June’s Attention!� Magazine (a benefit of CHADD membership) has several articles on ADHD across cultures. Contrary to a popular misconception, ADHD is not just an American, white, middle-class, suburban phenomenon. It crosses all lines. That can be particularly baffling as we try to support each other in different cultures.
The misconceptions that people have generally about ADHD are often repeated about different sub-groups as well. Is ADHD over-diagnosed in some groups? (Probably not, even though diagnosis may be affected by bias in the rating scales.) Are children from some of these groups over-prescribed medications? (No, in fact they may have less access to effective treatments.) Haven’t these questions already been adequately researched? (No!)
As a first step, CHADD of Northern California is now embarking in outreach to Latino families and adults with ADHD. The Latino community will often have further complications in treating ADHD, and CHADD hopes to begin to address those. Ultimately we want to create a new branch of CHADD: CHADD Latino!
There are two general categories of barriers in getting the best care for ADHD among Latinos: access to care and cultural barriers. In terms of accessing care, some of the barriers are financial. Of course these barriers can affect any ethnic group, and they may get worse as government programs become more under-funded.
A more important access issue for many immigrant groups, including first generation Latinos, may be language barriers. Even Latinos that would consider themselves fully fluent in English will report that they do not feel like they have understood their doctor on important health issues. In the worst-case scenarios a child may have to translate the doctor’s conversation for other family members or there may be no interpretation at all.
For those of you who have English as your first language, you know how hard it is to understand the complex information that you receive about ADHD from your doctor. Now imagine that you have to digest that information in whichever second language you studied in high school. Are you baffled? The amount of material available now in Spanish, though based on good science, is still less accessible than English information was a decade ago. (There is no book in Spanish like Driven to Distraction.)
With poor access to care and information, there is little counterforce to cultural attitudes that may impede access to care. The biggest of these might be the associated stigma of a mental health condition. This is not an unreasonable wariness for families that may have first hand experience of discrimination. The idea of attaching a label by which your child may be further discriminated against is a daunting prospect. If combined with misinformation or lack of information, it is much less likely that a Latino family would seek out a diagnosis of ADHD.
We all know that the consequences of untreated ADHD can be quite dramatic: school failure, driving accidents, unwanted pregnancies, juvenile justice incarceration and so on. In families with first generation immigrants and fewer resources, the stakes may be overwhelming. If it is important to support families grappling with ADHD generally, doesn’t it follow that we should be bringing this to families that face barriers to access even more so?
This is just a start. We certainly know that there are lots of other groups and individuals that need our extra attention. We hope that CHADD can expand its reach to help everyone.
Announcement: CHADD Latino Conference
The CHADD Latino conference is now set. Put it on your calendar! Our first conference that is entirely in Spanish is set for Saturday, September 6, 2003, to be held at Christ the King Catholic Church in San Jose. The hour is still tentative, but it will probably run from 8 to 2 pm.
See this week’s article above for more background on why it is important for the Latino community, and particularly primarily Spanish speaking families, to have access to a culturally competent CHADD.
If you would like to be involved in the planning, please let us know.