Black Americans receiving mental health services are disproportionately diagnosed with disruptive, defiant and psychotic disorders, and are nearly twice as likely to be physically, mechanically, or chemically restrained in mental health facilities, restrained for a longer time, and more likely to die in restraints.
African Americans and other Black Americans are more likely than other racial and ethnic groups to receive mental health diagnoses of psychiatric disorders related to disruptive, defiant and psychotic behavior, according to an updated government report on Americans’ use of mental health services.
In mental health programs operated or funded by state mental health agencies, psychiatrists, psychologists, and other mental health providers disproportionately diagnosed Black people with attention-deficit hyperactivity disorder (ADHD), schizophrenia, conduct disorder, and oppositional defiant disorder (ODD), the 2026 annual report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) indicates. The report is based on data collected in 2024.
Black people comprised 19.6% of those utilizing state mental health services, but accounted for 32.7% of individuals diagnosed with schizophrenia or other psychotic disorders – significantly higher than their proportion in the population serviced.
Black young adults aged 18 to 24 years, comprising 19.7% of young adults serviced, accounted for an even more disproportionate 35.4% of young adults diagnosed with schizophrenia or other psychotic disorders.
Black children aged 0 to 17 years comprised 18.7% of all children receiving mental health services from state agencies, but received a disproportionate 26.2% of diagnoses of oppositional defiant disorder and 27.3% of diagnoses of conduct disorder.
An exceptionally large proportion of Black children – one in three (36.2%) – were diagnosed with ADHD, the most frequent mental health diagnosis for these children.
The typical treatment is ADHD drugs, many of them stimulants, often prescribed before changes in behavior management are even tried. Research has found, however, that any initial benefit from stimulants decreases over time, with little if any long-term benefit.
