Black Neurodiversity: The Intersectionality and Representation of Neurodivergence in the Community

By Renee Bakis

Neurodiversity is a term we are all starting to become more familiar with, we hear it talked about in the news and on social media, but are we doing enough to normalise it? Neurodiversity at its simplest refers to the variations in neurocognitive functions within the human population, the idea behind the term is to normalise the differences in brain function rather than seeing them as deficits or a disability, much like the way we consider gender or ethnicity to be a normal human variation. However, in this fight to normalise neurodivergence, we have missed mark in terms of equal representation and support for individuals across the board, and this is something felt by the Black community more than most.

Black individuals are often not treated with the same level of compassion as their Whiter counterparts, and that is no different when it comes to neurodivergence and mental healthcare. Amongst the five broad ethnic groups, known rates of detention for the ‘Black or Black British’ group (321.7 detentions per 100,000 population) were over four times those of the White group (73.4 per 100,000 population). This is one of the key facts highlighted in the Mental Health Act Statistics, Annual Figures 2019-20 for NHS England, and it is a prime example of how intersectionality in healthcare affects the level of care received by the Black community. Conditions such as Autism or ADHD often go hand in hand with other mental health conditions such as anxiety and depression, yet despite this link, mental illness is often overlooked. Additionally, undiagnosed neuro conditions can also be masked by mental health conditions, which only adds to the trouble of getting the appropriate care for those who need it. Despite the fact there are no published statistics on diagnosis by ethnicity, it is still clear from the high number of Black bodies currently detained under the Mental Health Act that there is a distinct link between Black Neurodivergence and inequality when compared with other ethnic groups.

This doesn’t just apply in just a hospital setting, when looking at the statistics on Community Treatment Order’s (CTO), it has shown that “Amongst broad ethnic groups, known rates of CTO use for the ‘Black or Black British’ group (61.3 uses per 100,000 population) were over ten times the rate for the White group (6.0 uses per 100,000 population)”. This is a significant difference that highlights that even out in the community, there is a disproportionate number of black patients with mental illness who have left hospital but still require further management or treatment. This is ironically at odds with the ongoing stigma that the Black community is reluctant to engage with mental health services, because as the statistics show, they are more likely to have professional input compared to other ethnic groups.

It does however highlight something worrying, and that is how the statistics indicate that the number of black people who are already at crisis point by the time they engage with mental or social services is high. Despite the focus on mental health and the awareness surrounding mental illness and neurodiversity, there is still not enough representation and support available for those who don’t tick all the boxes. The lack of public acknowledgement and acceptance surrounding neurodiversity in the Black community is a contributing factor to the societal imbalances they face.

Even in my personal experience, I have worked with many individuals who have been labelled as “difficult” or “problematic” in relation to their neuro conditions, which is a common stereotype when discussing neurodiversity in general and is a separate problematic issue in itself. What has been the most shocking bit for me is how often these remarks were “justified” based on factors such as ethnicity or status. I have had multiple discussions in which developmental issues, especially regarding the younger generation, are often dismissed early on as being related to socioeconomic reasons instead of a genuine need for medical care, and the same is equal for the older generation. Things are often put down to excuses such as there being a “language barrier” or “cultural differences'' with BAME patients, as it is often easier to blame external factors that are considered “common knowledge” than to address deep rooted issues of racial bias or stereotyping. Racism has no place in the discussion of neurodiversity, as it affects everyone no matter your background or ethnicity, yet there is a lot of racial bias and discrimination that needs to be addressed as these harmful assumptions and stereotypes are very damaging and take away from the equality and acceptance we are trying to achieve.

In short, there just simply isn’t enough being done to represent and support Black Neurodiversity. There is a notable lack of dedicated resources and research available to the BAME community, and this goes hand in hand with the lack of awareness and acceptance as there is not enough representation in the media to change the narrative and normalise Black Neurodiversity.