Suitability for GP-Led ADHD Care
Suitability for GP-Led ADHD Care (and when specialist input is needed)
GP-led ADHD care can be appropriate for many people, particularly when ADHD is already established or when symptoms and history are straightforward. However, there are situations where it is not clinically appropriate or safe to proceed directly to a full range of ADHD treatments without additional assessment and support.
This section explains when we can help, and when we’ll recommend psychiatry and/or Alcohol and Other Drug Services (AODS) involvement first.
High-risk features that change the pathway
If any of the following are present (current or past), we may recommend specialist input before progressing to certain ADHD treatments:
Bipolar spectrum features
Examples include:
A clear history of manic or hypomanic episodes
Marked mood elevation, reduced need for sleep, grandiosity, impulsive risk-taking
Episodes linked to antidepressants, stimulants, or substance use
Why this matters: ADHD symptoms and bipolar symptoms can overlap, and some ADHD treatments can worsen mood instability if bipolar disorder is not stabilised first.
Psychosis or possible psychosis
Examples include:
Hallucinations, delusional beliefs, severe paranoia
Past psychotic episodes (even if brief or substance-associated)
Strong family history with concerning symptoms
Why this matters: Where psychosis is part of the clinical picture, management often requires specialist assessment and a carefully staged plan.
Substance use and dependency concerns
Examples include:
Current or recent problematic use of cannabis, methamphetamine, cocaine, MDMA, alcohol, benzodiazepines, or opioids
Suspected dependency, misuse of prescribed medication, or medication diversion
Unstable patterns of use, repeated intoxication/withdrawal states, or high-risk behaviours
Why this matters: Substance use can mimic or worsen attention and mood symptoms, and it can significantly affect treatment safety and risk-management requirements.
What this means for treatment options
Where high-risk features are present, we may not be able to offer the “full spectrum” ADHD treatment options immediately. In these situations, care is usually safest and most effective when:
The diagnosis and risk picture are clarified, and
Comorbid conditions are stabilised (e.g., mood disorder, psychosis risk, substance use disorder), and
A shared plan is in place across the relevant treating team.
This may involve psychiatry, Alcohol & Other Drug Services (AODS), and sometimes psychological therapy and additional medical investigations.
Two pathways (you choose, but we’ll guide you)
Option A: Direct referral from your regular General Practitioner to the most appropriate service (often fastest)
If high-risk features are clearly present, it can be more streamlined to proceed directly to:
Psychiatry (diagnostic clarification and management planning), and/or
AODS (assessment, treatment, and stabilisation support)
This approach can reduce delays and avoid repeated appointments that don’t change the recommended pathway.
Option B: Assessment first, then referral if indicated
Some people prefer to start with an initial GP assessment to clarify history, review previous reports, and identify risk factors. If specialist input is indicated, we can:
Arrange referral to the appropriate service (psychiatry and/or AODS)
Provide a structured summary of findings to support that referral
Support ongoing care and coordination while specialist input is obtained
Our role in ongoing care
Where it’s clinically appropriate, we can assist with:
Reviewing documentation and previous assessments
Coordinating referrals and communicating with treating teams
Monitoring physical health and relevant investigations
Supporting non-medication strategies and broader wellbeing care
Providing shared-care support where a specialist plan is in place
Important note
Your safety is the priority. If we identify high-risk features, it doesn’t mean “no care”—it means the right care, in the right order, with appropriate supports in place. We’ll explain our reasoning and help you navigate the most appropriate pathway.