19 Jul 2024

Talks underway for specialist GPs to diagnose and treat ADHD

7:24 pm on 19 July 2024
The man's GP believed he was getting counselling for his depression.

(file image) Photo: 123RF

The Royal College of GPs (RNZCGP) says it will be a game changer if specialist GPs can pick up the diagnosis and treatment of ADHD in adults.

The hopes of an ADHD diagnosis for many adults are sinking, as getting a referral through the public system has become almost impossible, while the cost of going private puts it out of reach for many.

But RNZCGP medical director Dr Luke Bradford told Checkpoint talks were underway to make that happen - and it could become possible in the next six to 12 months.

"I believe it [allowing specialist GPs to diagnose and treat ADHD] will absolutely allow us to get a better handle of this.

"It does take a full assessment to check for other psychiatric conditions or other psychological issues, but we believe that just having that ability to ask the question and have it work through and diagnosed in a structured fashion will be a game changer for patients."

Royal New Zealand College of General Practitioners medical director Dr Luke Bradford.

Dr Luke Bradford. Photo: Supplied

GPs would have to take it onboard as a "specific interest" similar to the way some do skin cancer surgeries, but it would take longer than a normal GP visit and cost more too, he said.

"We'd expect it to take a good hour to two hours for each patient.

"The cost of the clinic and stuff is around $400 an hour to pay for the overhead. So I think we have to assume that it will be upward of the $400 mark, but currently it can cost up to $2000. And so I do expect it to come down to market, but I have to just see how the market adjusts for that."

While the diagnosis shift to GPs could happen now, the initiation of therapy could not begin until Medsafe applied a Gazette notice of change to the law, Bradford said.

"We're going through a consultations process with them at present around that change.

"There's nothing firm at the moment, but we would certainly hope that it's within the next six to 12 months."

Struggles to get diagnosis

Bradford believed ADHD was likely to have been under-diagnosed in New Zealand and that was affecting many, including people on job seekers benefits who were struggling with employment and people in the Corrections system.

RNZ's story on Thursday night, about the long wait for ADHD diagnosis, resulted in a strong response from people who got in touch with their experiences of ADHD - these are some of their stories.

Helen, from Wellington, first thought she might have ADHD after finding out her daughter had it.

She checked in with her GP, who referred her to a mental health nurse.

"The lady basically said they could only help the worst 3 percent of people, and that even though I showed strong ADHD symptoms she decided to give me the diagnosis of PTSD... so I never actually got to try the medication to see if it would work at all."

Helen was left with no option but to see a private psychiatrist - which she could not afford at the moment.

Kirsten, also from Wellington, had been trying to get a diagnosis for her 24-year-old son.

She tried to get him an appointment on psychiatry.nz, a telehealth service, but she said she was put on a waiting list behind "80 something" other people.

"I then went looking for other psychiatrists, to see if I might be able to get something. I went on their websites and almost of all of them said that they don't take in any new clients."

She believed a diagnosis would make a huge difference to her son's quality of life.

"I think it really is stopping him having a job. And he's lost one recently. So now he's going to go on the benefit, which will cost the government more money.

"I just feel like the health system is really failing us on this one."

Sarah lived in Taranaki, in the small town of Inglewood. She rang around several people in the area to try to get a referral through for an ADHD diagnosis through the public system, without any luck.

Eventually, she saw a private psychiatrist in Auckland remotely, after waiting for 10 months.

Finally getting a diagnosis was life changing, she said.

"A lot of people associate it with being a label. It's not a label, it's a roadmap."

People with ADHD often "self-punished", she said, and the diagnosis helped them to understand how their brain worked.

"That's why at times we struggle with some of these everyday issues."

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