Stimulant Shared Care

Supporting flexible care

This information is for patients who are under GP shared care for stimulant prescribing.

Introduction

What shared care means

Western Australian stimulant prescribing regulations recently changed, allowing longer gaps between psychiatrist appointments where appropriate under a shared care arrangement. This replaces the previous stimulant co-prescribing process.

In practical terms, shared care allows you to see your GP for stimulant prescriptions and routine monitoring between appointments with me, while remaining an active patient under my care. The gap between appointments with me is generally between 1 and 3 years, with the option to book an earlier appointment if needed at any stage.

Shared care is entirely optional. If you'd prefer to remain under my care for all your mental health needs, including prescriptions, I'd be delighted to continue working with you more closely.

Note: Stimulant prescribing in Australia is regulated, and state/territory rules vary. We will only proceed with shared care arrangements that comply with local regulations and any required permits/approvals.

Eligibility

Shared care may be suitable if:

You have been under my care for at least two years
Your mental state and treatment plan have been stable for at least 12 months
Your medication is effective and well-tolerated
You have not had any recent physical health or psychiatric safety concerns
Your GP agrees that shared care is suitable and manageable within their practice
You are able to attend GP appointments for prescriptions and monitoring when required
You agree to keep me informed of any changes in your mental state or medication plan

How it works

Step 1: Psychiatrist review

I'll usually give you the option of GP shared care if you are eligible, but you are welcome to ask about your eligibility at an appointment. We will discuss the plan together, and I'll write to your GP to initiate shared care. I'll usually issue a prescription at this appointment.

Step 2: GP review

Provided your GP agrees the plan is manageable within their current model of care, you'll see your GP for your next script approximately 6 months later. I recommend confirming that your GP can proceed with shared care before your prescription is due to avoid any gaps in treatment.

Step 3: GP prescriptions

You'll continue to see your GP every 6 months until your next psychiatrist review is due. At each appointment, your GP will review your physical and mental health, check your monitoring results, and issue a new prescription if everything remains stable. If you require any travel letters or medical certificates, these would be provided by your GP.

Step 4: Psychiatrist review

Once your psychiatrist review is due, you'll attend an appointment with me for your mental health review and prescriptions. At this appointment, we will review whether the current plan should continue, and whether your next review should be in 1, 2, or 3 years based on your clinical needs.

Step 5: Repeat!

You'll continue to see me every 1-3 years, depending on your individual circumstances, safety needs, and regulatory requirements, with 6-monthly physical/mental health monitoring and prescriptions issued by your GP in between.

Important details

What you are responsible for

While under GP shared care, you are responsible for the following:

Ensure you are aware of the prescription due date and expiry date to avoid gaps in treatment
Collect your medication at regular intervals. Delayed collection may result in your script expiring before you can collect all the repeats due to dispensing interval rules.
Please tell me before starting any new medications for sleep or mental health prescribed by other healthcare providers, so I can provide advice on the suitability of this medication.
Keep all of your doctors informed about any changes in your physical or mental health.
Ensure you are aware of the costs of GP shared care. Your GP's fees are set by your GP clinic, and I cannot advise on this.
Ensure you prepare in advance before travelling interstate or overseas. Arrange a travel letter early and be aware of the laws of each country you visit or transit through.
If your GP is unable to continue shared care for any reason (due to clinic policy, capacity, or regulatory changes), please notify me as soon as possible so we can plan your follow-up.

When shared care may pause or stop

If any of the following occur, your shared care may need to be stopped:

Safety concerns emerge (related to your mental or physical health)
You are not attending reviews - I will discharge you if you do not attend an appointment by the specified review date, as I cannot maintain medicolegal responsibility for inactive patients
If your condition changes and you need approval to continue stimulant medications according to Health Department regulations
If you move interstate (as regulations differ), we may need to update your plan. I'm most familiar with WA regulations, and you'll need to establish care with a new GP, so it may take time to organise a new co-prescribing arrangement.
Your mental state has destabilised, or your treatment needs to be adjusted. Once your mental state and treatment plan stabilise for at least 12 months, you can resume shared care.

My advice

Self-manage your appointments & prescriptions

I usually ensure your appointments are timed to avoid running out of medications. I take your script expiry and run-out dates, as well as my leave plans, into account when recommending the review date.

If you are under GP shared care, you'll need to take responsibility for your appointments to ensure you don't run out of medications. I recommend you book your prescription appointments at least 2-3 months in advance, where possible, to ensure you don't run out of medication. GPs don't do prescription requests for stimulant medications, so it is best to plan ahead.

If you need to see me sooner than planned for any reason, you are welcome to book the earliest available appointment. Online bookings are coming soon, and appointments are usually available at short notice. It is essential to note that without an active GP referral, you won't be eligible for a Medicare rebate.

Following the agreed plan

Your stimulant dose, review interval, and prescribing plan must not be altered outside of my approved specialist plan. If another provider suggests changing your dose or extending your review interval, please do not accept this. Doing so places you outside the agreed safety plan and means I cannot continue to take clinical responsibility for your stimulant prescribing.

If this occurs, I will need to pause or end shared care and discharge you from my service. Always check with me before accepting any changes.

Summary

Let's recap

Shared care is a great option for stable patients who no longer need more frequent psychiatry appointments. Participation is voluntary for both you and your GP. As long as you are eligible and you meet your responsibilities, I'm happy to support your preferences, and I'm always here if you need an earlier review.

Disclaimer

This information is general and does not replace individual medical advice. Always discuss treatment decisions and any changes to your medication with your prescribing doctor and pharmacist.

Shared care arrangements require active participation from all parties. If required information or monitoring is not completed, prescribing may be paused until a review can occur. Stimulant prescribing must follow Australian and state/territory regulations, permit conditions, and your individual treatment plan. Always follow the instructions provided to you by me and your GP.

Last reviewed: March 2026