New Zealanders with attention-deficit hyperactivity disorder (ADHD) will now have easier access to diagnosis and medication after the government changed prescribing rules.

But there is still so much we don’t know about ADHD in Aotearoa. And while these changes will help many, easier access to medication alone won’t fill the gaps in other supports people with ADHD need to live well.

From February 2026 trained GPS and nurse practitioners will be able to diagnose and treat ADHD. Under the current system, only paediatricians or psychiatrists can make the diagnosis. GPs and nurse practitioners then provide followup care.

The current process – which is both time-consuming and expensive – has been widely criticised. The government’s changes are expected to at least partially address these issues.

Worldwide estimates suggest ADHD in adults ranges from 2.5% to 3.4% of most populations. But England’s 2023 Adult Psychiatric Morbidity Survey found 13.9% of adults met criteria warranting clinical assessment. Only 0.5% had been professionally diagnosed.

Recent research found 0.6% of the adult population in New Zealand was receiving drug treatment for ADHD. Based on a conservative estimate of 2.6% of adults with ADHD, this shows a large “treatment gap” exists.

Māori and Pacific peoples are less likely to receive ADHD medications. These inequities begin early. Tamariki Māori screened for ADHD at age four are less likely to receive medication than their non-Māori peers.

There are also substantial differences in the age of diagnosis across sociodemographic groups. These inequities raise serious concerns about access and systemic bias.

International research shows untreated ADHD is linked to worse mental and physical health, higher mortality, and reduced life expectancy.

ADHD prevalence is also five times higher among youth prisoners and ten times higher among adult prisoners compared to the general population. In Australia, ADHD’s social and economic costs are estimated at A$20.42 billion per year, or $25,071 per person.

Adult women were overrepresented in the sample, constituting 83% of the 689 participants, with over 80% reporting being diagnosed after age 24, reflecting global trends of underdiagnosis in early age among women.

Growing evidence shows many of the negative outcomes of ADHD are mitigated by treatment with medication. One study from Sweden found a significant association between initiating ADHD medication treatment and lower mortality.

However, medication is only part of the solution. Strategies focused on the strengths of people with ADHD can have huge benefits for the individual, their whānau and communities. Particularly when they receive timely diagnosis, treatment and necessary accommodations.

Researchers argue that while ADHD medications provide effective treatment, they should never be the only form of treatment offered.

Expanding prescribing authority is a vital step, but this alone will do little to increase access to psychological and allied health supports to ensure the right care can be provided to people with ADHD.