Rural mental health systems faces structural barriers to recognising and supporting neurodivergence, particularly where it intersects with trauma, socioeconomic disadvantage and service fragmentation. Limited workforce capability and inaccessible private pathways leave neurodevelopmental needs unidentified, contributing to elevated mental health risk and reduced participation across health, education and employment. This presentation describes a rural, workforce-led innovation that moved from capability-building to service redesign. Prior to implementation, low clinician confidence and a critical gap in autism and ADHD understanding and assessment was identified. A brief pilot ADHD clinic for GP referrals further highlighted unmet need, identifying many individuals with likely co-occurring autism and generating a waitlist prior to service establishment. Its closure reinforced the fragility of access pathways and the need for a sustainable response. In response, the THRIVE Neurodevelopmental Assessment Service was established in May 2025 through partnership funding with Mindful at the University of Melbourne, designed to meet the needs of adults within public mental health services. THRIVE applies a distributed, multidisciplinary model adapted to rural workforce constraints, integrating psychiatry, psychology, occupational therapy, and flexible speech pathology input. Initially designed for Area Mental Health clients, the service expanded to include community-based partner organisations, reflecting shared community need and a desire to reduce access inequities. The scope broadened beyond autism assessments to include ADHD, recognising overlap and under-identification. Neuroaffirming, sensory-informed tools support more accessible assessment for adults who may not engage with traditional modes of assessment. In under 12 months, the service exceeded its target, delivering 50 assessments. This model demonstrates how rural services can leverage workforce, partnerships and staged capability-building to address unmet need. It contributes to a broader multi-site research initiative coordinated by Mindful and informs scalable approaches to care. Future directions include post-diagnostic supports and cross-sector collaboration and further workforce capacity building activities

Rural mental health systems faces structural barriers to recognising and supporting neurodivergence, particularly where it intersects with trauma, socioeconomic disadvantage and service fragmentation. Limited workforce capability and inaccessible private pathways leave neurodevelopmental needs unidentified, contributing to elevated mental health risk and reduced participation across health, education and employment. This presentation describes a rural, workforce-led innovation that moved from capability-building to service redesign. Prior to implementation, low clinician confidence and a critical gap in autism and ADHD understanding and assessment was identified. A brief pilot ADHD clinic for GP referrals further highlighted unmet need, identifying many individuals with likely co-occurring autism and generating a waitlist prior to service establishment. Its closure reinforced the fragility of access pathways and the need for a sustainable response. In response, the THRIVE Neurodevelopmental Assessment Service was established in May 2025 through partnership funding with Mindful at the University of Melbourne, designed to meet the needs of adults within public mental health services. THRIVE applies a distributed, multidisciplinary model adapted to rural workforce constraints, integrating psychiatry, psychology, occupational therapy, and flexible speech pathology input. Initially designed for Area Mental Health clients, the service expanded to include community-based partner organisations, reflecting shared community need and a desire to reduce access inequities. The scope broadened beyond autism assessments to include ADHD, recognising overlap and under-identification. Neuroaffirming, sensory-informed tools support more accessible assessment for adults who may not engage with traditional modes of assessment. In under 12 months, the service exceeded its target, delivering 50 assessments. This model demonstrates how rural services can leverage workforce, partnerships and staged capability-building to address unmet need. It contributes to a broader multi-site research initiative coordinated by Mindful and informs scalable approaches to care. Future directions include post-diagnostic supports and cross-sector collaboration and further workforce capacity building activities.

Rural mental health systems faces structural barriers to recognising and supporting neurodivergence, particularly where it intersects with trauma, socioeconomic disadvantage and service fragmentation. Limited workforce capability and inaccessible private pathways leave neurodevelopmental needs unidentified, contributing to elevated mental health risk and reduced participation across health, education and employment. This presentation describes a rural, workforce-led innovation that moved from capability-building to service redesign. Prior to implementation, low clinician confidence and a critical gap in autism and ADHD understanding and assessment was identified. A brief pilot ADHD clinic for GP referrals further highlighted unmet need, identifying many individuals with likely co-occurring autism and generating a waitlist prior to service establishment. Its closure reinforced the fragility of access pathways and the need for a sustainable response. In response, the THRIVE Neurodevelopmental Assessment Service was established in May 2025 through partnership funding with Mindful at the University of Melbourne, designed to meet the needs of adults within public mental health services. THRIVE applies a distributed, multidisciplinary model adapted to rural workforce constraints, integrating psychiatry, psychology, occupational therapy, and flexible speech pathology input. Initially designed for Area Mental Health clients, the service expanded to include community-based partner organisations, reflecting shared community need and a desire to reduce access inequities. The scope broadened beyond autism assessments to include ADHD, recognising overlap and under-identification. Neuroaffirming, sensory-informed tools support more accessible assessment for adults who may not engage with traditional modes of assessment. In under 12 months, the service exceeded its target, delivering 50 assessments. This model demonstrates how rural services can leverage workforce, partnerships and staged capability-building to address unmet need. It contributes to a broader multi-site research initiative coordinated by Mindful and informs scalable approaches to care. Future directions include post-diagnostic supports and cross-sector collaboration and further workforce capacity building activities