An adult ADHD assessment is a structured clinical process used to work out whether long-standing difficulties with attention, focus, organisation or impulse control meet the recognised criteria for Attention Deficit Hyperactivity Disorder (ADHD). At Shire Family Medical, a GP practice in the heart of Sutherland, we regularly see adults who suspect they may have ADHD and aren’t sure where to start, and in NSW there are now two genuine pathways to a diagnosis, not just one.
Shire Family Medical, a GP medical centre at 154 Flora Street, Sutherland, has cared for patients across the Sutherland Shire for more than 11 years. This article explains what an adult ADHD assessment actually involves, when a referral is and isn’t needed, and how the practice’s own GP-led assessment pathway compares with the traditional route through a psychiatrist or psychologist.
What Is an Adult ADHD Assessment?
An adult ADHD assessment is a structured evaluation that looks at the pattern, timing and impact of attention and impulse-control difficulties over a person’s whole life, not just how they’re feeling on the day of the appointment. It typically combines a detailed clinical interview, standardised questionnaires and, often, information from people who know the person well, rather than relying on a single test or a quick online quiz.
It’s common for adults to first consider an ADHD assessment after a child or family member is diagnosed, or after recognising familiar patterns described online. Whatever prompts the question, a formal assessment is the only way to reach an actual diagnosis, and as of 2026 there are two different routes to get one.
Signs That May Prompt an ADHD Assessment
Adults often consider an ADHD assessment after noticing a long-standing pattern, rather than a single recent change. Signs that commonly lead people to raise the topic with their GP include:
- Ongoing difficulty concentrating, staying organised or finishing tasks, especially ones that feel repetitive
- Frequently losing items, missing deadlines or forgetting appointments despite trying to keep track of them
- Restlessness, impulsivity or difficulty sitting through meetings or long conversations
- A pattern of starting projects with enthusiasm but struggling to see them through
- Difficulties that can be traced back to childhood or school, even if never formally investigated at the time
- A close family member, such as a child, being recently diagnosed, prompting recognition of similar traits
None of these signs alone confirm ADHD, and each can also be explained by other causes, including anxiety, sleep problems, thyroid conditions or a demanding period of life. This is one of the reasons a proper assessment, rather than a checklist, matters.
Two Ways to Get an ADHD Assessment in NSW
NSW patients now have two genuine pathways to an ADHD diagnosis: a GP-led assessment through a specially trained prescriber, or a traditional referral to a psychiatrist or clinical psychologist. Since 1 September 2025, GPs who complete additional NSW Health training can become endorsed prescribers, and some, known as Tier 2 Endorsed Prescribers, can go a step further and assess, diagnose and initiate ADHD medication themselves, without a specialist referral. We’ve covered the regulatory detail behind this reform, including continuation prescribing for GPs who aren’t Tier 2 endorsed, in Can a GP Prescribe ADHD Medication in NSW?
At Shire Family Medical, Dr Katrina Mikhail is a Tier 2 Endorsed GP Prescriber, which means eligible patients aged 6 and over can be assessed, diagnosed and, where appropriate, started on treatment through our GP-led ADHD assessment service in the Sutherland Shire, without needing to see a psychiatrist or psychologist first. The traditional pathway, referral to a psychiatrist or a suitably experienced clinical psychologist, remains available and is still the right route for some patients, as the table below sets out.
| ADHD Assessment Pathway | Referral Needed? | Who Diagnoses | Best Suited To |
|---|---|---|---|
| GP-led (Tier 2 Endorsed Prescriber) | No | The endorsed GP | Straightforward presentations without significant comorbidities, ages 6+ |
| Traditional specialist referral | Sometimes, depending on the specialist | A psychiatrist or clinical psychologist | Complex psychiatric comorbidities, current substance use, or where specialist-led care is preferred |
What Happens During an ADHD Assessment?
Both pathways follow a broadly similar clinical process, whether it’s led by an endorsed GP or a specialist. Expect a detailed interview covering your history and current symptoms, standardised, validated questionnaires such as the Adult ADHD Self-Report Scale (ASRS) used to structure and score reported symptoms, and, where possible, some collateral information from a partner, close family member or someone who has known you a long time, to build a picture of how symptoms show up outside the consultation room.
Your assessing clinician will also want to rule out other conditions that can look similar to ADHD, including thyroid problems, iron deficiency, sleep disorders and anxiety. This is often where a broader GP health check or a set of blood tests fits in, either as part of the assessment itself or as a starting point before a referral is made.
Who Is the GP-Led Pathway Suitable For?
The GP-led assessment pathway is designed for relatively straightforward presentations and is not appropriate for every patient. Our own ADHD Assessment & Diagnosis service notes that GP-led assessment may not be suitable where there are complex psychiatric comorbidities requiring specialist-led care, a history of substance use or drug dependence, including medicinal cannabis, or for children under 6 years of age. In these situations, a referral to a psychiatrist or an experienced clinical psychologist remains the appropriate next step, and your GP can help arrange this.
Do You Need a Referral for an ADHD Assessment?
Whether you need a referral for an ADHD assessment depends on which pathway you use. No referral is required for the GP-led pathway at Shire Family Medical, since Dr Mikhail’s Tier 2 endorsement allows her to assess eligible patients directly. For the traditional pathway, requirements vary between individual psychiatrists and psychologists: some require a GP referral before booking, while others accept direct bookings. Seeing a GP first is generally worthwhile either way, since they can help rule out other causes and point you toward the pathway that best suits your circumstances.
What Does an ADHD Assessment Cost?
The cost of an ADHD assessment varies considerably depending on the provider, the pathway used, and whether a Medicare rebate applies to part of the process. There is no single standard fee across Australia, and fees are also more prone to change than most other content on this page, so rather than quote a figure here that may be out of date by the time you read it, we’d encourage you to check current fees directly on our ADHD Assessment & Diagnosis page or our fees and billing page. A Medicare rebate may apply to part of the appointment cost; ask at the time of booking what this looks like for your situation.
What Happens After an ADHD Diagnosis?
Once a diagnosis is confirmed, whether by an endorsed GP or a specialist, treatment planning may include medication, non-medication strategies such as coaching or structured routines, or a combination of both, depending on what suits your circumstances. If medication is appropriate and you were diagnosed by a psychiatrist rather than a Tier 2 endorsed GP, that specialist (or another doctor with authority to initiate treatment) needs to make the initial decision to start it.
Once you’re stable on a medication plan, an authorised GP may be able to continue your prescriptions under NSW’s continuation prescriber arrangements. Our ADHD Management service supports eligible patients with this kind of ongoing prescription care once a diagnosis and initial treatment plan are already in place.
ADHD Assessment for Children vs Adults
ADHD assessment for children generally follows a different pathway to adults and usually involves a paediatrician, often alongside input from a psychologist, teachers and parents. If you’re wondering about ADHD in a child rather than yourself, our paediatric GP care is a reasonable starting point, since ongoing paediatric care and any developmental concerns are often considered together.
Talking to Your GP About an ADHD Assessment
If you’ve been wondering whether an ADHD assessment might be worth pursuing, raising it at a GP appointment is a reasonable and common way to start. Your GP can talk through what you’ve been noticing, check for other possible explanations, and help you understand whether the GP-led pathway or a specialist referral is the better fit for your circumstances. Book an appointment with Shire Family Medical →
Frequently Asked Questions
What is an adult ADHD assessment?
An adult ADHD assessment is a structured clinical evaluation used to determine whether a person’s symptoms meet the recognised diagnostic criteria for Attention Deficit Hyperactivity Disorder. It typically combines a detailed interview, standardised questionnaires such as the ASRS, and often information from people who know the person well.
Do I need a referral for an ADHD assessment?
It depends on the pathway. No referral is needed for a GP-led assessment with a Tier 2 Endorsed Prescriber, such as Dr Katrina Mikhail at Shire Family Medical. For the traditional route, some psychiatrists and psychologists require a GP referral before booking, while others accept direct bookings.
Can a GP diagnose ADHD in NSW?
Since 1 September 2025, GPs who complete specific NSW Health training and become Tier 2 Endorsed Prescribers can assess, diagnose and initiate ADHD medication for eligible patients without a specialist referral. GPs without this endorsement cannot diagnose ADHD and would refer a patient to a psychiatrist or psychologist instead.
What’s the difference between a GP-led assessment and a specialist assessment?
A GP-led assessment is carried out by a Tier 2 Endorsed GP Prescriber and does not require a referral, while a specialist assessment is carried out by a psychiatrist or clinical psychologist, sometimes requiring a referral first. Both follow a broadly similar clinical process, but the GP-led pathway is intended for more straightforward presentations.
Are ADHD assessments covered by Medicare?
A Medicare rebate may apply to part of an ADHD assessment, but there is no single standard rebate that covers a full assessment on either pathway. It’s worth asking about current fees and any applicable rebate directly when you book, since arrangements can vary between providers.
What if I’m not suitable for the GP-led ADHD assessment pathway?
The GP-led pathway may not be appropriate for patients with complex psychiatric comorbidities, a history of substance use or drug dependence including medicinal cannabis, or children under 6. In these situations, a referral to a psychiatrist or an experienced clinical psychologist is the appropriate next step.
How long does an ADHD assessment take?
An ADHD assessment may take place over a single appointment or be spread across more than one session, depending on the pathway and the complexity of the case. Demand for ADHD assessment currently exceeds the number of specialists available in some areas, so wait times can vary between providers.
Can I get ADHD medication straight after my assessment?
On the GP-led pathway, a Tier 2 Endorsed Prescriber can initiate ADHD medication as part of the assessment process where clinically appropriate. On the traditional pathway, the diagnosing psychiatrist makes this decision, and an authorised GP may later continue prescriptions once you’re stable on a treatment plan.
This article provides general health information only. It is not a substitute for personalised medical advice and does not create a doctor-patient relationship. Any treatment, test, procedure or vaccination mentioned is for illustrative purposes only. Suitability depends on individual circumstances and assessment by a qualified health professional. Medical information can change; always speak with your GP about your specific symptoms, health history and care options. In an emergency, call 000.
About Shire Family Medical
Shire Family Medical is an AGPAL-accredited general practice in Sutherland, providing patient-centred GP care for individuals and families at every stage of life. Led by Dr Louis Traynor and registered nurse Rebel Traynor, the practice offers a broad range of general practice services at 154 Flora Street, Sutherland — conveniently located near Sutherland Station and serving the wider Sutherland Shire community. All doctors practising at Shire Family Medical are registered medical practitioners with the Australian Health Practitioner Regulation Agency (AHPRA).
Shire Family Medical publishes general health information across preventive care, women’s and men’s health, children’s health, travel health and chronic disease management. Articles are written to help patients make informed decisions about their health in partnership with their GP.