‘Differently ordered brains’: ADHD changes bring hope and hurdles for Pacific families

Jordyn Rapana’s ADHD journey started at 30, but it wasn’t a moment of deficit; it was a revelation.

It was also a moment that changed how she sees her brain and her life.

For years, she struggled with concentration, emotional regulation, and everyday tasks.

“I don’t think it’s a disordered way of being or thinking, it’s just a differently ordered way of having a brain,” she told PMN News.

Rapana, an award-winning soul artist of Māori and Sāmoan heritage, says her challenges with concentration and emotional regulation were more obvious in study environments or while completing administrative tasks.

“I’ve always been a bit of a type B personality, running last minute, procrastinating, with big emotional responses to smaller events,” she says. “People can just do mundane tasks that I find really difficult to get done.”

After seeking support for post-partum depression following her second child, Rapana’s doctor recommended pursuing an ADHD diagnosis.

It took six months and “over a grand” in specialist appointment fees, but Rapana says the diagnosis has allowed her to restructure her life so her brain can thrive.

“In Māori spaces, we see it in our environment, we have our pīwakawaka fantails who can barely ever sit still, but they play very functional and important roles in our world. I can’t really change my brain, I’m stuck with it for the rest of my life, so I wanted to allow it to thrive and put it in environments where it could operate like a superpower.”

The Pīwakawaka or fantail is known for it's friendly curiosity and energetic flying antics. Photo/Department of Conservation

From 1 February, general practitioners and nurse practitioners will be able to diagnose and start medical treatments for adults with ADHD.

The changes are expected to improve access for many New Zealanders.

Dr Siale Foliaki, Associate Clinical Director of Mental Health at Te Whatu Ora Counties Manukau, says the shift is mostly positive, but warns that other factors in Pacific families could complicate diagnosis.

“Pacific communities and households are under more psychological stress. If you stress a child’s brain during the developmental phases between zero and five, then they present like they’ve got ADHD,” he says.

“Often the treatment is what you’d give for ADHD, but if you don’t treat the other things going on for a child, you’re not addressing the full picture.”

Foliaki says stigma, low health literacy, and medical costs remain major barriers for some Pacific families.

Listen Dr Siale Foliaki's full interview below.

Health sector response

Chris James, Group Manager of Medsafe, says the change will allow highly experienced general practitioners and nurse practitioners to treat patients.

“Implementing this change will mean they can do this work more quickly and efficiently without needing to wait for approval from a specialist,” he says in a statement.

Foliaki says the rollout may take up to two years for the sector to build the necessary training and experience.

“If you start to ask GPs to do extended work in making this diagnosis, that’s time not spent doing other diagnostic and primary care work at a time when primary care’s already under pressure.

“What we haven’t spoken about is the 25 to 30 per cent who have other significant mental health issues alongside ADHD - trauma, severe anxiety, or serious mental health concerns like psychotic illnesses or mood disorders.”

Rapana’s story illustrates both the hope and hurdles of ADHD care. For Pacific communities, new rules are a start, but experts warn systemic pressures, costs, and stigma mean progress will take time.