GPs can now prescribe ADHD medication – but big barriers to treatment remain
In February, NZ rolled out new rules promising easier access to ADHD treatment. Today, gaps in training, cost and access show why the reform was only a first step.
In New Zealand, GPs can now prescribe ADHD medication to adults, but significant challenges persist in ensuring effective treatment. Public mental health services have struggled to assess adults with ADHD, while private psychiatric appointments can be prohibitively expensive. The reform, effective in February, aimed to make treatment more accessible by allowing trained GPs and nurse practitioners to prescribe stimulant medication.
However, this change has unveiled new issues, as the expanded pool of prescribers does not guarantee improved access to care. ADHD is estimated to affect 2.5% to 3.4% of adults, with untreated cases linked to poorer educational outcomes, mental health problems, substance abuse, and involvement in the justice system. Stimulant medication is recommended as a first-line treatment by international guidelines, yet only about one-third of adults under 50 with suspected ADHD in New Zealand received stimulant medication in 2022.
Access to treatment remains uneven, with those who can afford private assessments having a clearer path forward. Māori, Pacific peoples, and people facing financial hardship are more likely to miss out on care. The new system relies heavily on clinicians' expertise in ADHD assessment, which lacks required training or competency standards.
Many GPs are not yet following an ADHD care pathway, leaving patients without a clear route to diagnosis and treatment. The assessment process, which can last one to three hours, often exceeds the typical GP appointment length, complicating diagnosis further. Approximately 60% of adults with ADHD also have other conditions such as anxiety, depression, PTSD, or autism, which can complicate diagnosis and potentially worsen symptoms with stimulant medication.
Cost is another major barrier, as GP visits are not free, and lengthy assessments may be unaffordable for many. This could create a new barrier based on practice choice and financial capacity rather than individual need. While new models of ADHD care are emerging, such as GPs, mental health nurses, and specialists handling assessment and treatment, there is a lack of consistency in quality, cost, and availability of care across providers.
Medication alone is insufficient; psychoeducation and practical management strategies are crucial for effective ADHD care. A better system should establish clear national pathways, competency standards, and appropriate assessment tools tailored to Aotearoa New Zealand, incorporating the perspectives of people with ADHD and their families, and grounded in Te Tiriti o Waitangi.
Written by urgent.news from The Conversation AU's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
