Beyond Black History Month: Addressing Barriers in ADHD Care for People of Color
Melvin Bogard, MA
In honor of Black History Month, CHADD focuses on the importance of cultural awareness and competency in diagnosing, treating, and caring for Black children and adults with ADHD.
According to the CDC’s National Health Interview Survey, 2016-2018, approximately 14% of Black children aged three to 17 were most likely to be diagnosed with either ADHD or a learning disability than were Hispanics and white children (16.9%). Other studies suggest that the lack of cultural competency and implicit racial bias may cause a higher prevalence rate in Black individuals. The authors of a literature review published in the journal Transcultural Psychiatry write, “Cultural, racial, and language bias may also lead to the overidentification of ethnic minority children as disabled and to higher ratings of ADHD symptoms… It further supports calls for increasing cultural competence in communications during clinical assessment, diagnosis, and treatment in minority communities.”
A greater understanding of the challenges in ADHD care for Black Americans will require the country to shift its consciousness and acknowledge that systemic racism and implicit racial biases exist. Studies show that white Americans’ implicit biases are at about the same level as they were in the 1950s, and that they still affect how clinicians diagnose and treat patients. “Minority families have reported that [white] practitioners can be dismissive of their concerns for their child, or less likely to solicit developmental concerns,” says Paul Morgan, PhD, professor of education and director of the Center for Educational Disparities Research at Pennsylvania State University. “When doctors don’t ask the right questions—or rely on unfair stereotypes when interpreting behavior—many kids with ADHD don’t get the diagnoses they deserve.” CHADD is striving to address these barriers and other obstacles in ADHD care for people of color by developing resources to educate and bring greater awareness and understanding to the problems.
Combatting disparities in ADHD care for Blacks will require doctors, educators, and communities to recognize and acknowledge their prejudices and make a conscious effort to change their behavior. CHADD CEO Bob Cattoi agrees. “For decades, CHADD has served as a resource to underserved communities. We have recently undertaken a deeper analysis of our own unconscious biases and realize we need to update our efforts. Our board of directors recently participated in diversity, equity, and inclusion (DEI) training. We are now planning to expand that training to our 115+ chapter coordinators across the country… We hope to reach out at the local level to Black, LatinX, and other underserved communities.”
Pat Hudak, president of CHADD’s board of directors, echoes Cattoi’s sentiments. “Including people from different cultures with diverse life experiences and ideas is key to CHADD successfully fulfilling its mission to improve the lives of people affected by ADHD,” she says. “CHADD has begun taking intentional, meaningful actions to increase awareness of social injustice and identify ways we can meet the needs of underserved communities.”
Meeting the needs of people affected by ADHD in communities of color demands a strategic plan, leadership, and dedication. Sarah Brown, director of CHADD’s National Resource Center on ADHD, says, “Our long-term goal is to provide information that will educate parents, caregivers, and adults so that all those who are living with ADHD are appropriately diagnosed and treated in order to give them a path to a successful life.” She adds, “We need the support of the communities that we want to serve to understand where the barriers are to diagnosis and treatment. With input from these communities, we can work to educate healthcare providers and educators about the barriers then to develop a plan to remove barriers to diagnosis and treatment.” Cattoi agrees. “We must listen to the members of those [underserved] communities. We do not have the answers,” he says. “But working with local leadership, we can begin to understand the multitude of issues facing these communities. It takes time to establish trust. CHADD is committed to this process.”
Establishing trust in the Black community does not come easy due to decades of healthcare abuse and mistreatment from the medical community. But also, Black people must overcome the stigma of ADHD that persists within the culture. Research studies have shown that a high percentage of Black Americans perceive ADHD as a disciplinary problem and not as the mental health issue it is. According to a Mental Health America report, “Stigma and judgment prevent Black and African American people from seeking treatment for their mental illnesses.” CHADD hopes that its efforts to raise awareness and provide information and resources to dispel myths and mistruths will empower Black individuals to make the best-informed decisions about mental health and live healthy and productive lives.
Cattoi, Brown, and Hudak are optimistic about the future of CHADD’s outreach endeavors, which honor the organization’s mission: improving the lives of people affected by ADHD. “To be successful at meeting these goals, CHADD must be aware that the ADHD populations we serve are very diverse,” says Hudak. “The inclusion of representatives from the different communities on our staff and leadership teams present an opportunity to listen and learn firsthand what the needs are. Understanding the similarities and differences amongst people affected by ADHD, with appreciation, open minds, and hearts… allows CHADD to join in the celebration of Black History Month—and beyond,” says Hudak.
Melvin Bogard, MA, is CHADD’s director of multimedia content development. He is passionate about supporting and empowering marginalized communities, fighting for social justice, and reducing ADHD stigma by leveraging social media platforms as a conduit to learn, meet these communities’ needs, and distribute resources.
I am pleased to read about the commitment of CHADD to diversity, equity and inclusion. The data provided in The ADHD Blog is very helpful in providing documentation of the effects of racial bias and its effect on receiving timely and appropriate treatment. Please share any additional references you have on this subject.