If I want an ADHD assessment, is telehealth a legitimate option?

Telehealth assessment by a qualified psychiatrist or specialist is legitimate clinical practice — it is not an unvalidated shortcut. The concern this analysis raises is not about the clinical validity of telehealth assessment itself, but about who is accessing it (predominantly people in wealthy urban areas able to absorb higher out-of-pocket costs) and whether market dynamics have concentrated services in affluent areas rather than underserved ones. For rural or lower-income patients, telehealth remains an important access pathway; state governments are also expanding GP-led ADHD prescribing rights, which may offer a more equitable route over time.

Why are so many more women being diagnosed with ADHD now?

ADHD diagnostic criteria were historically developed and validated on male cohorts — primarily school-aged boys presenting with hyperactive, disruptive behaviour. Women with ADHD more commonly present with inattentive-type features: difficulty sustaining focus, time management problems, emotional dysregulation, and chronic overwhelm that is frequently misattributed to anxiety or depression. Decades of systematic under-recognition mean many women are now receiving diagnoses in their thirties, forties, and beyond. The telehealth expansion has improved access to assessment, which partly explains the numbers — but it also means the quality, thoroughness, and equity of that assessment process now matters more than ever.

Telehealth tripled ADHD scripts — but the access gains went to the wealthy

What just happened

A new analysis of Australian Medicare data published in The Conversation this week has put hard numbers on a pattern that the general practice and psychiatry communities have been discussing since the COVID telehealth expansion: the ADHD prescription surge driven by video consultations — and critically, who is and is not benefiting from it.

The researchers analysed nearly 4 million MBS psychiatric consultation records from 2017 to 2023, alongside corresponding PBS prescription data. Before the COVID telehealth expansion, fewer than 5% of psychiatric consultations were linked to ADHD prescriptions. By 2022, that figure had climbed to nearly 12%. Video consultations alone accounted for approximately a quarter of all stimulant prescriptions dispensed in Australia by that year.

Across a broader timeframe, national ADHD medication dispensing rose approximately eleven-fold between 2004-05 and 2023-24. Some of that growth reflects genuine improved recognition of ADHD in adults — particularly women, who were chronically underdiagnosed when diagnostic criteria were built on male cohorts. Some of it reflects market dynamics that this analysis begins to quantify.

The both-and

The case that the surge reflects overdue recognition

There is a legitimate clinical story underneath the prescribing numbers. ADHD in women was systematically underdiagnosed for decades. The inattentive presentation — time management difficulties, emotional dysregulation, chronic overwhelm misattributed to anxiety or depression — did not match the hyperactive, disruptive male stereotype that dominated early diagnostic thinking. Women in their thirties, forties, and fifties are now receiving diagnoses that, in many cases, make sense of a lifetime of misattributed symptoms and inadequately treated conditions.

Telehealth expanded access to psychiatrists for people who previously could not access metropolitan waitlists in person — parents of young children, people in regional areas, people managing complex work and health schedules. For these patients, video consultation made specialist assessment possible in a way it had not been before. The growth in diagnoses during this period is not, on its own, evidence of over-diagnosis.

The problem the data expose

The data also show something that complicates a simple access-improvement narrative. Almost half of the psychiatrists driving the increase in video ADHD prescriptions practised in Australia’s wealthiest postcodes. Video ADHD consultations carry higher out-of-pocket costs than equivalent face-to-face appointments — a barrier felt most acutely by people in lower-income areas.

The result is a paradox: telehealth was supposed to dissolve geographical barriers to specialist care. In ADHD assessment, what appears to have emerged is a model where urban, affluent patients access video assessment with high volume and relative ease, while the equity gap in rural and lower-socioeconomic communities largely persists. The researchers use the word “commoditisation” to describe this dynamic — a market-shaped concentration of services toward the most financially accessible patients, rather than the most clinically underserved.

What happens when general practice takes on ADHD prescribing

Several state governments are moving toward enabling GP-led ADHD diagnosis and prescribing — a reform that has support on access grounds and that the RACGP has advocated for. Victoria took a meaningful step in this direction in 2026.

The equity caution in this analysis applies directly to that transition. If the same market dynamics that shaped specialist telehealth prescribing patterns are allowed to replicate in general practice — where high-volume, brief consultations become the norm for ADHD assessment — the quality and equity problems could expand, not contract. The reforms have strong clinical rationale. They need deliberate structural safeguards to deliver on the equity promise, not just the access headline.

My two cents

ADHD in adults is real, clinically significant, and chronically underdiagnosed in women. The telehealth expansion made assessment more accessible for some people who genuinely needed it. Both of those things are true.

What this analysis adds is a structural caution that matters for the current policy moment. Access improvement that concentrates in wealthy urban practices and carries higher out-of-pocket costs is not the same as equity. An eleven-fold growth in ADHD medication dispensing over twenty years is not, on its own, evidence of over-diagnosis — and it is not, on its own, evidence of the system working well. The distribution matters as much as the volume.

For anyone currently navigating ADHD assessment through a telehealth service: the assessment itself, when conducted by a qualified clinician with appropriate time and clinical rigour, is legitimate. The questions worth asking — of the service and of yourself — are whether the assessment is thorough enough to be diagnostic rather than confirmatory, whether the clinician is taking a full history, and whether the out-of-pocket cost you are being asked to carry is proportionate. Some telehealth ADHD services do this well. Some have moved toward brief, high-volume consultations that raise legitimate quality questions. The difference matters for diagnostic accuracy, and it matters for what happens after the script.

Verdict: maybe — the prescription surge reflects both genuine overdue recognition of ADHD in women and market-driven patterns with real equity costs. The GP prescribing reform question is live and the structural issues are worth tracking.

Sources cited

How telehealth is fuelling a surge in ADHD scripts in a business model that benefits the rich. The Conversation, 2026. https://theconversation.com/how-telehealth-is-fuelling-a-surge-in-adhd-scripts-in-a-business-model-that-benefits-the-rich-286761
Medicare Benefits Schedule data — Services Australia. https://www.servicesaustralia.gov.au/medicare