A policy change allowing GPs and nurses to diagnose and prescribe ADHD medication without specialist input is raising alarm among Māori health advocates, who say it could sideline the communities most in need.
Bronwyn Ngatai, Director of ADHD Aotearoa, says the policy breaches clinical standards and tino rangatiratanga. She claims the change, approved by PHARMAC and Medsafe in 2025, was introduced without consultation with Māori despite their disproportionate rates of ADHD.
“Māori, we have the highest rate of ADHD in our children as well as in our men,” she says.
Ngatai, diagnosed with ADHD at age seven and mother to two tamariki with ADHD, emphasises that specialist diagnosis and care are essential. Inspired by her own experience, she founded ADHD Aotearoa, separate from ADHD New Zealand, which supports Māori and non-Māori whānau facing difficulties at home, school, work, and in relationships.
Under the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), ADHD is classified as a neurodevelopmental disorder.
However, in many countries, including New Zealand, it is funded and treated through mental health services.
Ngatai fears the policy change will strip access to vital support like psychiatrists, social workers, and culturally safe care.
“We will no longer be defined as a mental illness. It means we will not be entitled to the support and help that we receive at the moment through the mental health system.”
Kei runga noa atu a Ngāi Māori i roto i ngā tatauranga aroreretini
As of June 2024, 14.2% of Māori boys and 3.4% of Māori girls aged 2–14 had ADHD, higher than non-Māori. Yet Māori preschoolers flagged in B4 School Checks were less likely to receive follow-up care.
However, the new policy will mostly affect adults 18 and older. According to the New Zealand Medical Journal (2024), Māori adults make up 17% of the population but only 10% of those receiving ADHD medication. Ngatai says this shows systemic barriers, not lower need.
“This [policy] looks good on paper, but it’s dangerous.”
Ngatai stresses that support from mental health professionals is crucial and fears the change will limit access to care and result in poor prescribing by undertrained staff.
She compares ADHD medication to a temporary fix.
“Look at ADHD as being a leaky radiator. That’s what our ADHD medication does – it stops that chemical leaking and holds it in. But like that leak stop, it doesn’t last for long.”
“So in other words - goodbye mental health specialist, goodbye psychiatrists that we really need, goodbye clinical specialists, goodbye Māori mental health services.”
‘Ka wātea ngā rongoā ki te iwi tūmatanui’
PHARMAC says the changes are intended to increase access to treatment. Under the current rules, only specialists can initiate prescriptions for ADHD stimulants. The new policy will allow GPs and nurse practitioners to diagnose and prescribe ADHD medication for adults without needing prior specialist approval.
For tamariki, nurse practitioners working within child health or mental health services will be able to diagnose and start treatment.
PHARMAC’s Acting Director of Advice and Assessment, Catherine Epps, says the change is based on feedback from psychiatrists, paediatricians, GPs, nurse practitioners, and patients.
“This is one of many changes we are making to increase access to ADHD medicines,” she says.
“It follows our decision last year to remove the two-yearly renewal criteria for these medicines, making it easier to access ongoing treatment.”
Ngatai disagrees.
“Why the hell do you want to fast-track diagnosis if you’ve got a shortage of medication? I mean, you’re only going to fast-track it, and then you haven’t got the medication you claim to do it with.”
She argues the policy overlooks the complexity of ADHD and the range of medications involved.
“They want to move us ADHDs into general. [It] just doesn’t make sense.”
‘Kīhai te tirohanga Māori i kitea’
More than 900 submissions were received during the consultation process, but Ngatai claims Māori voices were not included.
“Not one Māori organisation mentioned in that were involved in these talks – not one.”
“This is a systemic issue that cuts across health, law, and tino rangatiratanga.”
Speaking to RNZ last month, Associate Health Minister David Seymour called on PHARMAC to modernise and improve access to medicines. In a letter of expectations, Seymour said PHARMAC should adopt ‘faster, smarter processes’ and continue a ‘positive culture shift’ toward being more transparent and inclusive.
Te Ao Māori News has contacted PHARMAC and Medsafe for comment. The policy will come into effect in February 2026.
