sum up before proceeding to the vote on both matters.
Mr BEHRAKIS (Clark) -Honourable Speaker, on the amendment, it was flagged yesterday, and it was discussed today, and I used the term 'people' as a bit of a catch‑all. I appreciate Ms Rosol's suggestions about explicitly stating some of the issues and regulations around paediatric care and a carer for adults is different. I think it does need to be addressed differently, and it does benefit to say the two out loud.
It is also important to note that one of the other issues is that those who are receiving care as children who age into adults, kind of just drop off and have to find their way through the system as an adult, almost from scratch without any guidance. There is no transfer, it is 'You are an adult now, the paediatricians will not look after you anymore, off you go into the world and figure it out'. That is another issue that needs to be looked into.
As I said earlier, and the minister said, I more than happy to support that. It is a good addition and s good suggestion.
In summary, I am on the Facebook group the member for Clark mentioned. I am a member of that group. I do mostly lurk though, at this point. I have not really spoken too publicly about it.
One of the reasons I felt it necessary to talk about this is, just over the past few minutes that I have been listening to other contributions, which I thank members for and for their support, I have gotten a bunch of messages from people I know, thanking me. I did not know they had the condition or their family member's children have the conditions. I have had people message me saying thank you so much, it is good to hear it said out loud.
A number of weeks ago when I was talking to a staff member about wanting to say something about this, I went through what might be the best way to speak about it and a couple days later, I had him say 'I think, on reflection, I might have to…' and it was a sort of funny moment, but that is part of the reason why it is important to talk about it. It is not just the people that have it severely enough that they need help getting through adult life, there are people that exist in successful professions and are successful in life that you know, you would not know what issues they have behind closed doors and do not feel comfortable speaking about it. That is why it is so important to speak about it.
Just to finish up, it was mentioned about the timeline of the inquiry. I did put that to try to be as generous as possible, I know the government committees are going to get very busy, they already are quite busy, and I know there has been some talk about the staff and the workload for them.
The SPEAKER - Desperate need for resourcing, thank you for bringing the House's attention to that, Mr Behrakis.
Mr BEHRAKIS - Yes, and just wanting to make sure that this does not constrain or put an unfair burden on the committee. It is important work, but I do not think it is something that needs to be done and completed next week. There is time to do it, there is time to get it right. Itis really important work. I thank members in this place for their support on this.
Members - Hear, hear.
Amendment agreed to.
Motion as amended agreed to.