Editorial: Stakes high in treating NZ’s ADHD issues

It’s now recognised that ADHD impacts individuals of all genders equally and can persist into adulthood. Photo / 123RF

EDITORIAL

Kiwis waiting for up to a year for adult ADHD assessments represent both a public and private failure in our medical system.

The disorder — a condition with symptoms that include attention difficulty, hyperactivity and impulsiveness — was traditionally identified as one that mainly affected boys, primarily because girls tend to conceal their symptoms more effectively. It’s now recognised that ADHD impacts individuals of all genders equally and can persist into adulthood, leading to a surge in the number of people seeking assistance.

The Herald surveyed 20 specialists across New Zealand who are known for assessing ADHD.

Around half of them were not taking new patients at all because they had full books. Of the remainder, the earliest available appointment was six weeks away.

That was an outlier. The typical wait was six months to a year. One exasperated receptionist, who had no free appointments until August 2025, said they had received another request for an assessment two minutes earlier.

Cost is another barrier for people seeking diagnosis — an assessment can cost up to $2000, which is prohibitive for a huge swathe of the New Zealand population.

The situation appears even more dire in the public system. Adults can seek a free assessment in the public system but psychiatrists, psychologists and neurologists are primarily focused on severe psychiatric conditions.

“There is almost no adult public access for ADHD,” Royal New Zealand College of GPs medical director Dr Luke Bradford told the Herald.

There does appear to be light at the end of the tunnel. Advocacy groups, doctors and health officials are pursuing several solutions, including training GPs to carry out ADHD assessments.

Bradford, from the college of GPs, said this initiative required a technical amendment to the medical regulations, which says that only psychiatrists can treat ADHD. He expects this to be altered by the end of the year, which would allow GPs with an interest in ADHD to diagnose and treat the condition — a significant step.

It would increase access for patients and decrease costs. While patients would have to pay for a longer appointment — possibly 90 minutes — the bill would be much lower than the typical $2000 fee for a private assessment, Bradford said.

Medicines agency Pharmac is also reviewing the “special authority” rule which requires ADHD patients to see a psychiatrist every two years to renew their medication. If that requirement was changed, or delegated to GPs, it could also free up specialist capacity.

For many Kiwis and their families, any changes can’t come soon enough.

Failing to get a diagnosis can be a life-and-death issue. Those who go undiagnosed are more likely to attempt suicide, or end up in prison. The stakes are high — and improving access should be a priority, for all parts of the health sector.