Advocating for ADHD in the Departments of Correction
by Janet Kramer
ADDA advocates for the improvement of treatment of ADHD, mental illness and developmental delays for individuals in the correction system. Parents, spouses, friends and professionals have reported that ADHD-diagnosed individuals rarely receive prescribed medication during incarceration and even while on probation, a huge problem since ADHD is the most common developmental/behavioral disorder in correction facilities, affecting over 25 percent of offenders.
ADHD Affects Many Offenders
ADDA and the National Commission on Correctional Health Care (NCCHC), the major correctional health accreditation organization, formed a collaboration to educate correctional professionals concerning the identification and appropriate treatment of ADHD. We hope to make accreditation of correctional institutions hinge on an institution’s appropriate treatment of inmates who are mentally ill, developmentally delayed or who have ADHD.
Jailing citizens for socially unacceptable behaviors, including poverty and mental illness, was once common. Despite improvements between 1920 and 1970, "tough on drug crime” policies implemented in the 1970s were a step backward. Under these policies, people experimenting with drugs, behaving badly or impulsively, self-medicating with street drugs and even the mentally ill end up in prison. The result? More mentally ill people are in prison today than in all the United States mental hospitals combined, and still public mental hospital funding decreases.
Corrections Focus Is Counter-Productive for ADHDers
In its role of maintaining public safety, corrections shifted its philosophy from rehabilitating offenders to "not letting offenders use the system to get drugs.” Because of potential abuse, incarcerated drug offenders no longer receive appropriate medications for mental illness, ADHD and autism while incarcerated. Furthermore, only recently did substance abuse treatment programs in prisons and jails admit incarcerated offenders on medications to treat mental illness or ADHD, making it impossible for a prisoner with ADHD and/or mental illness to receive substance abuse rehabilitation services and medication at the same time.
ADDA’s Working Group on ADHD and Correctional Health
In 2007, several ADDA members formed the Working Group on ADHD and Correctional Health to work with correctional health professionals concerned with the quality of diagnosis and treatment of offenders with developmental delays, ADHD and mental illness. Though some correction facilities treat ADHD-diagnosed juveniles with medication and counseling, only rare adult facilities will treat an inmate with ADHD with medication or coaching and training, even if other psychiatric comorbid illness is treated.
Making Significant Progress
The ADDA Working Group’s twenty volunteer members have worked to raise awareness of ADHD in the correctional system and to promote the recognition, evidence-based diagnosis and treatment of all ADHD offenders by:
- Publishing numerous articles in scientific and general interest publications.
- Presenting at:
- The National Commission on Correctional Health Care (NCCHC) Annual Conference for the past 3 years (DVDs of the proceedings reach over 2000 correctional health care professionals)
- The 2008 ADDA Annual Conference, and
- Other national and state conferences sponsored by mental health, correctional health and policy organizations.
- Developing the ADHD Harm Reduction pilot research project, which we’ve been supervising and supporting since March 2010. We evaluate ADHD prisoners scheduled for release and bring together community resources to provide treatment to reduce the high rate of reincarceration for these offenders.
- We educate probation officers, law enforcement professionals and correction officers to recognize ADHD symptoms and to interact more therapeutically with ADHD-challenged individuals. Even the judiciary has expressed interest in incarceration alternatives for low-level offenders with ADHD.
Primary Goal: Corrections Accreditation Hinges on Proper Handling of ADHD
In 2011, we have set a goal to develop an ADDA White Paper on ADHD in Corrections to advocate for national correction accrediting organizations (NCCHC and ACA) to include the diagnosis and full treatment of ADHD and its co-occuring disorders as the standard of care for both adult and juvenile inmates.
ADDA needs you. While we’re making progress, we have a long way to go and we need your help. All ADDA members interested in joining the working group should contact Janet Kramer, MD CCHP, the co-chair at email@example.com.