I just got diagnosed myself yesterday, went straight to a psychiatrist given the advice on this sub. My GP seemed to want to go the psychologist route first also, to me it just feels like a money making scheme knowing that the psychologist can’t actually prescribe the medications
I went to my GP, referral for a psychiatrist and diagnosed in 1 appointment with my GP comments, school reports, etc. I really don't see the point in the psychological assessment unless it's something that you are wanting for a non medical treatment plan and/or special assistance in work, study, etc.
This is an issue that needs to be discussed more. I have seen psychologist clinics advertising an ADHD diagnosis process and not been clear that they cannot prescribe medication. Medication is the best first line treatment and not being upfront about their scope of practice is, IMO, unethical. The psychiatrist can diagnose and give authority to your GP to prescribe.
100% this!
It needs to be highlighted clearly that psychologists CANNOT prescribe.
Therefore, by default, any assessment/diagnosis by a psychologist does not authorise pharmacological treatment (Schedule 8 stimulants for ADHD).
Every psychiatrist will subsequently treat a psychology report differently, but ultimately they will conduct their own assessment... to make their own diagnosis and formulate a treatment approach.
It's unfortunate that unscrupulous psychologists are not upfront about this.
I ended up doing something similar with different results.. Psychologists can diagnose you but not prescribe medication. If you want medication you need to go to a psychiatrist. Some psychiatrists will accept the report from the psychologist, but some want to assess you themselves. It sucks. I was able to find one who took my psychologist report, but I think it's less common and I am in NZ (we don't have out own sub so I hangout here)
The psychologist assessment is still an assessment and diagnosis, unfortunately psychiatrists all have different processes - some will accept a psychologists’ diagnosis and others won’t. It’s very frustrating as it sounds like your assessment was very comprehensive. A psychologist report can still be useful in treatment or for support with accommodations in work/study, as medication won’t be right for everybody. You could see if the psychologist who did your assessment has referred clients to any psychiatrists in the past who will take the report into account.
Nice advice.
My GP described the biannual 291s with psychiatrist as a medication review even though it feels like a diagnosis review. The 291 assessment has been short compared to what some clinical psychologists seem to offer. But sometimes I think maybe those more comprehensive assessments might help steer my therapy and allow it to be tailored to me. Like the psychologist assessment would be a therapy modality review.
I think that GPs may not appreciate the cost of all these assessments, or realise how helpful stimulant meds can be as first line treatment, or not be the best at communicating what is leading them down a particular pathway (why psychologist assessment instead of a 291 if there is a good reason) -_-
Wow, what a drama and I’m borking at the expense of it all! I see a GP and psychiatrist through a fairly bougee inner city health clinic in NSW. I’ve seen the psychiatrist a few times over the last few years. He was questioning ADHD a while ago (I’m a 40yo M). All I had to do was make the appointment, renew the referral from my GP.
I think I paid $350 and $170ish got rebated through Medicare. Initial script and five repeats on the spot.
I think it pays to have and maintain a good and lengthy relationship with a GP, and find one that has supporting services under the same roof.
Yeah, my (Telehealth) psychiatrist charged me the PBS recommended fees. I think initial assessment was $660, and I got $200ish back. And have since had a couple 5 min check-in appointments.. charged me a bulk-billed $45 (legend).
We’ll have another proper appointment before they hand over prescribing to my GP (GP has confirmed they can do this). That will be a few hundred I think? $3-400 but also partial rebate.
Horrified by the amounts being charged in many cases.
If you’re accessing Telehealth because you’re rural/regional there are additional Medicare codes the psychiatrist can use. Not sure how it works cause my psych took care of that, but could be worth raising if relevant.
I would head back to the GP and question him. Can he apply for a permit now that you have been thoroughly assessed? Sorry I’m not sure that is possible, I would ask your GP why he didn’t discuss this with you before sending you via the psychologist route, particularly with the amount of money involved… that’s not professional and I would say a bit incompetent given first line treatment is medication - along with psychological support/ guidance. What a waste of time. That’s what I would do, I would hate to think this GP just assumes this is the process. Honestly, some GPs really don’t have that much knowledge or experience.
I’d use the assessment if possible and book in to Fluence asap. It’s a lot of $$$ but you would want this over with by now I’m guessing….
GOOD LUCK, YOU CAN DO THIS!!!!!!
Thanks so much! I'm all booked in just gotta wait a couple of weeks :).
Definitely going to go back. I'm hoping it's just a misunderstanding, ive been seeing this GP since I was a kid.
A psychologist can diagnose ADHD but cannot prescribe medication. Medication needs to be through a psychiatrist. Psychiatrists all have different processes, so some will accept a psychologist’s assessment, and some will insist on their own assessment prior to prescribing medication. Most psychologists I have come across tend to ask if you are after medication prior to booking in an assessment, and if yes, they will refer you straight to a psychiatrist.
It’s unfortunate that the process to be diagnosed for ADHD is so tricky and expensive! I hope the psychologist’s report at least had some recommendations and will hold some weight with the psychiatrist.
It can also happen to teens who where diagnosed by their paediatrician and prescribed medication, but need to redo an assessment when they become an adult and move onto to seeing a psychiatrist.
It feels really unethical that GPs (medical professionals!) are not clarifying the difference between an assessment by a psychiatrist (medical professional, diagnostic/prescribing capacity) and clinical psychologist (health professional, diagnostic capacity).
The information gained from a psychologist is likely to be more in-depth and may be more helpful as far as understanding yourself, the impacts of your diagnosis specifically on you. But if you want to access/trial medication, it’s an expencive way to go about it.
I work in (state hospital) mental health, so thankfully knew this distinction, but would have been raging if I got the run around you’ve had. I would definitely raise this with your GP if you’re comfortable doing so.
For what it’s worth, at this point, I waited a long time to see a psychiatrist because of how hard it is to get one personally/meaningfully recommended. From the time I was certain of going ahead with assessment, it took close to 3 years. I was a bit more limited as I work with psychiatrists and wanted to see someone without connection to my colleagues.. but still. Now I have my diagnosis and medication has been a really helpful tool. I also see a clinical psychologist, for asd assessment and therapy. Being able to talk through both adhd/asd with the clin psych has really underscored for me the difference between their approaches. I really like my psychiatrist and psychologist, but they have very different focus. The psychiatrist is a much more efficient, ?task oriented process. … I think what I’m trying to say is, even though you haven’t been given the information to make an informed decision about your assessment process, the silver lining will hopefully be that you have a more detailed report/outcome from your psychologist assessment. While it won’t provide access to medication, there is a lot of value and power in understanding yourself. The medication can be very helpful, but as annoying as it is to hear (esp from people taking meds, lol) the medication really is just a tool. And we need to use it inline with our own personalised strategies.
Sorry you’ve had this pathway, hopefully it’s through genuine ignorance from your GP, and good luck with the next stages. Welcome to the club!
I just got diagnosed myself yesterday, went straight to a psychiatrist given the advice on this sub. My GP seemed to want to go the psychologist route first also, to me it just feels like a money making scheme knowing that the psychologist can’t actually prescribe the medications
Also what state are you in?
Tassie. It kind of does feel sketchy doesn't it!
I went to my GP, referral for a psychiatrist and diagnosed in 1 appointment with my GP comments, school reports, etc. I really don't see the point in the psychological assessment unless it's something that you are wanting for a non medical treatment plan and/or special assistance in work, study, etc.
This is an issue that needs to be discussed more. I have seen psychologist clinics advertising an ADHD diagnosis process and not been clear that they cannot prescribe medication. Medication is the best first line treatment and not being upfront about their scope of practice is, IMO, unethical. The psychiatrist can diagnose and give authority to your GP to prescribe.
100% this! It needs to be highlighted clearly that psychologists CANNOT prescribe. Therefore, by default, any assessment/diagnosis by a psychologist does not authorise pharmacological treatment (Schedule 8 stimulants for ADHD). Every psychiatrist will subsequently treat a psychology report differently, but ultimately they will conduct their own assessment... to make their own diagnosis and formulate a treatment approach. It's unfortunate that unscrupulous psychologists are not upfront about this.
I ended up doing something similar with different results.. Psychologists can diagnose you but not prescribe medication. If you want medication you need to go to a psychiatrist. Some psychiatrists will accept the report from the psychologist, but some want to assess you themselves. It sucks. I was able to find one who took my psychologist report, but I think it's less common and I am in NZ (we don't have out own sub so I hangout here)
The psychologist assessment is still an assessment and diagnosis, unfortunately psychiatrists all have different processes - some will accept a psychologists’ diagnosis and others won’t. It’s very frustrating as it sounds like your assessment was very comprehensive. A psychologist report can still be useful in treatment or for support with accommodations in work/study, as medication won’t be right for everybody. You could see if the psychologist who did your assessment has referred clients to any psychiatrists in the past who will take the report into account.
Nice advice. My GP described the biannual 291s with psychiatrist as a medication review even though it feels like a diagnosis review. The 291 assessment has been short compared to what some clinical psychologists seem to offer. But sometimes I think maybe those more comprehensive assessments might help steer my therapy and allow it to be tailored to me. Like the psychologist assessment would be a therapy modality review. I think that GPs may not appreciate the cost of all these assessments, or realise how helpful stimulant meds can be as first line treatment, or not be the best at communicating what is leading them down a particular pathway (why psychologist assessment instead of a 291 if there is a good reason) -_-
Wow, what a drama and I’m borking at the expense of it all! I see a GP and psychiatrist through a fairly bougee inner city health clinic in NSW. I’ve seen the psychiatrist a few times over the last few years. He was questioning ADHD a while ago (I’m a 40yo M). All I had to do was make the appointment, renew the referral from my GP. I think I paid $350 and $170ish got rebated through Medicare. Initial script and five repeats on the spot. I think it pays to have and maintain a good and lengthy relationship with a GP, and find one that has supporting services under the same roof.
Ok usually I just don’t but.. *baulking The other one is woofing. Bork!
I’m a dog person. I meant what I said. Imagine a chihuahua with a jar of peanut butter!
Ooof those prices sound amazing 🤩
Yeah, my (Telehealth) psychiatrist charged me the PBS recommended fees. I think initial assessment was $660, and I got $200ish back. And have since had a couple 5 min check-in appointments.. charged me a bulk-billed $45 (legend). We’ll have another proper appointment before they hand over prescribing to my GP (GP has confirmed they can do this). That will be a few hundred I think? $3-400 but also partial rebate. Horrified by the amounts being charged in many cases. If you’re accessing Telehealth because you’re rural/regional there are additional Medicare codes the psychiatrist can use. Not sure how it works cause my psych took care of that, but could be worth raising if relevant.
I would head back to the GP and question him. Can he apply for a permit now that you have been thoroughly assessed? Sorry I’m not sure that is possible, I would ask your GP why he didn’t discuss this with you before sending you via the psychologist route, particularly with the amount of money involved… that’s not professional and I would say a bit incompetent given first line treatment is medication - along with psychological support/ guidance. What a waste of time. That’s what I would do, I would hate to think this GP just assumes this is the process. Honestly, some GPs really don’t have that much knowledge or experience. I’d use the assessment if possible and book in to Fluence asap. It’s a lot of $$$ but you would want this over with by now I’m guessing…. GOOD LUCK, YOU CAN DO THIS!!!!!!
Thanks so much! I'm all booked in just gotta wait a couple of weeks :). Definitely going to go back. I'm hoping it's just a misunderstanding, ive been seeing this GP since I was a kid.
A psychologist can diagnose ADHD but cannot prescribe medication. Medication needs to be through a psychiatrist. Psychiatrists all have different processes, so some will accept a psychologist’s assessment, and some will insist on their own assessment prior to prescribing medication. Most psychologists I have come across tend to ask if you are after medication prior to booking in an assessment, and if yes, they will refer you straight to a psychiatrist. It’s unfortunate that the process to be diagnosed for ADHD is so tricky and expensive! I hope the psychologist’s report at least had some recommendations and will hold some weight with the psychiatrist. It can also happen to teens who where diagnosed by their paediatrician and prescribed medication, but need to redo an assessment when they become an adult and move onto to seeing a psychiatrist.
It feels really unethical that GPs (medical professionals!) are not clarifying the difference between an assessment by a psychiatrist (medical professional, diagnostic/prescribing capacity) and clinical psychologist (health professional, diagnostic capacity). The information gained from a psychologist is likely to be more in-depth and may be more helpful as far as understanding yourself, the impacts of your diagnosis specifically on you. But if you want to access/trial medication, it’s an expencive way to go about it. I work in (state hospital) mental health, so thankfully knew this distinction, but would have been raging if I got the run around you’ve had. I would definitely raise this with your GP if you’re comfortable doing so. For what it’s worth, at this point, I waited a long time to see a psychiatrist because of how hard it is to get one personally/meaningfully recommended. From the time I was certain of going ahead with assessment, it took close to 3 years. I was a bit more limited as I work with psychiatrists and wanted to see someone without connection to my colleagues.. but still. Now I have my diagnosis and medication has been a really helpful tool. I also see a clinical psychologist, for asd assessment and therapy. Being able to talk through both adhd/asd with the clin psych has really underscored for me the difference between their approaches. I really like my psychiatrist and psychologist, but they have very different focus. The psychiatrist is a much more efficient, ?task oriented process. … I think what I’m trying to say is, even though you haven’t been given the information to make an informed decision about your assessment process, the silver lining will hopefully be that you have a more detailed report/outcome from your psychologist assessment. While it won’t provide access to medication, there is a lot of value and power in understanding yourself. The medication can be very helpful, but as annoying as it is to hear (esp from people taking meds, lol) the medication really is just a tool. And we need to use it inline with our own personalised strategies. Sorry you’ve had this pathway, hopefully it’s through genuine ignorance from your GP, and good luck with the next stages. Welcome to the club!
Psychologist isn't worth it for diagnosis at all. They can't help. Only a psychiatrist can.