Mixed-methods analysis identifies unmet needs and service priorities in ADHD, suggesting reforms for policy integration.
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder defined by impaired levels of inattention, organisation, and/or hyperactivity-impulsivity. Although previously considered a disorder of childhood, it is increasingly recognised that it can persist into adult life or be newly diagnosed in adulthood. Untreated ADHD has been associated with poorer outcomes across a range of diverse health and social domains, but services have not kept pace with increasing demand. In 2023 the Australian Government launched an inquiry into ADHD services in Australia. OBJECTIVE To analyse written submissions from individuals and families with lived experience of attention-deficit hyperactivity disorder (ADHD) to the 2023 Australian Senate Inquiry, using artificial intelligence (AI)-assisted thematic analysis. The aim was to identify priority concerns, service needs, and community-proposed solutions. Presenting the Senate Inquiry submissions data numerically makes it very accessible to policy makers. This study is important for designing new services and for their subsequent evaluation. METHODS A mixed-methods study of 505 publicly available submissions from individuals with ADHD and their families, drawn from a total of 701 submissions to the Senate Inquiry into ADHD services. Submissions were analysed using large language model (LLM)-assisted data extraction and thematic clustering, with human validation and review. Main Outcome Measures: Frequency and thematic distribution of (1) problems experienced; (2) services wanted; and (3) solutions suggested, as identified in submissions. RESULTS Thematic analysis of 480 eligible submissions revealed the most frequently reported issues were high costs and long wait times for assessment and treatment (each cited by 46%), lack of specialised care (39%), diagnostic delays (36%), and gender bias (27%). The most common service request was for affordable and accessible ADHD-specific care (71%), followed by support services tailored to diverse populations and life stages. Proposed solutions focused on Medicare-funded access to psychological and psychiatric services (68%), expanded roles for general practitioners, improved provider training (39%), and recognition of ADHD under the National Disability Insurance Scheme (NDIS). Submissions also highlighted misalignment between current clinical guidelines and public expectations, particularly regarding school-based screening and NDIS eligibility. CONCLUSIONS The findings highlight substantial unmet needs and systemic barriers in ADHD diagnosis and care in Australia. The AI-assisted analysis of consumer submissions offers a scalable method for integrating lived experience into policy development. Coordinated reforms in access, funding, and workforce training are needed to align services with both clinical evidence and community expectations. CLINICALTRIAL Not applicable
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