Better access to diagnosis

ADHD is much more prevalent in the population than is formally diagnosed. According to population-level studies such as the Dunedin longitudinal study being undertaken in Otago, anywhere between 5% and 7% of people have ADHD.

That’s not a problem – it’s an opportunity. ADHD people are more creative, have a greater tolerance for change and uncertainty, are mentally flexible and agile, can think outside the box, are natural entrepreneurs, and have exactly the ways of looking at the world we’re going to need in our post-pandemic climate-changing society.

But ADHD people can also be highly self-critical and struggle with those boring everyday activities. So getting a formal diagnosis of ADHD allows people to understand why they think the way they do, how their mind works, and their strengths and weaknesses. It allows people to stop comparing themselves with neurotypicals and move past the messages they’ve probably been getting from family and employers and partners that they’re a problem, or they’re hopeless, or they’re a bit broken.

ADHD is a formal diagnosis in the DSM V. It is a matter of brain wiring and chemistry, and there are genuine physical and neurochemical differences between an ADHD brain and a neurotypical brain. Here in Aotearoa New Zealand, both psychologists and psychiatrists can make a diagnosis of ADHD – but only psychiatrists can prescribe the standard ADHD medications such as methylphenidate and dexamphetamine. And psychiatric assistance – particularly for adults, particularly for women, and particularly for under-privileged people in parts of the country – is exceptionally hard to come by.

For a great many people who suspect they have ADHD, getting a diagnosis from a psychiatrist means going to see them privately. In some DHBs there is no access to psychiatrists for suspected ADHD through the public system. And there’s a very substantial cost in going private, typically running into the hundreds or thousands of dollars, with very long waiting times. This is a direct result of psychiatrists being under enormous pressure and badly under-resourced – so we are advocating for more funding and vastly improved workforce development and planning.

Our Western world seems to be putting more and more pressure on mental health, yet the resourcing needed to address the very real issues being experienced by people and their whānau simply isn’t keeping up. As a society, we need to do better than this.

In the case of adults with ADHD, part of the problem rests with GPs. Thanks to growing awareness of depression and its pernicious effects, GPs are trained to recognise the signs and symptoms and can prescribe medication that helps a great many people. But they’re not trained to recognise ADHD, despite its incidence being much higher in the population than depression. And in some cases, GPs are openly hostile to ADHD – our community has been told by GPs that ADHD isn’t actually a thing, that it’s simply a poor attitude or a lack of moral backbone, or that they don’t personally agree with an ADHD diagnosis.

These attitudes need to change. We need reform of the sector to improve resourcing for the psychiatric profession, but we also need better approaches to how and where and by whom ADHD is diagnosed, so more people can realise they’re not broken – they’re merely different.