Wednesday, August 15, 2007

Addressing Mistrust and Disparities Barriers

Last week I attended the annual conference of the National Medical Association (NMA), an African-American medical society in its 112th year of operation. For the fourth consecutive year, CHADD has hosted a dinner presentation on AD/HD for the NMA section on psychiatry and behavioral science. Former CHADD professional advisory board member Karen Taylor-Crawford, M.D., provided the address, speaking on “AD/HD Across the Lifespan, Questions and Quandaries.” Current CHADD PAB member Diane Buckingham, M.D., serves as the NMA section chair. This activity is consistent with CHADD's mission to provide science-based information on AD/HD and related disorders to all populations. Only two percent of the nation's psychiatrists are African Americans. At the NMA conference, 70 medical doctors discussed with CHADD how to bring the most recent science-based information on AD/HD and related disorders to their patients.

Last month, CHADD and the Black Mental Health Alliance of Baltimore conducted a public forum in Prince George's County, Maryland. Approximately 140 African-American families attended to learn about AD/HD. Moving personal stories were shared by audience participants and the all African-American faculty on dealing with the disparity in resources and information and responding to mistrust of professionals and the institutions of society.

The most recent issue of the Journal of the National Medical Association contains an article entitled, "Beyond Misdiagnosis, Misunderstanding, and Mistrust: Relevance of the Historical Perspective in the Medical and Mental Health Treatment of People of Color" (by Derek H. Suite, MD, MS; Robert La Bril, MDiv; Annelle Primm, MD, MPH; and Phyllis Harrison-Ross, MD). This article discusses how the attitudes within the clinical community and the disparities in resources have influenced African-American culture. The article reinforces the conclusion of former U.S. Surgeon General David Satcher's report, "Mental Health: Culture, Race, and Ethnicity": that mistrust is a major barrier to people of color receiving mental health treatment. This was evident at our Prince George's County forum. The article emphasizes that clinicians must be aware of and responsive to such attitudes and experiences of mistrust. As a voluntary health agency, CHADD must also be aware of and responsive to these attitudes. One of the authors of the JNMA article, Dr. Annelle Primm, attended the CHADD-NMA dinner.

Two areas of greatest concern to families attending the Maryland forum were that the use of medication to treat AD/HD might lead to substance abuse, and that placement in special education is not a service to enhance a child's ability to deal with their disability but a mechanism to isolate children, particularly boys, of color. The forum faculty, comprised of African Americans of multiple professional disciplines and family members, shared science-based information on the potential relationship between medication and substance abuse. While acknowledging that some schools and school districts have used special education as a way of segregating children, in the past and at present, many examples were given showing how special education can be extremely helpful for the growth and development of children.

CHADD's effort is to empower individuals with AD/HD and their families by providing practical, science-based information and compassionate support, allowing such persons and families to more effectively manage their lives throughout all the stages of life. We recognize that some populations and communities experience special challenges. I am proud that CHADD is able to engage in outreach and support to these communities. As a result of our Prince George’s County forum, 18 new individuals signed up to become part of the CHADD support group in their community.


No comments: