ADHD: Let’s find it and treat it

Article written by Sarah Templeton for insidetime.org

‘Screening would half the prisoner and young offender population,’ argues Sarah Templeton

Prisons and Young Offender Institutions in this country are packed with people both diagnosed and undiagnosed with Attention Deficit Hyperactivity Disorder (ADHD); but why? And what can we do about it? 

First, let’s deal with ‘why’. ADHD is not just hyperactivity, distraction, inattention and impulsivity; there are dozens of traits. Most offenders aren’t aware ADHD is a lifelong condition and many are misdiagnosed with personality disorders, bipolar and psychosis. 

Traits

ADHD can lead youngsters astray – from ‘typical boy’, to ‘naughty kid’, to ‘teen in trouble’, and ‘young offender’ within months. There are dozens of ADHD traits that lead to this, including:

Low boredom threshold. Needing to DO something.
Impulsivity. Doing/saying things without thinking.
Hyperactivity/restlessness.
Not thinking of consequences.
Risk-taking and thrill-seeking.
Pushing boundaries.
Thinking they know best.
Wanting everything their own way.
Having no patience. Wanting everything now.
There are plenty more reasons why young ADHD people get into trouble. Often, they will be drawn to older kids who are doing ‘exciting’ things like smoking cannabis or drinking alcohol. Before long they are stealing alcohol and cigarettes.

Frustration and anger

Another problem area is criminal damage. ADHD boys, in particular, have difficult times during puberty. ADHD is connected to hormones; it is a lack of dopamine in the brain that causes ADHD. So, during puberty, things go from rocky to hugely frustrating. Their emotions are dysregulated and for boys this can turn into frustration and anger. Teens get into trouble for causing affray, criminal damage or assault. Girls tend to get angry and frustrated, but more often this comes out verbally. 

With ADHD there is a higher risk of self-harm and suicide. It is accepted that uncontrolled emotion is the most serious impact. 

Having worked with young offenders and adult male offenders for 25 years, I see the same ADHD traits causing problems. What can we do about it? It’s only since 2009 that adults have been diagnosed with ADHD in this country. Until then, medical professionals believed ADHD was ‘a behavioural disorder you outgrew in your late teens’. It isn’t. ADHD is a neurodiversity. ADHD people are born with different brain wiring. There are literally thousands of people who do not have the correct ADHD diagnosis … and a big chunk of those are currently behind bars. 

Addiction

We can so easily change this crazy situation – starting by screening children in schools for ADHD at five and also screening young people when they first enter a police station. A simple tick-box, five-to-ten-minute screening tool can pick up indicators of ADHD. Those showing enough ADHD signs need assessing before further action is taken. I work closely with ADHD-diagnosed police officers, and they fully support this. For those who have been missed, and for all those currently in YOIs and prisons, we need to test for ADHD on prison induction wings. Yes, testing happens on induction wings – but not usually for ADHD.

Often people don’t realise that addiction goes alongside ADHD, because of the compulsive brain, so screening on substance misuse wings is crucial. Other issues that can go with ADHD are overthinking, ruminating, rejection sensitivity, having a heightened sense of justice and insomnia. ADHD can exist alongside dyslexia, dyspraxia and dyscalculia – so people diagnosed with these conditions are more likely to have ADHD.

Medication

If we identify and medicate serving prisoners they will get fewer adjudications and they will also be able to engage in education and training inside prison more easily. Their hyperactivity and distraction will be pretty much eradicated. And when released, medicated, they have a much higher chance of not returning to prison. Their need for adrenaline, risk-taking, thrill-seeking, pushing boundaries and needing excitement will have been eradicated by being medicated. They will be less impulsive and able to think of consequences.

So what are the benefits of screening all children and young people for ADHD and catching people quickly? Children identified young will do better academically, and will be much less likely to get involved in petty crime. Prisons and young offender institutions will be half-emptied, so the government won’t need to spend money building new ones. We just need to screen current prisoners, and medicate those with ADHD. A mental health nurse working in prisons for 20 years puts the rate of ADHD inside at 85 per cent. This gives you an idea of how serious this problem is. ADHD is one of the most treatable psychiatric conditions, and ADHD medication transforms lives.

Sarah Templeton is a qualified counsellor and therapist who has worked in four English prisons. She is the Chief Executive Officer of the charity Headstuff ADHD Liberty, which helps to keep young people with ADHD away from the criminal justice system. Sarah is diagnosed with ADHD.

About: Inside Time Newspaper

The Inside Time newspaper is a weekly online and monthly printed national newspaper for prisoners and detainees.

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