Attention-deficit hyperactivity disorder stigma: The silent barrier to care.

Background: Attention-deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in childhood, with symptoms persisting into adulthood in 60% of individuals. If left untreated, the emotional, social and financial consequences can be dire, with many children and adults not reaching their full potential and having a reduced quality of life. Aim: The study explored parents' and educators' understanding and experience of stigma in relation to their children's ADHD. Setting: Participants were recruited from six schools in the Cape Town metropole, in which the Goldilocks and The Bear Foundation (which delivers mental health services to underprivileged children) were active. Methods: A convergent parallel mixed methods research design (consisting of a quantitative survey and an in-depth interview component) was conducted to explore the lack of knowledge about ADHD and stigma as potential barriers to help-seeking behaviour, diagnosis and treatment for children with ADHD. Results: Instrumental barriers to care had a bigger impact on practical access to care, while attitudinal and stigma-related resources were found to have a significant impact on well-being of individuals. Core to the themes arising from the interviews were questions of how lack of knowledge influences stigma, how stigma materialises in discriminatory behaviour and how stigma acts as a barrier to care. Conclusion: The findings contribute to the literature by exploring parents' and educators' understanding and experience of stigma in relation to their children's ADHD. A collaborative stakeholder approach is needed for effective, comprehensive and relevant interventions to combat stigma and enhance early identification of and interventions for ADHD. Contribution: In order to improve access to care, treatment, and well-being of individuals directly or indirectly affected by ADHD, it is crucial that stigma needs to be addressed.