The Melbourne Clinic is fine as an institution, I believe they have the largest number of private psychiatrists in Victoria. I have never worked there, but have occasionally referred patients for inpatient care and second opinions. There’s a few people there who would rate highly regarding OCD and neuropsychiatry. They bill on the higher side, but they do charge their doctors the highest room rents in the state. Then again, some years back a patient of mine went there for an ADHD/addiction second opinion and was bulk billed by a professor.
But it’s hard to say what a proper job regarding ADHD assessments is nowadays.
When I qualified (> 10 years ago now), the expectation was that every mental health condition including ADHD could be diagnosed in a single one hour session (Item 296). 291 assessments were reserved for situations where care could be handed back to the referring GP for 12 months, which were mainly relatively straightforward cases like depression where we could recommend a trial of 2-3 different antidepressants or augmentation strategies that the GP could trial. ADHD didn’t tend to fit this as easily, as it was very difficult finding a GP who would be agreeable to initiate stimulants and go through the rigmarole to get a government permit.
Since then ADHD has somehow morphed into something requiring 3-4 sessions before treatment can be commenced, requiring numerous investigations, rating scales, collateral and expensive feedback sessions. There is one psychiatrist near me charging $4770 for 4 sessions!
When I first heard about this practice style, my personal feeling was that this was only going to be viable for new (and inexperienced) private psychiatrists who had the booking space to accommodate multiple sessions. I also noted it was happily adopted by psychiatrists with predatory pricing models (see above) as well as some who had been around for a while and well known for being substandard. There was one who started demanded 4x 1 hourly sessions in a month (even for those diagnosed in childhood coming out of paediatric care), was the subject of frequent complaints for promoting various conspiracies and placed a lot of emphasis on observations made from viewing patients in their waiting room via CCTV.
If a psychiatrist in Australia can see you very quickly for ADHD (i.e. under a month) without a cancellation list, they’re likely to be new, ADHD assessment mills or just **** because they’ve never been able to build up a cohort of patients who want to see them. You’ll pay a lot of money and get a generic treatment template with all the stimulants but you’ll have to find a GP who is happy to start you on treatment. Great if you want meds and little scrutiny, but you’ll have to pay to be reassessed every 2 years.
Now if you only want to explore non-medication treatment for ADHD, you don’t really have to see a psychiatrist at all. You can go down the ADHD lifecoach route, which doesn’t require any referrals although there are a lot of people in this space now so quality can be variable. There are some psychologists who have an interest in managing ADHD, and you can get a GP referral to see them. But what you have to avoid is anyone charging for expensive multi session psychology assessments for ADHD. A lot of the psychologists offering these are chasing the dollar and aren’t interested in providing long term assistance. These assessments usually won’t be accepted by a psychiatrist if you want to go down the medication route later on.
