(Note: The views of Context essays rest completely with the author; Simply Psych provides a platform for their voices because we feel they will interest you.)
The underdiagnosis and undertreatment of ADHD in Black Women has caused decades of grief.
Inequity in health care is not a new topic (and sadly is still an issue). And it goes beyond physical wellness. Disparity in diagnosis and treatment of mental health concerns such as ADHD of non-white males has left ripples in the quality of life of countless, including increased mortality rates and even creating greater financial burdens. There are myriad reasons why this is the case, including mental health stigmas, socioeconomic barriers such as being underinsured or having none at all, and lack of diversity or cultural competence in mental health clinicians.
The solution to this multifaceted (and deeply ingrained) issue must be equally as all-encompassing. Thus, it will take time. And many more societal shifts must take place to allow for structural changes in the mental health ecosystem to bear any weight. Awareness of the issue and its severity is where we must begin.
Even while showing more symptoms, African American, Latino, and Asian children were significantly less likely to be diagnosed with ADHD than their white counterparts. Furthermore, white kids were most likely to receive treatment (either psychotherapy or medication) as compared to other groups. This is not to say that white kids should get less mental health care to treat ADHD. Instead, other groups should be receiving the same rates of diagnoses and level of care to combat the disorder. These discrepancies do not only affect children though.
Black Women seem to take the brunt of the negative effects from this disparity. According to this study, Black Women who are living with undiagnosed ADHD were found to struggle with daily activities at work, in their social life, and at home with their family responsibilities. Furthermore, they were more likely to be diagnosed with other mental health disorders such as depression, anxiety, or bipolar disorder. The compounding of other mental health disorders only makes diagnosis and treatment more complicated as many symptoms could be attributed to various disorders.
Because of all these factors, Black Women seem to be some of the most significantly un-, mis-, or underdiagnosed individuals when considering ADHD. The effects of this omission and discrepancy are impacting generations of Americans that are already feeling constrained due to too many other societal inequities and inequalities. The mental health ecosystem possesses the opportunity to help right some of these wrongs by combating mis/disinformation and stigma, and prioritizing care and treatment for marginalized groups that are so often overlooked, excluded, or given unequal levels of care.
First step: let’s improve the back-office for all clinicians (especially Black clinicians) to be better able to assist all people (especially Black women) when they actively address their mental health concerns. We’re fortunate to have more companies in the practice management space (www.easepractice.com; www.simplypsych.com) and here’s hoping more will come online in the coming years.
– Brian J. Dixon, MD
Dr. Dixon is a practicing psychiatrist and owner of multiple mental health companies. He firmly believes in the power of working through difficult concepts and conversations. Learn more at: www.drbriandixon.com
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