Psychiatrists and GPs are deeply concerned about the Victorian Government's announcement to allow the Virtual Emergency Department to provide ADHD prescription refills from September. The policy bypasses treating doctors and turns emergency health services into a workaround for prescription refills.

The Royal Australian and New Zealand College of Psychiatrists Victorian Branch (RANZCP Victoria) and the Royal Australian College of GPs (RACGP) said the policy undermines efforts to ensure ADHD care is safe.

The Colleges warned that virtual EDs exist to provide emergency care for acute medical situations. Using them as prescription refill services for Schedule 8 controlled substances is not appropriate and increases the risks of misuse and diversion of stimulant medications if the safeguards are not robust.

The RANZCP’s position statement on ADHD highlights that while stimulant medications can be highly effective, they carry known risks, including appetite suppression, sleep disruption, cardiovascular complications, potential misuse, diversion or dependency, and exacerbation of underlying psychiatric conditions such as anxiety, mania or psychosis and related symptoms.

Quotes attributed to Dr Simon Stafrace, Chair of RANZCP Victoria:

“We have had longstanding concerns about existing barriers to accessing ADHD care for Victorians, including limited options to accessing specialist care in public health system within the community.

"However, the policy announced today removes treating GPs, psychiatrists and paediatricians who know their patients from their continuing care.

"Without strong safeguards, this model risks fragmenting care and creating new safety concerns for people with ADHD, including inappropriate prescribing and unmonitored side effects of stimulant medications.

"It can also delay proper assessment, diagnosis and treatment of emerging mental health conditions, and may divert valuable resources away from genuine emergencies.

"ADHD medication prescribing requires knowledge of the patient's treatment history, response to medication, side effects, and any other conditions. A single, short virtual consultation cannot provide this context.

"ADHD symptoms can overlap with a wide range of other psychiatric and physical conditions. Stimulants may not always be the right treatment, and this may only become clear over time.

"Today's announcement is inconsistent with yesterday's commitment to stakeholder consultation. Less than 24 hours after announcing a measured approach to ADHD reform, the government has announced another significant policy change without consulting medical colleges or ADHD experts.

"Continuity of care with clinicians who know their patients is key. Victoria needs a shared care model for ADHD built together with doctors on the frontline.

"We know accessing ADHD care is hard for many Victorians. But the answer is making sure people can see psychiatrists, paediatricians and GPs, and building specialist ADHD care capacity and accountability within the public health system.

"We're calling on the government to work with RANZCP, the Royal Australian College of General Practitioners (RACGP) and other stakeholders to create safe pathways so people with ADHD get treated by someone they trust, someone who knows them and their health."

Quotes attributed to Dr Anita Muñoz, Chair of RACGP Victoria:

“Renewing a stimulant medication prescription for six months without an appropriately structured physical and psychological review or an in-person consultation does not provide continuity of care and risks missing the emergence of adverse side effects, including cardiovascular harms and symptoms of psychosis or mood elevation.

“GPs and psychiatrists managing or co-managing patients with ADHD take stimulant medications’ risks seriously. Regular review by a member of your ADHD care team is essential, and a patient potentially going six months without one following a telehealth appointment is deeply concerning. 

“To prescribe stimulants for ADHD, GPs must have a valid permit and a co-management arrangement with the diagnosing medical specialist, including guidance on suitable medication types and ceiling doses, potential risks, and non-medical interventions.

“The ⁠Victorian Virtual Emergency Department website is clear that it 'is an emergency care service and does not do routine prescription refills.' This announcement sends mixed messages to the community that the VVED is now available for routine scripts and chronic disease management. 

“The RACGP and the Victorian branch of the RANZCP have been collaborating with each other and the Victorian Government to design an approach that supports patients to receive ongoing ADHD care from a team of clinicians who knows them and them and their medical history, like a specialist GP or psychiatrist. 

 “We made a commitment to work with the Victorian Government to improve access to ADHD care safely, and would welcome consultation on this plan. That this has not happened before this announcement on VVED is very disappointing.”

For all other expert mental health information visit Your Health in Mind, the RANZCP’s consumer health information website.

ENQUIRIES: For more information, or to arrange an interview call Dishi Gahlowt 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.

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