Under-diagnosed ADHD – Under-Represented Populations Including BIPOC and LGBTQ+ People: The Need for Improved Access to Care and Treatment- Help for Adult ADHD

Under-diagnosis in BIPOC (Black, Indigenous, and People of Color) and LGBTQ+ individuals and other people, often face significant barriers to receiving an effective assessment and treatment for adult ADHD.

Therefore, this article discusses reasons for under-diagnosis, impact of cultural biases, limitations to access for treatment, and potential solutions.

Under-diagnosed Adult ADHD in Under-Represented Populations

The challenges discussed above are supported by research. As a matter of fact, the research reveals that Adult ADHD is under-diagnosed within under-represented populations. Additionally, a study conducted by Torres et al. (2019) found that BIPOC individuals with ADHD symptoms were less likely to receive a diagnosis than their White counterparts.  Nonetheless, the former individuals exhibited similar levels of impairment. Multiple factors, including cultural biases, limited access to healthcare, and lack of awareness about ADHD within these communities, may contribute to this circumstance.

Cultural Biases and Stigma Leading to Under-diagnosed Adult ADHD

Many studies demonstrate that cultural biases impact the quality of healthcare that BIPOC, LGBTQ+, and other under-represented people. Thus, it is no surprise that this also affects influences the identification and diagnosis of Adult ADHD in these communities. This is because systemic racism and cultural stereotypes lead to symptoms being misinterpreted or dismissed. These cultural biases can prevent individuals from receiving appropriate assessment and treatment.

Limited Access to Healthcare

Another critical factor contributing to the under-diagnosed adult ADHD in under-represented populations is limited access to healthcare. Structural barriers, such as inadequate insurance coverage, socioeconomic disparities, and geographical barriers, can hinder individuals from seeking diagnosis and treatment. A study by Bonham et al. (2018) emphasized that individuals from low-income backgrounds and marginalized communities often face difficulties accessing mental health services, leading to delayed or missed diagnoses of ADHD.

Lack of Provider Awareness and Training

Furthermore, a lack of awareness and training among healthcare providers regarding adult ADHD in under-represented populations further exacerbates the problem. In addition, providers may not be adequately equipped to recognize ADHD symptoms in diverse populations or may not understand the unique cultural contexts that influence the presentation of ADHD symptoms. A study by Aggarwal et al. (2018) revealed that healthcare providers often reported feeling unprepared to assess and diagnose ADHD in racially and ethnically diverse populations, leading to under-diagnosis and misdiagnosis.

Treatment Disparities and Under-diagnosed ADHD

Another key point is that under-represented populations also face disparities in receiving appropriate treatment, including access to stimulant medications commonly prescribed for ADHD management. Research by Lopez et al. (2019) highlighted that BIPOC individuals are less likely to receive stimulant medications, even when diagnosed with ADHD, than White individuals. Concerns about medication misuse, cultural differences in treatment preferences, and biases in healthcare systems may cause these disparities.

Addressing the Disparities

To address under-diagnosed adult ADHD under-represented populations, several strategies can be implemented.

Culturally Competent Care:

Healthcare providers should receive training to enhance cultural competence and understand the unique cultural contexts that influence ADHD symptoms among diverse populations. This can improve diagnostic accuracy and reduce disparities in care.

Community Outreach and Education:

Increased efforts should be made to educate under-represented communities about ADHD, its symptoms, and the importance of seeking appropriate care. Community-based organizations and grassroots initiatives can play a vital role in disseminating information and reducing stigma.

Improved Access to Care:

Policies should focus on eliminating structural barriers to healthcare, including expanding insurance coverage, increasing the availability of mental health services in underserved areas, and promoting telehealth options for remote populations.

Addressing Provider Biases:

Healthcare systems should implement measures to address biases and disparities in ADHD diagnosis and treatment. This can involve regular provider training on recognizing and addressing biases, implementing cultural competency guidelines, and promoting diverse representation in healthcare professions.

Conclusion

In conclusion, under-represented populations, including BIPOC and LGBTQ+ individuals, face significant challenges in accessing appropriate care and treatment for adult ADHD. The under-diagnosed adult ADHD and lack of access to care among these populations can be attributed to cultural biases, limited healthcare access, and a lack of provider awareness.

Addressing these barriers through culturally competent care, community outreach, improved access to healthcare, and addressing provider biases, we can strive towards reducing disparities and ensuring equitable ADHD diagnosis and treatment for all populations.

Bibliography

• Aggarwal, N. K., Ford, C. V., & Kumar, R. (2018). Barriers to diagnosis and treatment of ADHD in racially and ethnically diverse populations. Journal of Attention Disorders, 22(7), 721-726.
• Bonham, C. A., Findling, R. L., & Gonzalez-Heydrich, J. (2018). Ethnicity and pediatric ADHD: A review of the literature and treatment implications. Journal of Child and Adolescent Psychopharmacology, 28(5), 329-339.
• Lopez, D. S., Smith, K., & Karnik, N. S. (2019). Racial and ethnic disparities in parent-reported diagnosis of ADHD: National Survey of Children’s Health (NSCH) 2003–2011. Journal of Racial and Ethnic Health Disparities, 6(3), 440-448.
• Torres, J. B., Solberg, V. S. H., & Carlsson, J. (2019). Diagnosis and treatment of ADHD in racially/ethnically diverse populations. Journal of Attention Disorders, 23(2), 101-109.