Black women have ADHD too! with Abigail Agyei MBE

Abigail Agyei - civil servant raising awareness about Black women having ADHD - in front of Salt's wall

Abigail Agyei MBE is a Senior Policy and Strategy Advisor with the Civil Service, working for the UK government. She’s currently an Early Years Health Workforce Lead by day, but uses her own platform to champion DEI, making the Top 50 Influential Neurodivergent Women list in 2022and was awarded MBE by Her Majesty The Queen in 2022 New Year British Honours for Public and Community Services. 

She’s a TEDX speaker and a LinkedIn content creator dedicated to shedding a light into ADHD and neurodiversity in women and Black women, representing her own experience of ADHD to inspire others and showcase how ADHD manifests differently for everyone.

Follow Abigail on LinkedIn to keep up with her work and her interview series!

Introducing Abigail

My name is Abigail Agyei. I’m a policy and strategy advisor and I work in the civil service. I’ve been in the civil service for about eight years and done a lot of work in terms of community engagement and building strong relationships with voluntary communities and underserved communities.

I’m currently working in the Department of Health and Social Care. I’m an Early Years workforce capability lead focused around the ages of conception to the age of two, looking at the workforce for that area supporting them and creating a robust, diverse and skilled workforce to support the needs of babies and families

So that’s the day role side! Broader than that, I’m a nefamilies.sity advocate and passionate about diversity and inclusion. I’m incredibly passionate about amplifying the voices of intersectional identities and looking at how their lived experiences are shaped in the world.

I also have ADHD and dyspraxia. It ties into parts of my work in terms of supporting the network and talking about this within the workplace making sure that organisation is neuro-inclusive.

I often focus on Black women and their experience with ADHD and neurodiversity because research shows that Black women are often underdiagnosed and misdiagnosed when it comes to ADHD and neurodiversity.

So that’s a bit about me.

What’s your experience with the Civil Service been like?

It is definitely been an interesting journey and experience. In the Civil Service you have an opportunity to work in a range of different areas supporting a range of different needs.

I’ve been able to work in the Home Office supporting asylum seekers. I’ve been able to work in the Department for Levelling Up, Housing and Communities where I have worked on supporting Grenfell survivors and Windrush commemorations, making sure we’re celebrating the Windrush community and their contributions to British society and I am now working in the Department of Health and Social Care supporting the early years workforce and supporting the needs of babies and families.

So, the Civil Service does give you an opportunity to work in a range of different departments and support in loads of different areas to support communities. I’ve really enjoyed that.

Just like everywhere else, I think Civil Service has more work to do to be even more diverse at all levels.

We don’t have to my knowledge at the moment, any ethnic minority, Permanent Secretaries, (that is the most senior civil servant in a department  leading the department). There’s also work needed to be more neuro inclusive. But the conversations are happening, which I think is really important.

What is ADHD and how would you define it?

ADHD is attention deficit hyperactivity Disorder. It’s a group of behavioural symptoms:

  • Inattentive: tends to be things such as poor concentration, distractibility being disorganized
  • Hyperactive: tends to be things such as restlessness, excessive talking, being unable to sit still
  • And then you can have the combined, which is what I have, it’s a mix of both.

Rather than affecting your intelligence, it’s more the impact on your behaviour, so executive function.

People have spoken about how it should probably be called something more like executive function disorder because the attention deficit isn’t always necessarily the case. It’s more things like your working memory or concentration and self-regulating actions.

What is intersectionality and, and why is it important to factor into a conversation about ADHD or neurodiversity?

So, it’s a term that was coined by Kimberley Crenshaw. She’s a feminist and does a lot of critical thinking work, and I think it’s a term that came out in the nineties, but it’s been used more often recently. It’s acknowledging that everyone has their own unique experiences of discrimination in inequalities, but there’s social identity overlap.

We must consider everything that can marginalise people as a whole: gender, race, class, sexual orientation, physical ability. In terms of intersectionality and ADHD with the things I’m talking about, I guess it’s looking at that intersection of gender and race and how they come together. 

My experiences as a woman with ADHD creates its own unique experiences. But then being a Black woman with ADHD brings on its own unique experiences. You need to make sure that you are looking at all those different parts of people’s identities when you are thinking about stuff like this.

How did you get diagnosed with ADHD?

ADHD in adults came onto my radar probably about 2017 – 2018, but I got my official diagnosis last year.

I’d say it’s been quite an interesting journey and that’s why I’m really passionate about the work I’m doing now.

Prior to me reading about it, I didn’t know much about ADHD in adults. I’d be quite frank about saying I associated it with white, hyperactive boys. It’s not something that I’d ever seen or heard about in adults and especially in Black women. It’s not anything that I would’ve associated with myself, but, when I look back, I now think there was so many ways it showed up in parts of my life.

I read an article, in about 2017 by a mental health advocate called Penny Belle (now Penny Jarrett) where she talked about her experiences being diagnosed, funnily enough at the same age at 30. She shared feeling like her mind was on constant overload, feeling overwhelmed, feeling physically and emotionally worn out, and a lot of the characteristics she spoke about were a lot of my own experiences.

Looking back, I knew I was hardworking, and I knew I would try my hardest, but I always felt like I wasn’t living up to my potential and I wasn’t really understanding why things that seemed so simple for some people felt like it exert a lot of effort for me. I would try, but I would always feel like I was kind of missing out of various things and would be unorganized.

So, I thought, okay, let me just continue to read up about this and find strategies to support myself. Then about the start of the pandemic 2020 was when I think for a lot of people it was quite a busy time and I think that’s when a lot of what I now understand to be my traits or symptoms felt quite exacerbated. I felt like I was struggling to balance work and loads other stuff and I thought, okay, I think I need to seriously look into getting a diagnosis and like what the process would be with this.

So, at first I reached out to my workplace about occupational health and support that I could get.

They brought in a provider to talk through things with me and they said, okay, yeah, a lot of these symptoms do seem to align with ADHD, but they were not professional psychiatrists, their focus was more on workplace assessments.

So, I decided to email my GP. I kind of had at least this information from my workplace assessment to say that they thought the symptoms could be aligned with ADHD.

It wasn’t too bad for me going through that route. At first, I think my GP was trying to understand why I thought it might be ADHD. I’d explained how I’d gone through all this research and this information and then he’d eventually decided to proceed with that route.

So, that wasn’t too bad for me. Nine months later I ended up getting the official diagnosis that it was ADHD and that I had combined type.

Why are women often diagnosed later with ADHD?

Men are three times more likely than women to be diagnosed with ADHD. That’s why it’s great that we’re seen over the last few years that women are becoming more aware and we’re seeing a lot of people talk about that lost generation of girls.

I think for a long time the current diagnosis system was heavily reliant on traits that I guess would be stereotypically associated with men. So that kind of hyperactive side. That’s why often people question the name of ADHD in itself, it’s can be a detriment because there’s all these ideas that it’s just about hyperactivity and that’s kind of why it’s associated with young boys. I think early research was just on that pool of people, so predominantly looking at white, hetero, cis young boys. So based on that, that was what people thought for a long time: ADHD, you’ll grow out of it.

Girls and women often are socialized to assimilate and often can develop coping mechanisms, which means the disorder can often be masked.

As I look back, even though I was quite talkative in school, I probably would’ve been associated with being more of a daydreamer or these kind of traits that a women or young girls have more and are looked at differently when thinking of ADHD.

So, I think that’s a lot of it. Women are often taught to mask and are probably not always given the luxury to display some of the symptoms that young men and boys are able to. So, I think that’s why often it’s not maybe seen in women in the same way, because the traits and the diagnosis criteria is often associated with symptoms that you’d more probably be evidently able to see more in men.

Already women are less likely to be diagnosed later than men, and Black women in particular are diagnosed later on average. Why do you think that is?

So GOV.UK published research recently came out that showed if Black women are receiving diagnosis, it is much later. I think there are a number of reasons.

When I was speaking to others as I’m part of a community groups I am in with Black women with ADHD, and also of doing a lot of my own research, there’s a lot of things that come into it: preconceived judgment, cultural differences, and the engagement difficulties that Black women can have with health practitioners.

So, I think some of it can be the idea that when engaging with practitioners, sometimes there is kind of that higher threshold to almost have to prove and advocate for themselves. We know there is a history in terms of gaps in addressing Black women’s needs that comes up in maternity and how Black women are, I think it’s now 3.5, it was previously 4 times more likely to die or have complications in childbirth.

I remember having a friend who was studying nursing and she was saying in their medical textbooks for a long time had tropes such as that Black women could sustain pain and had a higher threshold for pain and things like that.

So, I think there’s already sometimes this distrust or miscommunication with practitioners and when I’ve spoken to other Black women, their experiences. I think mine going through the ADHD process, because I was able to advocate for myself and had that research, it was easier.

But I think for a lot of Black women I’ve engaged with who don’t have an idea of what these symptoms or the experiences might be, I’ve heard some of them say that they’ve felt they’ve dealt with covert discrimination where they’ve been fobbed off by health practitioners or have dealt with microaggressions.

Sometimes if people do try and advocate for themselves, they might have to deal with stereotypes like the Black angry woman trope, or we know there’s a history of Black women often being associated with being strong. There is something called the Superwoman Schema – where Black Women can face pressures and feel obligated to appear strong, suppress emotions and resist being vulnerable or dependant on others cause of how they are perceived.

So, this idea of, oh, you are fine, you’ve done too well in school for it to necessarily be ADHD. Or anxiety or bipolar disorder, often they’re misdiagnosed with other things because there is not an understanding or not really trying to look at that full range because there’s not been that association of ADHD and Black women.

There’s often that lack of cultural sensitivity, so often Black women are really having to find ways to fight and advocate for themselves.

Even looking from a younger age in terms of how late it can happen, adultification happens to Black boys and Black girls at times. Adultification is the idea that Black boys and girls are treated more maturely and more like adults and are not looked at as kids in the same way.

So, when I was reading into this and doing a lot of research to try and understand a lot of people’s processes, the agenda report was something that came up. I looked at Black girls’ experiences in school, the fact that they’re twice as likely to be suspended from school. They are often not listened to and ignored. Sometimes their behaviour, if they are seen as acting up or noncompliant, can often be viewed as disruption rather than thinking that this might be a sign that they need more support.

Black children are ten times more likely to be referred to CAMHS via social services rather than GP service. Negative stereotypes and bad experiences can lead to distrust of the education and health system, with Black parents being fearful of their children being labelled and stigmatised as stupid or troublesome, meaning their struggles may be overlooked and a fear to request for further support. So all these nuances come up.

How do you think that relationship Black women have with health practitioners contributes to that late diagnosis and that lack of support that they receive?

In a lot of the cases I think is that sometimes on both sides, some of the preconceived judgements and not always having that cultural sensitivity can cause some of that kind of dynamic and problems.

I think sometimes those ideas about, Black women being stronger and having it all together can feed into that. Some of the stuff I said earlier about angry tropes, I think sometimes there can be conscious or unconscious biases that can play into engaging with Black women and that can mean that often they’re having to fight and advocate in a way that maybe people from other backgrounds are not having to.

So I think that can really play a part for many Black Women I’ve spoken to,  it can often be those certain milestones and points in life whether it’s at University or going into the working world or motherhood.

Where maybe that structure is no longing in place where and that is when things can feel unattainable and things can really exacerbate for Black women they’re often having to try and figure things out.

How did you find the experience of giving a TEDx talk in May – and what has the response been like since?

I had been thinking about it for a little while as I was researching,  learning more and engaging with community groups and different people. I just thought this conversation needs to be on a bigger scale.

I’d read and seen some great TEDx talks about ADHD and women, and they were all really important and I learned lots, but I thought, oh, there’s not a lot of conversation happening on this big scale with Black women. As I talked about earlier with intersectionality, if something’s affecting a certain group cause of their gender and then affecting race, then when we kind of look at that intersection of gender and race, it’s often going to have huge effects.

I just thought, oh, let me maybe do a TEDx on this and just share some of kind of my own experiences, what I’ve heard other people say from their experiences and what I think some of the solutions should be into what we can be do to bring more awareness and support Black Women

So yeah, I decided to put that together. I was thinking about where I could do this TEDx and then TEDx Essex, I happened to see, because I live in Romford area, so not too far from where their University is.

I’d seen that they were doing, TED talks all around the theme was, are you paying attention- and I thought, oh wow, the attention theme fits in with my talk on So, I filled in the application form, had an interview with them and they were like, yeah, we’re really keen to have you be involved.

So that was the end of 2021 and then I found out, in January 2022 that it was going to be in May 2022. So I was like, oh wow, all this research I’ve been doing, I need to actually put it into a TEDx and think about how I want to present this. I  felt like I put a lot of time and effort into putting it together, but probably in typical ADHD fashion I underestimated the idea that I’d have to memorize the 15 minute talk.

I found that really challenging and I feel like I spent so much time kind of crafting it and wanting it to be perfect when it was written down. I really struggled the month before trying to memorize it.

It was such a challenge and I kept rearranging and rewriting it, trying to be a perfectionist. There was a lot of fear, of the  week before when we were having active rehearsals, because I was really struggling to memorize. And towards the end I just tried to focus on the fact that I  know what I want to cover and the message I want to get across so just tried to focus on that.

So, I did the TEDx and I got a great reaction from the crowd and it felt good. I felt like there was bits I slipped up but I tried not to focus on that.

Then the video came out,  I was quite honest about watching it and just not liking it. And I think that’s very often common of people with ADHD that you tend to be your biggest critic . So I was so  worried about sharing it, and I had it for about a week and I didn’t share it with anyone and then I thought I am doing a disservice to others and I had to .remember the reason why I did this. You wanted to share and advocate for Black women with ADHD and get them support. You’re being selfish to not share it. Even if you don’t exactly think it’s perfect, there’s a message you want to get out there.

So I put it on my LinkedIn and I was very nervous and I was very transparent about the fact that I didn’t like it, but I felt like the message was bigger than me.

And then, yeah, I was just really overwhelmed by all the lovely messages I got and people reaching out to me saying how it helped them. It has taken a life of its own and it just reminded me that it is bigger than me and you can’t focus on all the internal things in your head and I was just telling myself I have to give myself grace that I give to other people.

So that’s been my  journey with it, but the reaction has been amazing and lovely.

How are you using your LinkedIn content to raise awareness about Black women with ADHD and ADHD more broadly?

I was recently on the inaugural LinkedIn UK creator accelerator program. So this is a six week program where you get mentoring and coaching. The idea is really publicizing creating a community around something you are passionate about. They opened up applications in the beginning of the year and they said they had thousands of people apply, but they picked 150 people who they thought were really passionate about their community idea and the content they were creating.

I was lucky to be part of the first year that they were doing this in the UK. My ideas all around kind of expanding on the work I’m already doing, advocating and bringing more awareness around ADHD and neurodiversity in Black women.

So I’ve been creating content. I’ve created an ADHD series that’s called As an ADHDer, where I kind of speak to Black women and allies who are experts and advocates in ADHD around a range of topics.

I’ve done about six  interviews and conversations around the ADHD covering a range of different topics with a range of advocates.  One on ADHD Diagnosis journey with Rachel, who she’s known as Adulting with ADHD. So she’s an amazing content creator who got her diagnosis at the beginning of 2020 and has newsletters and a platform where she talks about her experiences.

I had an ADHD coaching one with Lola Day, who’s an ADHD coach and she’s really good at supporting women with productivity hacks, like busy moms and busy women with their ADHD.

I had a really good, good conversation with Dr. Loucresie Rupert and she is a psychiatrist. We talked about Black families and children and how we can support them and create culturally competent care for Black children and families so they can get the support they need with ADHD and being neurodivergent.

I also recently had one with ADHD accountant – her name is Tina Mathis. She’s really amazing. So she’s an ADHD money coach she helps people who have ADHD with their money and accounting and budgeting.

That has been a really good series that I’ve enjoyed doing. and my last one was with the founder of ADHD Babes – Vivienne Isebor an amazing organization and community group for a, women, Black women and non-binary people with ADHD. Where we talked about the importance of community and safe spaces. I’ve been doing that and newsletters and just content around this.

The program has definitely pushed me out of my comfort zone to talk more about this on LinkedIn because I was definitely doing a lot of engagement within communities and organizations, but not as regularly on LinkedIn. So it’s really kind of helped me kind of push that and make sure I’m doing that.

What’s some career advice you wish you’d heard earlier on?

I think for me, it’ll just be really embracing and valuing my lived experience and the diversity that I bring to an organizations like the Civil Service. I think sometimes when you come from a background where you feel different or you don’t see many people like you, and that was definitely my experience when I first started the Civil Service and still in some spaces now… I’m in a team at the moment where I one of the only Black people there. So when you’re outnumbered you can sometimes make you feel small in a team and I think it’s important not to make yourself smaller and to remember why you’ve been brought into that team. I wish I really understood that at the time.

Bring your own skills, bring your lived experience and talents that’s why you’ve been hired. If you don’t feel that you have a seat at the table, bring your own chair.

Make your voice heard and understand that ministers and senior people you are working with often, they need to hear your lived experiences and how it affects the communities that we’re serving that look like all of us.

That goes for everyone, for women, for people from different social mobility backgrounds, for those that are part of the LGBTQ+ community whatever your background is, it is important to feel that way and remember why you’ve been hired and brought into that space.

What a favourite learning moment for you in your life so far?

I think it would be the mental health advocate and youth worker I mentioned Penny Belle because as she’s a person whose article I read and first realized that I had ADHD. Reading her article is where that feeling of being liberated came from and feeling like, oh wow, there’s like an aha moment and I know where this comes from and there’s something that I can recognize and see myself in.

What are some of your favourite resources about ADHD and intersectionality?

There’s a few that come to mind!

On YouTube, look at the How to ADHD page! There’s really great bite size YouTube videos just on learning strategies and hacks. She’s been very helpful for me in terms of like how to organize my home and how to make it more ADHD friendly.

ADHD UK is a really good website. I think that’s really good for understanding the ADHD process within the UK and the diagnosis process. It kind of breaks down the pathways and support quite well on there.

I mentioned earlier ADHD Babes. They’re amazing support group for Black women and non-binary people with ADHD, they’re really good at sign posting.

You don’t have to have an official diagnosis to join their community group. If you think you have ADHD, ADDitude is a really good website as well for ADHD symptoms, signs, treatment and support.

Another support group that I think is really good is, they’re for in neurodivergent women overall, so if you’ve got ADHD or autism, they’re a really good community group and have lots of good information on their social media and website as well.

I also messaged Adulting with ADHD | Rach Idowu | Substack earlier who writes a newsletter sharing her experiences with ADHD and strategies. She also created flashcards for both inattentive and hyperactive traits! They include descriptions, examples, and top tips.

What did you want to be when you grew up?

I have to think about this because I think when I was younger, I think at first randomly I wanted to be a hairdresser, and then I realized I was not good at doing hair! And then I think at one point I wanted to be a social worker, I think, because my dad was a social worker and I always liked caring for children which, kind of looking at it now, I guess I do get to do some of this work In some way supporting babies and families in a different way.

So, they were the two things that came to mind when I was younger!

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Abigail Agyei - civil servant raising awareness about Black women having ADHD - in front of Salt's wall

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