meaning that, even if these families get a diagnosis, the only
treatment they may be offered is medication. “Not every family
is going to agree to medication right away,” she said. “It’s one
thing to give the diagnosis and the offer of medication, but
another to give a diagnosis and to offer resources to help the
family understand what [ADHD] is and why it’s happening. If
you make a diagnosis and you can’t help, that’s an issue.”
The good news, according to Morgan, is that “we have ways
to help children with ADHD. We don’t want it to be the case that
only some kids are getting those treatments.” Correcting the
disparity will require schools, doctors, and communities to work
together. (See “Fixing the System” for potential solutions.)
No proposed solution can make a dent in the problem if
the doctor-patient relationship—or the teacher-parent
relationship—lacks trust, Cort said. After hundreds of years
of racialized history, trust won’t come overnight, but it can be
improved by diversifying the educa-
tional and medical communities,
which remain overwhelmingly white.
A 2016 report by the Department of
Education found that only 18 percent
of U.S. teachers are people of color,
while nearly 90 percent of mental
health professionals are non-
William James College, in Newton,
Massachusetts, where Cort teaches, is
leading the charge toward diversify-
ing the mental health field by pio-
neering programs focusing on the
mental health of those of Latino or
African descent. Cort herself is the
director of the Black Mental Health
Graduate Academy, a mentorship pro-
gram that aims to develop a group of
black clinicians who can be “present
and powerful in the field,” she said.
“It’s really hard to push back
against implicit bias if you don’t actu-
ally have something to challenge it,”
she said. “We need more people of
color in the field—by our presence,
we challenge bias.”
Janel agrees. She’s had her ADHD
diagnosis for just over a year, but in
that time, most real-life ADHDers that
she’s come across have been young
white boys. “When there are women,
they’re not usually of color,” she said.
More people of color are needed “to
raise awareness of what ADHD is and
dispel some of the stereotypes about
it. It might look a little bit different,
when you put it in the context of gen-
der or culture, [but] people of color
are affected just as much.” A
DEVON FRYE is a journalist based in Ne w York
City, focusing on mental health and social
ADHD & Latinos: Unique Challenges
Justine Larson, M.D., is a child and adolescent
psychiatrist at Community Clinic, Inc (CCI), in
Maryland, which serves a large Latino population. ADDitude intervie wed Larson about
the challenges of diagnosing ADHD in these
ADDITUDE: How do language barriers
affect doctor-patient interactions?
DR. LARSON: There’s a huge shortage of
psychiatrists nationally, and that’s even truer
when you’re trying to find somebody who
speaks Spanish. Some patients really want to
see somebody who’s from their own culture.
Sometimes I see kids who have communication difficulties even within the family.
A: Do cultural barriers exist?
LARSON: A lot of Latino parents are less
likely to see behavior as something that you
would see your doctor about. It’s more of a
There are cultural differences in terms of
the patient-provider relationship. In some
Latino cultures, there is a more authoritarian relationship with the doctor. So when I’m
trying to solicit opinions, people might not
be used to that, or might not be comfortable
with it. They might be expecting me to tell
them what to do; I think it’s more empowering to have a dialogue.
Among Latino patients, because of that authoritarian relationship, some people will agree
and say yes to things—but inwardly, they’re not
comfortable with it. They might not necessarily
tell me, because they feel like they have to say
yes. Then they might not keep up with treatment.
A: What unique concerns exist for im-
LARSON: There is a lot of trauma and adversity in the population—either interpersonal
violence or loss of parents or other people in
their lives. It can definitely play a role: Trauma
can impact attention; anxiety and depression
can impact behavior. In little kids, it’s hard to
tell the difference—they might not have the
ability to express what’s going on.
A: What’s happening in schools that
increases this disparity?
LARSON: There are cultural differences
in terms of school involvement. I see families
where the parents don’t know the names of the
teachers—or can’t talk to the teachers because
they don’t speak Spanish. There’s less communication with the school about what’s going on,
or what the school could be doing to help.
A: What needs to be done?
LARSON: I encourage people to tell me
what they think, and I say, “It’s OK if you
don’t agree.” If they don’t take the medicine,
instead of giving up, talk to them about what
may be going on—and, over time, build trust.
It would be great if there were more
Spanish-speaking psychiatrists. There’s also
a move to educate pediatricians and increase
their ability to diagnose and treat ADHD. That
will improve access to care and decrease
There are also parent advocates and
community health workers. If we use them
more—people who are part of the community, who speak the language—they can
help people navigate the system and become
more comfortable with it. That would be
This intervie w has been edited and condensed for clarity.
LEFT BEHIND MINORITY REPORT