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Shared care explained: how your GP, psychiatrist and you work together
Shared care is how most ongoing mental health treatment actually works in Australia. Here is what it means in practice, who does what, and how it makes specialist care sustainable.
Clinically reviewed by Consultant Psychiatry Team · FRANZCP
If you are about to start ongoing care with a psychiatrist, you will almost certainly hear the term shared care. It is the standard model for managing long-term mental health treatment in Australia, and it works well, but the name does not really explain it. Here is what it actually means.
The basic idea
Shared care means your treatment is delivered by your GP and your psychiatrist together, with clear roles for each. The psychiatrist initiates and reviews. The GP handles the day-to-day prescribing, monitoring, and continuity. You sit between the two of them, with both clinicians on the same page about your treatment plan.
It is different from the model people sometimes assume, where you would see a psychiatrist for every prescription refill and every check-in. That is not how specialist care is structured in Australia, and it is also not necessary for most people. Once treatment is stable, GP-led ongoing care is the right level of intensity.
Who does what
The psychiatrist
Diagnosis, treatment plan, medication initiation, and ongoing review. A psychiatrist starts you on treatment, adjusts it through the early weeks while the dose is being settled, and then sees you for periodic reviews, usually every three to six months once you are stable. They are the specialist your GP refers to when complexity goes beyond what a GP can manage alone.
The GP
Day-to-day care. Once your psychiatrist has stabilised treatment, your GP holds the ongoing prescription. They see you in between specialist reviews, check that things are going well, and contact the psychiatrist if anything changes. They are your continuity: they have known you longer, they see you more often, and they hold the rest of your health picture too.
You
The most important part of the picture. You see how the treatment is going day to day. You notice side effects, mood shifts, the things that are working and the things that are not. Telling both your GP and your psychiatrist what you are noticing, not just the polished version, is what makes shared care actually work.
The consultation letter: the connective tissue
The thing that keeps shared care from falling apart is the consultation letter. After every appointment with your psychiatrist, a written letter goes back to your GP. It contains: the diagnosis or current formulation, the treatment plan, any changes to medication, what to monitor, and when the next review is scheduled.
This is not a courtesy. It is the document your GP relies on to keep your care joined up. Without it, the GP is prescribing in the dark and the psychiatrist is reviewing without context. With it, everyone is working from the same page.
How prescriptions move over time
In the early weeks of treatment, your psychiatrist writes the prescriptions. They want to adjust dose, change formulation if needed, and respond quickly to side effects. The most efficient way to do that is for the specialist to hold the script.
Once treatment is stable, usually after a couple of months, prescribing moves to your GP. From that point on, you go to your GP for refills. Your psychiatrist reviews you every three to six months to confirm everything is still on track and to make any adjustments that come up.
For specific medications, this transition can look slightly different. Adult ADHD stimulant prescribing has its own regulatory pathway in Victoria, for example, and the timing depends partly on what your GP is set up to do. Your psychiatrist will walk you through what applies in your case.
What to ask your GP at your next visit
If you are about to start specialist psychiatric care, three useful questions for your GP:
- Are you happy to continue prescribing my medication long-term once the psychiatrist has stabilised it?
- What is the best way to reach you between appointments if something changes?
- Should I make a regular check-in appointment with you, separate from prescription refills, so we can talk about how things are going?
Most GPs are very used to this; adult psychiatry shared care is a normal part of general practice. The conversation is helpful because it sets the rhythm of who you talk to about what.
Why it matters
Done well, shared care gives you the best of both: specialist input when complexity calls for it, and continuous GP-level care for the longer arc. Done badly (when the letter does not arrive, when the GP and psychiatrist are not in contact, when no one is sure who is supposed to follow up) it falls apart at the seams.
We treat the consultation letter and the GP relationship as part of the work, not a courtesy. That is what makes the model worth describing as care, rather than as two clinicians billing separately.
Next step
For more on how shared care works in our clinic, see our Psychiatry Care page . GPs considering a referral can read our For Referrers page . To start an enquiry, send a short message .