From February 2026, GPs and nurse practitioners (NPs) will be able to diagnose and prescribe medication for ADHD. Advocates say the new law will increase access for thousands of people struggling to get help with ADHD, but critics say it could overwhelm a system already at breaking point.
Many agree the way we diagnose and treat ADHD needs improving. So, will this new law help? Or could it create more problems? Re: News journalist Zoe Madden-Smith investigates.
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When Rachel Hinds was diagnosed with ADHD and autism at the age of 28, she thought of her younger self.
She thought about all the emotional outbursts she had that she couldn’t understand or explain. All of the different anti-anxiety or antidepressants she tried to make sense of her brain. All of the days she spent constantly masking to fit in, constantly exhausted. All the times she binge-drank to try to quieten her brain – because nothing else really helped.
"I was angry that I didn't know up until now," the now 29-year-old says.
"Angry because there were so many opportunities for me and my family to have come to that conclusion as a child, as a teenager, and as an adult. I was in counselling from when I was a teenager, so it just blew my mind in the worst way knowing that I had to go through all of my 28 years not knowing this."
What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that can impact someone’s ability to focus, plan, control impulses, and complete tasks. It’s estimated 1 in 20 people in New Zealand have ADHD, but girls and women are less likely to be diagnosed, according to ADHD New Zealand.
After years of suffering from emotional outbursts and being treated for severe anxiety, Hinds was diagnosed with ADHD with support from a charity called A Change for Better. She paid off the subsidised consultation fees of about $600 through a weekly payment plan.
"I would not have been able to access any kind of diagnosis if it wasn’t a payment plan, and if it wasn't subsidised," she says.
But despite having a formal diagnosis of ADHD, Hinds has not been able to access medication because she cannot afford to see a psychiatrist. The lowest price she has seen for a psychiatrist is $900 – and she hasn’t come across any with a payment plan.
"It pisses me off, really," she says.
"It's one of the most treatable neurodevelopmental conditions. And if you happen to have it, you should be able to seek treatment for it, should you choose to do so. It shouldn’t be up to who has the most money."
Law change for ADHD is 'no silver bullet'
A new law, which will come into effect in February 2026, would allow people like Hinds to be diagnosed and treated for ADHD through a specialised GP or nurse practitioner.
Currently, only a psychiatrist can diagnose ADHD, and GPs can only prescribe repeat medication – an approach which has made ADHD diagnosis and treatment a long and expensive process.
The law is delayed until February as there is expected to be a better supply of ADHD medications, for which there is currently a shortage.
Medical director of The Royal New Zealand College of General Practitioners, Dr Luke Bradford, campaigned for the law change and says while it’s "no silver bullet", it is a step in the right direction for increasing access for people like Hinds.
"The system had become broken; it was overloaded. It was either a huge wait to get into public or a massive weight and huge expense to go private, and it just meant that people were struggling," he says.
Bradford says while not all GPs and nurse practitioners will be interested in specialising in ADHD, he expects to see a "few hundred" in the first year.
But Bradford wants people to understand that getting diagnosed through a GP won’t happen in a typical 15-minute doctor's appointment – and it won’t be a typical appointment fee either.
Just like seeing a psychiatrist, he says assessments will take one or two hour-long appointments and involve interviews about health records, life experiences, and cross-referencing these with people in the patient’s life.
The assessments will look at lifestyle changes and coping strategies. If the patient has moderate to severe ADHD that is causing impairment across their life, the GP may discuss medication options. However, Bradford says medication does not work for everyone and can take trial and error to get right.
"This is not going to be like seeing your doctor for contraception and then saying, 'I think I've got ADHD. Can I have some medicine?' It is a completely separate and longer consultation with a specialised doctor or nurse."
New approach to ADHD is 'setting us up for more inequities in our system'
New Zealanders are reportedly paying anywhere between $600-$2000 for an ADHD assessment – a price tag that has locked people like Hinds out of receiving care.
Bradford estimates it will cost between $400-$800 to get an ADHD assessment through a GP under the new law, but he expects this price to go down as more people upskill.
"To run a GP in a clinic with all of the clinic costs without any government input is over $400 an hour. An assessment will be a minimum of one or two hours. So, it’s not going to be really cheap."
Psychiatrist Jamie Speeden works across the public and private mental health sector and says while the new system is an improvement, it will still be "setting us up for more inequities".
"I think [the new law] is going to help a little bit, but it's still a barrier. A lot of people can't even afford to see the GP. In one of my other clinics, you have to pick the right day of the week for an appointment because they need to have enough petrol money."
Research shows ADHD increases the risk of mental health struggles, substance abuse, imprisonment, long-term unemployment, and dependency on benefits.
Both Speeden and Bradford say that to reach the most vulnerable communities, there will need to be targeted funding through Work and Income, Corrections, or other programmes.
The Ministry of Health did not say if there would be additional funding, but told Re: News, "fees for a consultation with a GP, nurse practitioner or psychologist will vary between providers, but we expect giving people more options will lead to faster access and lower costs over time."
Could the new law overwhelm a system already at breaking point?
Earlier this year, General Practitioners Aotearoa warned the primary care sector is at a tipping point that could lead to the collapse of the public health system. It estimated the country was 1000 doctors short of what it should be, with some clinics already closing their doors and patients seeing weeks-long wait lists across the country.
Speeden says both the primary and public mental health sectors are "overwhelmed" by ADHD and says there is a risk the same could happen to primary care.
"The public system and the team I work with, we get 100 [ADHD] referrals a week," he says.
"It takes a GP a couple of hours to do an [ADHD] assessment and our GPs or nurse practitioners, usually they're doing sort of 15-20-minute appointments. So, by doing one ADHD assessment, you're not going to be able to see six or eight patients," he says.
However, Speeden says the fact that health professionals can choose to opt in will protect practices that do not have the capacity to take it on.
"I don't think the primary care providers are going to step up and do it if it's going to tip their own primary care service over. GP practices are already overwhelmed, which is why I don't think there's going to be that many GPs to put their hands up unless they've really got a special interest."
Bradford says while it is true the sector is overwhelmed, the core of the issue is that there aren’t enough doctors in the country. He says offering a special interest like ADHD could help attract more people into the profession.
"We've seen it with telehealth, and we see it with cannabis clinics and menopause clinics. What it does do is hold more people in the career at the beginning and keep people longer," he says.
"We see people doing this alongside the general practice work as opposed to instead of."
'We need to better fund our mental health system'
Instead of adding more to already full plates, clinical psychologist Giselle Bahr says a better solution is properly funding the mental health system so that GPs and mental health experts can effectively work in tandem.
"The GPs that I talked to say what they most want is to reliably refer people to mental health services that are functioning," she says.
"Doctors do a great job of noticing when something is a mental health condition and triaging patients to the mental health sector. But right now, they can’t do that because it’s blocked up.
"We need to properly fund the mental health sector – asking really busy GPs to add another thing to their portfolio seems unwise to me."
Bahr also worries that putting ADHD into primary care could oversimplify the condition – something that she believes is already happening in the mental health sector.
"People don't usually come to the psychologist and say, 'I want a diagnosis of this'. Usually, they say, 'I'm struggling with these things. Can you help me?' But we've seemed to narrow that question to just 'Do I have ADHD, and can I get a diagnosis for that?'"
She says this narrowness can mean missing other diagnoses or can lead to misdiagnosis.
"I regularly see people who come with diagnoses of ADHD that are clearly due to something else," she says.
"I also see people who have had a specialist ADHD assessment and are really disappointed by the narrowness of it and the lack of care and support that happens afterwards. They felt they were sort of given the diagnosis and dumped in it."
Bahr worries that a focus on GPs and NPs providing 'ADHD assessments' puts the condition in a silo and could lead to nuances being overlooked.
"I don't really understand how you can train people up to just do one diagnosis. You need to be able to understand the whole mental health sector and dissect what it is and isn’t. I don't actually think it's possible to just pull out one thing."
Bradford says that if patients appear to have other complex mental health conditions present, GPs will refer them on to a mental health specialist as normal.
"Say if there is trauma or a severe post-traumatic stress disorder, then we're going to be talking about whether we need to refer you on [to mental health specialists]. GPs look after the stuff we can and we refer on the stuff we can’t," he says.
A waiting game
Hinds welcomes the new law change as she believes it may reduce wait lists and provide more affordable care options. But she understands it could be some time before those effects are felt.
"In the meantime, I hope I can save enough to see a psychiatrist before the law changes next year, but odds are I won’t. So, I will be relying on that law to come in. It’s going to be somewhat revolutionary."
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