In a significant development for mental health support in New South Wales and potentially across Australia, obtaining a diagnosis for Attention Deficit Hyperactivity Disorder (ADHD) is set to become considerably more accessible and affordable. This shift is sparking a growing conversation among Australians, with many now advocating for similar improvements to the diagnostic process for Autism Spectrum Disorder (ASD).
For individuals like Ashlee Law, the journey to understanding her own neurodivergence was a protracted and costly one. She always sensed she navigated the world differently, but the subtle signs of her ADHD and autism were overlooked for decades. Unlike the commonly perceived stereotypes of autistic individuals, such as avoiding eye contact or pronounced social struggles, Ashlee didn’t fit the mould. Consequently, her challenges were often misattributed to general mental health issues.
The turning point for Ashlee came when her three children, including her daughter, were diagnosed with autism. It was through their diagnostic process that she began to recognise mirrored traits within herself. “Through my daughter’s diagnostic process I realised her traits were reflected in myself,” Ashlee shared. “I just couldn’t ignore it.”
Recent research increasingly highlights that autism often presents differently in girls and women, which explains why so many receive diagnoses well into adulthood. Females with autism are more prone to exhibiting traits such as vivid imaginations, intense and possessive friendships, mimicking others in social settings, and a tendency to suppress emotions in public, only to experience meltdowns in private. Furthermore, they are more likely to consciously or unconsciously mask their autistic characteristics – a behaviour Ashlee had unknowingly engaged in for years.
Ashlee’s personal quest for a diagnosis was a demanding five-year ordeal, costing her close to $4000 in GP visits, specialist appointments, and formal assessments. By the time she received her formal ADHD and autism diagnosis in 2019, at the age of 30, she was juggling two jobs and raising three autistic children.
While the diagnostic process was emotionally taxing, the profound sense of validation it provided was immeasurable. It offered Ashlee a framework to comprehend her own mind and how she perceived the world. “I stopped with a lot of the self-blame,” she explained. “The shift was life-changing.” However, Ashlee candidly admits she likely wouldn’t have pursued the diagnosis if she hadn’t already navigated the system with her children, nor would she have been able to afford it without existing financial stability.
In Australia, the authority to diagnose autism rests with paediatricians, psychiatrists, and psychologists. The typical diagnostic pathway involves multiple referrals, often leading to significant out-of-pocket expenses. Medicare rebates are currently restricted to eligible patients under the age of 25, leaving many adults facing substantial financial barriers. “There’s so many people that are like, ‘I think I am [autistic], I know I am, but I can’t afford the the diagnosis,'” Ashlee stated.
Despite these financial hurdles, the number of autism diagnoses is steadily increasing. ABS data reveals that in 2018, just over 200,000 Australians were living with autism. By 2022, this figure had climbed to nearly 300,000, marking an impressive increase of over 40 per cent. This surge is attributed to heightened public awareness and a more nuanced understanding of how autism manifests in women and girls. Historically, autism was perceived as predominantly affecting males, but emerging research suggests the male-to-female ratio could be as low as 2:1. As our understanding of autism in women evolves, a growing number of adult women are actively seeking diagnosis.
Making autism assessments more accessible could be a transformative experience for many women like Ashlee. This is particularly relevant given the frequent overlap between autism and ADHD diagnoses. Crucially, New South Wales is implementing significant reforms aimed at making ADHD diagnoses more affordable and straightforward.
ADHD Diagnosis Reforms in NSW
- GP Diagnoses: GPs in NSW with specialised training will soon be empowered to diagnose ADHD, a role previously exclusive to psychiatrists and paediatricians.
- Medication Scripting: Since September 2025, GPs have been authorised to issue repeat prescriptions for ADHD medication, potentially saving some families up to $1400 annually.
Dr Rebekah Hoffman, RACGP NSW and ACT Chair, believes that enabling GPs to diagnose ADHD will be a life-changing development for thousands of patients in NSW.
Associate Professor and Clinical Psychologist Jessica Paynter, a member of the Australian Autism Alliance Board, is now campaigning for similar reforms to enhance the accessibility of autism assessments. “At the moment, pathways to diagnosis for autistic adults are quite costly and quite time consuming,” she explained. “The cost can be upwards of $2000 [and] waitlists can be substantial, so they can be three months, six months, or in some cases even years.”
While Dr. Paynter advocates for significant change, she is not suggesting that GPs should be able to diagnose autism. Instead, she proposes:
- Lifting the Medicare Rebate Age Cut-off: Removing the age restriction for Medicare rebates for autism diagnosis would open up access for adults.
- Increased Government Funding: Additional government funding is needed for diagnostic resources and providers, to be channelled through the National Autism Strategy’s health and mental health roadmap.
The National Autism Strategy and its accompanying roadmap, released a year ago, aim to provide a unified national approach to services and support for autistic individuals and their families. Dr. Paynter views these as a positive starting point but stresses the need for concrete action to achieve tangible impact. She also champions enhanced training for healthcare professionals on how autism presents in women and girls, ensuring that individuals like Ashlee are not overlooked for extended periods.
Dr. Susannah French, a sociologist and independent consultant who was diagnosed with ADHD and autism as an adult, echoes the sentiment that systemic change is imperative. Her doctoral research specifically investigated why girls and women are frequently missed during autism assessments, identifying cost as a primary barrier. Compounding this, clinicians are often inclined to dismiss female presentations because they deviate from diagnostic criteria historically based on male presentations. “Autism assessment in women, unfortunately has lagged behind the research and that gap still has real consequences,” Dr. French stated. “GPs, psychiatrists, psychologists, they’ve got to acknowledge that there is an opportunity to do better work in those spaces.”
Dr. French advocates for a co-design approach involving autistic individuals to improve diagnostic pathways in Australia. She asserts that everyone deserves to understand their own neurobiology, but prohibitive out-of-pocket costs and outdated diagnostic frameworks are preventing many from achieving this clarity. The consequence is that countless undiagnosed autistic adults across the nation live without crucial validation, understanding, and access to appropriate support, therapies, and accommodations. “You think you’re useless, broken, or damaged, but that’s not actually true at all.”
