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Some people waiting for a life-changing ADHD diagnosis are being left with no options, 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.
There are a rising number of people trying to get a diagnosis - but as awareness around the condition grows, so do dire shortages of clinicians who can diagnose it.
Questions have been raised around who can diagnose ADHD, as some advocates suggest that if GPs could diagnose the condition, it would ease the the strain on the system.
One Wellington woman, who did not want to be named, first suspected she might have ADHD after two of her children and her brother were both diagnosed.
Her struggle to get her own diagnosis came at an already difficult time in her life.
"Last year my husband passed away of cancer. So I had kind of dealt with all of that. One of the last things he wanted to do was, he told me I needed to focus on myself. Because I put myself behind everyone, behind my children... and part of that was I wanted to get this diagnosed."
Her GP agreed she should see a specialist to try and get a diagnosis - but the application for a referral through the public system was declined.
Dire shortages for clinicians who can diagnose ADHD
As a single mother, she did not have the money to see a private psychiatrist, leaving her unable to get a diagnosis that she felt could be life-changing.
"I feel like, if I could get this medication, it could help our family so much because I could be more focused, and that would lead down into my children."
For her daughter, she said ADHD medication meant her brain was less messy and she could focus on the task at hand.
"Your brain's thinking one way and you may be thinking of a song, or you may be thinking of what you need to do - three or four different tasks. Your brain isn't just focused on one particular task."
ADHD New Zealand chairperson Darrin Bull said he had heard that in several regions public mental health services had stopped taking ADHD referrals altogether.
"We've had rumours of it, and examples of it over the last five years. But more recently it's really started to step up, it's actually since Covid and the health system being overwhelmed with mental health issues."
For example, Health New Zealand Southern group said a general assessment for adult ADHD without a significant impact on the patient's life did not fit its criteria.
Some might need to travel to Auckland or Sydney
Even for people who could afford to see a private psychiatrist, there weren't many options.
"We are aware, in Auckland for example, there are wait times for people taking appointments right now, it's kind of 2025, so it's a year or so. And we're aware in particular in the South Island and in Wellington there's effectively no-one privately who's able to help someone."
He suggested patients in these areas fly to Auckland, or even Sydney for treatment if they could afford it.
For people with ADHD, getting a diagnosis was everything, he said.
"It can explain a lot about your life. But also we've got research from Canada which shows if you don't have a diagnosis, you're over four times more likely to attempt suicide. You have issues with being successful in relationships and successful at work."
Dr Louise Cowpertwait is the founder and chief executive of Mindmatters, which runs a remote telehealth ADHD clinic that people can access from across the country.
This approach came with pros and cons, she said.
"Most of our calls happen in the person's home. So we can see the physical environment that they live in. I've had clients do a walkthrough of their house and show me the state of their house because they have trouble with organisation."
She would support GPs with specialised training being allowed to diagnose ADHD.
"Hell yeah we would support that, anything that would increase people's access to the right support. Some people are worried about quality control, thinking GPs will be handing out ritalin willy-nilly. But GPs practise under strict codes of conduct."
ADHD NZ's Bull has been meeting with key stakeholders on the issue and hoped changes to the system would start from October.
There was a broad consensus among health professionals that enabling GPs to diagnose and prescribe medication for ADHD would help ease the load on mental health specialists, Bull said.