ADHD Maori Lens w Dr Diana Kopua

In one of my most challenging conversations of the year, Dr Diana Kopua asks us to slow down and look differently at ADHD.

Equity CME poinst can be claimed.

We meet Wiremu, a 22-year-old Māori man who comes to primary care with his auntie after his boss suggests he might have ADHD. He is struggling to stay focused at work and complete his apprenticeship theory, and it would be easy to move quickly towards a diagnosis.

But Diana challenges us to pause.

What happens when we start with the relationship rather than the diagnosis? What does context really mean when we are assessing ADHD? And what might we miss if we focus on symptoms without understanding whakapapa, whānau, culture, identity and the lived experience of the person sitting in front of us?

This is not a conversation about finding a different checklist for diagnosing ADHD. It is a conversation about questioning whether the way we currently approach assessment is always serving our patients well.

Diana shares how Māori models of health, including Mahi a Atua and Mauri, can change the way we think about distress and wellbeing. We talk about the role of whānau, culturally safe assessment, diagnostic labels and the uncomfortable possibility that our own clinical practice can sometimes contribute to inequity.

We also ask a difficult question: when is an ADHD diagnosis actually helpful, and when might we be too quick to assume that a diagnostic label is the answer?

There are no easy answers here. Instead, Diana asks us to be curious, to sit with some discomfort and to think more deeply about what we are doing, why we are doing it, and who our approach is working for.

For GPs and other primary care clinicians, this episode offers practical ways to rethink ADHD consultations, while challenging us to look honestly at the assumptions we bring into the room.

Sometimes better care starts with being willing to stop, listen and see the patient differently.

Practical clinical pearls:

Start with the relationship, not the diagnosis. Name the purpose of the consultation, establish what matters to the patient, and check how they want to approach the conversation.

Bring whānau into the conversation early. Where appropriate, invite whānau participation from the beginning rather than treating it as an add-on to the consultation.

Use a culturally appropriate framework. Frameworks such as Mauri can help explore wellbeing and the wider context of the patient’s experience alongside diagnostic assessment.

Ask what the diagnosis will change. Before pursuing a diagnostic label, ask how it will benefit this patient, at this time. Consider whether the focus should be on potential, strengths and support as well as symptoms.

Check how the consultation felt to the patient. Before finishing, ask whether they felt respected, heard and understood. Be willing to sit with discomfort, reflect on how your own practice may contribute to inequity, and stay curious about where you can do better.

Feeling out of your depth? Upskill- see resources below.

Resources:

Te Kurahuna – Mahi a Atua – Official website for Mahi a Atua, including information about the approach, training, publications, and resources.

Kopua, D., & Skirrow, P. (2023). Racism, Mātauranga Māori and ADHD: An Interview With Dr Diana Kopua. Journal of the New Zealand College of Clinical Psychologists, 33(1), 72–78. https://doi.org/10.5281/zenodo.8187808 (Mahi a Atua)

Kopua, D. M., Kopua, M. A., & Bracken, P. J. (2020). Mahi a Atua: A Māori approach to mental health. Transcultural Psychiatry, 57(2), 375–383. https://doi.org/10.1177/1363461519851606 (Sage Journals)

Te Kurahuna Publications & Resources – Collection of Dr Diana Kopua's publications, reports, and additional resources on Mahi a Atua, Indigenous mental health, racism, and systems transformation.

About Dr Diana Kopua: (Ngāti Porou) is a consultant psychiatrist, co-founder of Te Kurahuna, and the developer of Mahi a Atua, an Indigenous approach to mental health grounded in Māori pūrākau, whakapapa and mātauranga Māori. Originally trained as a nurse before studying medicine at the University of Otago, she completed specialist training in psychiatry in 2014 and has led the development of innovative kaupapa Māori mental health services, including Te Kūwatawata and Te Hiringa Matua. Through her clinical work, teaching and research, Dr Kopua has become a leading voice on Indigenous mental health, racism in healthcare, and culturally grounded approaches to ADHD and wellbeing.

Listen here:

https://podcasts.apple.com/nz/podcast/adhd-maori-lens-w-dr-diana-kopua/id1845748299?i=1000789362552

https://open.spotify.com/episode/7AHwjYFtJqcRYl4cY5syoi?si=85d7210fdc074d69