Black children in the U.S. face significant delays in ADHD diagnosis and treatment due to systemic inequities in healthcare, according to psychiatrist Dr. Napoleon B. Higgins, Jr. Writing for ADDitude, Higgins outlines how clinician bias, medical mistrust, and cultural stigma contribute to these disparities.
“Clinician bias can skew evaluation and treatment outcomes,” Higgins explains, noting that Black youth are often misdiagnosed with disruptive behavior disorders instead of ADHD. This mislabeling leads to years of inadequate treatment when simple medication adjustments could help.
Negative attitudes toward mental health in Black communities also play a role. Higgins recalls a mother telling him, “You think like those white folk,” after he confirmed her child’s ADHD diagnosis. Such skepticism, even toward Black clinicians, can prevent families from seeking or accepting care.
Medical mistrust, rooted in historical abuses like the Tuskegee Study, fuels fears about ADHD medications. Higgins frequently hears concerns that these drugs are addictive or part of a mind-control agenda.
Poverty and trauma further complicate diagnosis. Black children are more likely to live in disadvantaged neighborhoods and experience adversity that mimics or worsens ADHD symptoms. Communication differences and fear of labels—especially in the context of the school-to-prison pipeline—add more layers to the problem.
Higgins urges clinicians to identify their biases, ask thoughtful questions, and understand family dynamics. “Education and action are the foundation,” he writes, emphasizing that culturally competent care can help close the gap.
See: “Racial Disparities in Health Care: How Clinicians Can Better Serve Patients” (September 5, 2025)
