1. Richard Feng, Melanie Thomas, Connie Chen, James Dilley, Thao Tran, Christina Mangurian University of California, San Francisco and San Francisco General Hospital Objectives: Determine whether racial/ethnic disparities exist in the diagnosis of adult ADHD in the San Francisco county mental health system Background: Adult Attention Deficit Hyperactivity Disorder (ADHD) is a chronic, disabling psychiatric disorder Prevalence of adult ADHD is similar worldwide, roughly 4% across racial/ethnic groups. Studies suggest racial/ethnic disparities in rates of pediatric ADHD diagnosis, raising questions of similar disparities in adult patients San Francisco Community Behavioral Health Services (CBHS), a county mental health system, treats a diverse patient population Methods/Procedures: Cross-sectional study Adults aged ≥18 at one of three outpatient mental health clinics of the San Francisco Community Behavioral Health Services (CBHS) between November 2013 and November 2014. Demographic and other patient-specified variables, including racial/ethnic data, will be collected from electronic medical records The population of adults with ADHD (n=88) will be characterized and compared to patients at clinics without ADHD (n- 4020) T-tests to determine whether there appear to be any disparities in diagnosis based upon race/ethnicity. Results: Black and Asian patients are significantly less likely to be diagnosed with ADHD than White patients across the three study clinics Primary English speaking patients are significantly more likely to be diagnosed with ADHD than non primary English speaking patients No statistically significant difference by gender for ADHD diagnosis in our study population Discussion/Conclusion: Results suggest under diagnosis of ADHD among Asian and Black populations, as well as non primary English language speaking patients, served within a county public mental health care system. Possible explanations for the racial/ethnic disparities include cultural stigma against receiving treatment, clinician bias, lack of familiarity and linguistic challenges. It is also possible that Caucasian populations are over diagnosed with ADHD. Limits include reliance on an Electronic Medical Records system, and on user entered demographic and clinical data. Due to limits in the EMR system, we were unable to access overall clinic data on Hispanic ethnicity Results from this study may encourage enhanced education and development of more culturally appropriate and sensitive care. Table 1: Demographics of study population Total population n=4020 Gender, % (n) Male52 (2116) Female47 (1898) Race, % (n) White30 (1208) Black12 (520) Asian42 (1713) Other14 (581) Language, % (n) English57 (2320) Other42 (1700) Table 2: Demographics of ADHD patients vs. total population ADHD populationnon-ADHD populationZ-scoreP-value n=88n=4020 Gender, % (n) Male62 (55)52 (2116)1.830.067 Female37 (33)47 (1898)-1.810.070 Race, % (n) White62 (55)30 (1208)6.53<0.001 Black4 (4)12 (520)-2.330.020 Asian17 (15)42 (1713)-4.81<0.001 Other15 (14)14 (581)0.380.704 Language, % (n) English94 (83)57 (2320)6.89<0.001 Other5 (5)42 (1700)-6.89<0.001 Acknowledgements/Contact Info: This work was supported by the San Francisco Department of Public Health, Community Behavioral Health Services Richard.feng@ucsf.edu No disclosures