{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T08:32:07Z","timestamp":1793262727025,"version":"4.5.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Australas Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The rapid growth of ADHD assessment and prescribing in Australia reflects a gap between demand and service availability. Workforce shortages, restrictive stimulant regulations and limited adult ADHD care within public mental health services have contributed to this gap. ADHD-focused clinics have emerged in response. Using two de-identified clinical scenarios, this paper examines the drivers of this model and its potential harms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Focused clinics can improve access and provide expertise. However, a narrow scope and fee-for-service model may also encourage transactional and fragmented care. We describe this risk as organisational iatrogenesis. Potential harms include incomplete formulation, uncoordinated prescribing and missed psychiatric, neurodevelopmental or neurocognitive comorbidity. Broader concerns include inequity, cost, discontinuity of care and erosion of generalist skills. The solution is not to restrict focused practice, but to integrate it more effectively with mainstream care. Priorities include nationally consistent prescribing rules, stronger shared-care arrangements with general practitioners, greater adult ADHD capacity within public services and clearer standards for scope-restricted practice. These issues are also relevant to other single-disorder models of psychiatric care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10398562261491671","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:56:26Z","timestamp":1792479386000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the silo: Single-disorder ADHD clinics and the case for more integrated care"],"prefix":"10.1177","author":[{"given":"Soumitra","family":"Das","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Western Health"},{"name":"Department of Psychiatry, University of Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5554-2216","authenticated-orcid":false,"given":"Seshadri Sekhar","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Central Queensland Hospital and Health Services"},{"name":"Department of Psychiatry, The University of Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-024-00495-0"},{"key":"e_1_3_5_3_2","volume-title":"ADHD medications dispensed over time","author":"Australian Institute of Health and Welfare","year":"2025","unstructured":"Australian Institute of Health and Welfare. ADHD medications dispensed over time. Canberra: AIHW, 2025. Available from. https:\/\/www.aihw.gov.au\/mental-health\/topic-areas\/community-based-services\/mental-health-prescriptions\/adhd-medications-dispensed-overtime (accessed 19 July 2026)."},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/10398562251315006"},{"key":"e_1_3_5_5_2","volume-title":"Assessment and support services for people with ADHD","author":"Senate Community Affairs References Committee","year":"2023","unstructured":"Senate Community Affairs References Committee. Assessment and support services for people with ADHD. Canberra: Commonwealth of Australia, 2023."},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/10870547261421983"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1558\/isbn.9780714521206"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410120089033"},{"key":"e_1_3_5_9_2","volume-title":"Saving normal: an insider\u2019s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life","author":"Frances A","year":"2013","unstructured":"Frances A. Saving normal: an insider\u2019s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. New York: HarperCollins, 2013."},{"key":"e_1_3_5_10_2","volume-title":"Medicinal cannabis prescribing","author":"Australian Health Practitioner Regulation Agency","year":"2025","unstructured":"Australian Health Practitioner Regulation Agency. Medicinal cannabis prescribing. Melbourne: Ahpra, 2025. Available from. https:\/\/www.ahpra.gov.au\/Resources\/Medicinal-cannabis-prescribing.aspx (accessed 19 July 2026)."},{"key":"e_1_3_5_11_2","volume-title":"Prescribing ADHD medicines (psychostimulants)","author":"Queensland Health","year":"2025","unstructured":"Queensland Health. Prescribing ADHD medicines (psychostimulants). Brisbane: State of Queensland, 2025. Available from. https:\/\/www.health.qld.gov.au\/clinical-practice\/guidelines-procedures\/medicines\/monitored-medicines\/prescribing\/adhd-psychostimulants (accessed 19 July 2026)."},{"key":"e_1_3_5_12_2","volume-title":"NSW ADHD reforms: report on the implementation of general practitioner (GP) continuation prescriber reforms","author":"NSW Health","year":"2025","unstructured":"NSW Health. NSW ADHD reforms: report on the implementation of general practitioner (GP) continuation prescriber reforms. Sydney: NSW Ministry of Health, 2025."},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v7.i17.2420"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0277175"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.837424"},{"key":"e_1_3_5_16_2","volume-title":"Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (ADHD)","author":"Australasian ADHD Professionals Association","year":"2022","unstructured":"Australasian ADHD Professionals Association. Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (ADHD). Melbourne: AADPA, 2022."},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)30032-3"},{"key":"e_1_3_5_18_2","volume-title":"CanMEDS 2015 physician competency framework","author":"Frank JR","year":"2015","unstructured":"Frank JR, Snell L, Sherbino J. CanMEDS 2015 physician competency framework. Ottawa: Royal College of Physicians and Surgeons of Canada, 2015."},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/HMR.0b013e31821826a1"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201400178"}],"container-title":["Australasian Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10398562261491671","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10398562261491671","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10398562261491671","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:38:15Z","timestamp":1793259495000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10398562261491671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":19,"alternative-id":["10.1177\/10398562261491671"],"URL":"https:\/\/doi.org\/10.1177\/10398562261491671","relation":{},"ISSN":["1039-8562","1440-1665"],"issn-type":[{"value":"1039-8562","type":"print"},{"value":"1440-1665","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"article-number":"10398562261491671"}}