The need to address ADHD and Criminal Justice

ADHD in the criminal justice system: a case for change – with Takeda

A special podcast from Spotlight, the New Statesman’s policy supplement.
(July 2024)

Excerpt from The New Statesman in the United Kingdom:

Attention deficit hyperactivity disorder (ADHD) affects millions worldwide, yet its presence within the criminal justice system is often misunderstood or overlooked. 

In this podcast we navigate the complex landscape where ADHD and the criminal justice system intercept; shedding light on the unique challenges and misconceptions faced by people with ADHD in prisons and the opportunities for improved care and support. 


From late diagnosis to repeated prison sentences, the impact of ADHD can shape outcomes in profound and often unrecognised ways. 


Host Emma Haslett is joined by Dr Tony Lloyd, the CEO of the ADHD Foundation; Sir Robert Buckland, the former Secretary of State for Justice and MP; Daley Jones, trustee at ADHD Liberty; and Sarah Templeton, an ADHD author and therapist, to explore the stories of those living at this intersection.

Val's Take/Conjecture

• The Scandinavian Countries have recognized for awhile that there appeared to be a number of people with ADHD in their criminal justice systems.
  • Criminal convictions in males and females diagnosed with attention deficit hyperactivity disorder: A Swedish national registry study (2024)
• Great Britain is issuing papers about Neuro-Diversity in the Criminal Justice System. 
  • Attention Deficit Hyperactivity Disorder (ADHD) in the Prison System (2019)
  • (UK Criminal Justice Joint Inspection) Neurodiversity in criminal justice system - more effective support needed, say inspectorates (2021).
• Further, various members of British law enforcement are "coming out" as Neuro-Diverse --- with ADHD or Autism.   [See Police Neurodiversity Forum] That shouldn't be that surprising.
  
• Additionally, certainly in Colorado, Law Enforcement and 1st Responders are advocating for resources to address their own mental health needs.
• Clinicians, including some in Colorado, have recognized that there were a number of men with ADHD in Criminal Justice.
• The US response is slowly starting to get more formalized.  See the University of Michigan Policing A Neurodiverse World (2024).

More recently, new paradigms are viewing Neuro-Developmental and Psychiatric Disorders as "Brain Energy" issues implicating mitochondrial dysfunction.

• Mitochondrial-associated protein biomarkers in patients with attention-deficit/hyperactivity disorder (2019)
• Mitochondrial Dysfunction in Attention Deficit Hyperactivity Disorder (2022)
• Mitochondrial DNA copy number in autism spectrum disorder and attention deficit hyperactivity disorder: a systematic review and meta-analysis (2023)

Buena Vista Correctional Complex

Warning:  The "R" word is used below.

If He Outgrew it --
What is he doing In My Prison

T. Dwaine  McCallon,  M.D.                
Medical Director, Buena Vista Correctional Facility,
Asst. Chief Medical  Officer, Colorado Dept. of Corrections  (1998)

If your ADHD is so disabling that you have found yourself living in  a remote walled  prison of over 1,000 men, then it is unlikely that you  will  progress  toward  rehabilitation without the aid of medication. 

Stimulant  medicine  can greatly enhance  the ability to learn how to develop caution and  judgment, and to learn a job  skill.

. . . Over half of these recall being told they would not need treatment beyond the teens as they would outgrow their ADD.

None whom we have worked with were treated into their twenties.18% had discovered that crystal meth on the street would give them focus and a sense of calmness.

20% found solace from the feeling of “being a meathead”, “still being the retard kid” by seeking oblivion with marijuana and heroin."

The quote above came from an article on Canadian Adult ADHD Coach Pete Quily's  website.

[Medication is controversial.  More and more genetic testing for psychiatric medication may be available --- people can have the same diagnosis and not be able to take the same medication.]

People with Neurodevelopmental Disorders and an IQ over 70 have traditionally gotten little support.

Generally, because people thought and the person themselves may have thought --- they didn't need help.

And they often don't need help "intellectually."

Further, it has been relatively recently that we've started to hone in on "Executive Functioning" challenges as a  legitimate challenge and worthy of accommodation.

We do important work when we don't understand the issue or how to address it.

How to better understand issues and how to address them we learn through engaging with those issues.

Significant new paradigms are already here, we are also identifying biomarkers regarding ADHD and other neuro-developmental and psychiatric disorders.

Some researchers are already proposing new treatments based on new paradigms.

We need to consider the UK's policy recommendations with regard to neuro-diversity in the criminal justice system and come up with some policy recommendations of our own.