Recognising and treating ADHD in adults in public mental health services: A scoping review of key concepts

Abstract

Objectives

To summarise service models, facilitators and barriers relevant to recognising and treating attention deficit/hyperactivity disorder (ADHD) within adult public mental health services.

Methods

A scoping review following PRISMA-ScR guidelines examined international literature describing adult ADHD care delivered within public mental health systems. Data were charted on models of care, implementation facilitators and barriers, and evidence gaps were identified.

Results

Thirteen sources met inclusion criteria. The literature was limited and largely conceptual, consisting predominantly of editorials, commentaries and clinical guidance, with minimal empirical evaluation of implementation or outcomes. Three broad approaches to service delivery were described: embedding ADHD assessment and treatment within existing adult mental health teams; establishing specialist adult ADHD or neurodevelopmental services; and shared-care and primary-care–led models supported by specialist input. Facilitators included targeted workforce training and collaboration with primary care services. Barriers related to diagnostic complexity, clinician confidence, service capacity and concerns regarding prioritisation within public systems.

Conclusions

The literature consistently supports embedding ADHD care within routine adult public mental health teams, supported by targeted registrar and psychiatrist training and structured collaboration with general practitioners. Empirical evaluation of service models is needed to inform sustainable and equitable implementation within publicly funded mental health services.

Keywords

ADHD adult public mental health models of care service reform

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