Adult ADHD in Rural and Underserved Areas

Medically Reviewed by Smitha Bhandari, MD on July 13, 2022

Attention deficit hyperactivity disorder (ADHD) might be more common in children, but the disorder affects adults, too. The latest data shows that between 139 million and 366 million adults around the world have been diagnosed with ADHD, making it one of the most common mental disorders in adults.

The most common symptoms of adult ADHD include:

  • Inability to focus
  • Disorganization
  • Restlessness
  • Difficulty following instructions
  • Trouble remembering details
  • Inability to complete tasks

Adults with ADHD can experience symptoms with varying levels of severity from mild to severe.

Treatments like medication and cognitive behavioral therapy help manage ADHD symptoms, but adults living in rural and underserved areas often struggle to get a diagnosis or access treatment.

Difficulties With Diagnosis

Although there is a lack of data about the rates of adult ADHD in rural and urban communities, information about the geographic differences in diagnoses among children is clear: Children living in rural areas have a higher likelihood of being diagnosed with ADHD but less access to resources to treat the disorder.

An estimated 6.5 million Americans living in rural areas have mental health disorders like ADHD, but primary care providers might not be as familiar with the condition or as confident in their diagnosis.

A 2019 study found that only 34% of primary care physicians in the U.S. felt very or extremely knowledgeable about adult ADHD and 66% agreed it was difficult to diagnose ADHD in adults.

An accurate ADHD diagnosis depends on a complete clinical exam that takes into account medical history and an evaluation of symptoms of inattention, distractibility, impulsivity, and emotional instability, and it takes a trained health care provider to recognize the signs.

Due to a lack of knowledge, there might be gaps in the diagnosis and treatment of adult ADHD when primary care physicians are providing care.

Despite higher rates of ADHD in rural areas, prescriptions for the stimulant medications commonly used to treat ADHD are more common in urban areas with higher populations of white residents. Studies attribute the gap to racial and geographic disparities in the treatment and diagnosis of ADHD.

Finding Expert Care

Once adults receive a diagnosis of ADHD, it can be a struggle to find appropriate care.

There are often shortages of psychiatrists, psychologists, and neurologists who are knowledgeable about adult ADHD in rural areas. Estimates show that more than 60% of rural counties have been designated “mental health provider shortage areas” where there are too few mental health professionals to meet the local need.

It’s not just rural areas that lack access to health care providers trained to diagnose and treat adult ADHD. More than 15 million Americans live in “medically underserved areas” with a lack of access to health care providers, including trained mental health professionals. Regardless of zip code, low-income communities were the least likely to have access to mental health professionals.

In addition to the struggles to find a doctor who can diagnose adult ADHD and prescribe medication to treat the symptoms, adults with the disorder may find it harder to access nonmedical treatments, including cognitive behavioral therapy (CBT).

Despite research that shows CBT helps control symptoms of adult ADHD and improve time management, daily functioning, and overall well-being, more than 90% of psychologists and psychiatrists work in metropolitan areas, which means that the family physicians are the primary providers of mental health care in rural areas.

Higher poverty rates and lack of health insurance in rural and medically underserved communities mean that even when these services are available, residents might not be able to afford them.

Accessible Adult ADHD Treatments

Treatment for ADHD is essential. Left untreated, the disorder is linked to higher rates of problems in social and family settings, but it can be challenging for those living in rural and underserved areas to receive appropriate diagnosis and treatment for adult ADHD. Thankfully, there are a growing number of programs designed to improve access to treatment.

The Attention Deficit Disorder Association offers several virtual support groups and workshops for adults living with ADHD, and the National Alliance on Mental Illness operates the NAMI HelpLine that provides access to support and resources.

There are also robust telehealth options. Telehealth, also called telemedicine, allows patients to meet with their health care provider via computer or smartphone and eliminates the need for an office visit.

Data shows that it’s more practical for health care facilities in rural and underserved areas to provide access to specialists via telehealth than to hire staff specialists. The approach has proven effective for access to remote counseling and the management of chronic conditions like ADHD.

Using telemedicine to treat ADHD makes it easier for those in rural and underserved areas who lack access to specialized health care professionals and it’s been linked to improved symptoms and functioning among those with ADHD. The availability of telehealth has also been linked to decreased wait times for mental health services in rural areas.

While there are challenges to accessing an accurate diagnosis and treatment, adults with ADHD living in rural and underserved areas do have options.

Show Sources


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Anxiety and Depression Association of America: “Adult ADHD.”

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Frontiers in Psychology: “Long-Term Efficacy of Psychosocial Treatments for Adults With Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review.”

National Health Statistics Reports: “Prevalence of Children Aged 3-17 Years With Developmental Disabilities, by Urbanicity: United States, 2015-2018.”

Journal of Clinical and Translational Science: “A call to action to address rural mental health disparities.”

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