In most states/territories of Australia, clinical psychologists can diagnose ADHD, and a full cognitive (IQ) assessment is not required for an ADHD diagnosis under current diagnostic guidelines (DSM-5-TR or ICD-11). However, whether it’s more appropriate to go to a psychiatrist depends on your specific needs and the purpose of the diagnosis.
Why Some People Prefer to Go Directly to a Psychiatrist for ADHD Diagnosis
Medication Access: Psychiatrists are medical doctors and the only clinicians (besides some GPs with special training) who can prescribe ADHD medication. If your goal is diagnosis + medication, seeing a psychiatrist streamlines the process. Psychologists can’t prescribe, so a psychologist’s assessment often results in a referral to a psychiatrist anyway.
Avoiding Unnecessary Tests: Many psychologists offer full neuropsychological assessments (including IQ and achievement testing), which are not required for an ADHD diagnosis. And even if you do have a learning difficulty (eg dyslexia), you can still have ADHD. These tests are time-consuming and expensive, frequently costing well over $1000. So, some psychologists follow an extensive testing model that delays diagnosis and adds significant cost.
And you may still have to see a psychiatrist if you think you’ll want to access medication. Psychiatrists do not usually require cognitive testing unless differential diagnoses (e.g., intellectual disability, cognitive impairment) are being explored. Faster Diagnosis Pathway: A skilled and experienced psychiatrist may complete a diagnostic interview, review history, and use validated ADHD screening tools to diagnose — all within 1–2 sessions.
More Effective for Complex Diagnoses or Clinical Presentations: Psychiatrists are trained to manage co-occurring mental health conditions (e.g., depression, anxiety, bipolar disorder), which often overlap with or mask ADHD. They can adjust medications for complex clinical presentations, which a psychologist cannot. You may still wish to work with a psychologist, to assist you to better live with ADHD or it’s mental health implications.
Why Some Psychologists Recommend Full Cognitive Testing (Even Though It’s Not Required): They may be trained in neuropsychological or educational assessment and view ADHD through a broader cognitive profile. They may want to rule out learning disabilities (but you can have both at the same time) or better understand strengths and weaknesses. This is often useful for formal educational or employment support requests/needs. In some cases, it’s a just clinic policy, not an evidence-based necessity.
So When Might I Want to See a Psychologist?
- If you don’t want medication
- If you want in-depth cognitive or achievement testing to understand how your brain functions
- If you want ongoing therapy, and diagnosis is just part of that process.
- If cost and time are not urgent issues, or assessment waitlist are long, a psychologist can help you better understand yourself, how ADHD is impacting your life and how live with it as best you can without medication.
If your primary goals are diagnosis and access to medication, and you’re confident there are no complicating cognitive factors, then going straight to a psychiatrist is currently faster (number of sessions required, not taking into account any wait times), relatively cheaper, and more appropriate in Australia. Like all specialists, ask your GP for a referral to a psychiatrist who specialises in ADHD for adults, if you think you would benefit from an ADHD assessment. If you would like to know why you might want to access medication for ADHD, please have a look at my ADHD and Medication post.
As always, if you find that you’re struggling to understand your behaviours or find you’re frequently frustrated with your decision making, please consider getting some additional support. Deb is a clinical psychologist and lives with ADHD. Deb has the ADHD benefit of hyperfocus, so has deep dived the heck out of ADHD. Deb is always here to help you adjust to living with a recent ADHD diagnosis. If you aren’t diagnosed but suss that you have ADHD, Deb can help you decide if formal diagnosis is likely to be beneficial to you. Deb won’t waste your money or time on expensive assessments. Deb offers in clinic appointments and telehealth (video) sessions for those not able to conveniently get to Watsonia.
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