The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has called for calm, clinically led reform in ADHD care amid unprecedented demand, rapid policy shifts, and growing public scrutiny. 

In a new Position Statement released today, the RANZCP cautions that along with improving access, diagnostic rigor, safety and continuity of care are all critical, particularly as several jurisdictions move towards GP-led ADHD assessment and prescribing models. .  

RANZCP President Dr Astha Tomar said ADHD had become one of the most high profile and publicly contested areas of mental health and that recent proposed changes risk becoming reactive “band aid” solutions for a mental health system already in deep crisis. 

“Sudden changes across several jurisdictions, intense public debate, and inconsistent and rapidly shifting prescribing arrangements have created uncertainty for patients, families and clinicians,” Dr Tomar said. 

“ADHD is not an isolated problem. It is a symptom of a much deeper system failure.” 

Dr Tomar said major national reports released in recent weeks including the AMA Mental Health Report Card and the Productivity Commission’s latest analysis point to a mental health system that is profoundly overstretched and unable to meet escalating community need. 

“The community’s need for timely ADHD assessment and treatment is real, but so too is the need for coordinated, clinically informed reform across the broader mental health system. ADHD is exposing the fault lines in how we deliver care, reminding us that solutions must strengthen the whole system, not just one condition,” Dr Tomar said. 

“The sharp rise in brief patient assessments, growing rates of self-diagnosis driven by social media, and rapidly escalating stimulant prescribing have raised legitimate concerns among clinicians, patients, carers and families.  

“Reforms cannot prioritise speed over safety. When shortcuts in assessment become normalised, patients are the ones who bear the consequences. 

“Without thorough evaluation, it is too easy to miss mood and anxiety disorders, trauma related symptoms, autism or other neurodevelopmental needs, and substance use issues. These factors can completely change the diagnosis, require different treatment approaches, or make stimulant use unsafe.  

“Safe ADHD care depends on comprehensive, clinically informed assessments that look at the whole picture.” 

According to the Australian Institute of Health and Welfare, the rate of Australians dispensed ADHD medications has increased eleven-fold over the past two decades, with adult prescribing growing most rapidly, particularly among women.  

Safe prescribing requires diagnostic confidence, complexity management, and ongoing monitoring. 

The Position Statement, developed through extensive member input, provides guidance for safe and equitable ADHD care and a roadmap for governments. 

Recommendations in the Position Statement include: 

• Specialist oversight must remain in place for complex, comorbid or high-risk presentations. Psychiatrists have expertise and experience in managing diagnostic uncertainty and risk. 
• GP involvement should expand only with accredited training, mandatory CPD around comprehensive psychiatric evaluations, and clear referral and escalation pathways. 
• ADHD assessments must include thorough psychiatric evaluation clarifying diagnostic picture and comorbidities, typically requiring 1–2 hours, and must not pathologise developmental, educational or social stressors. 
• Stimulant medicines should be prescribed only after a full biopsychosocial-cultural assessment and discussion of non-pharmacological and non-stimulant medication options. 
• Governments must invest in specialist psychiatry access, multidisciplinary teams, community psychiatry clinics, and workforce growth, to address the structural failures driving demand. 
• People with lived and living experience should be partners in system reform, from design through to evaluation. 
• A national data system is much needed to track ADHD diagnoses, prescribing trends, adverse events, and service use patterns, and the impact of policy changes- ensuring safety, quality, and evidence-based practice across all jurisdictions. 

“A nationally consistent, well governed mental health system anchored in comprehensive assessment, structured shared care, evidence-based practice and national data collection is essential to meeting the needs of individuals, families and communities across Australia and Aotearoa New Zealand,” Dr Tomar said. 

The full position statement can be found here: Safe, Comprehensive, and Equitable ADHD Care.

ENQUIRIES: For more information, or to arrange an interview call Dishi on +61 437 315 911 or email media@ranzcp.org.   

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org.

In Australia: If you or someone you know needs help, contact Lifeline on 13 11 14 or www.lifeline.org.au or the Suicide Callback Service on 1300 659 467 or www.suicidecallbackservice.org.au.

In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or www.lifeline.org.nz/suicide-prevention.