It's Monday and a parole officer has not yet heard from his released offender. Later that day, the offender also misses a scheduled appointment. While one might think the offender has skipped town, the reality could have more to do with mental health than criminal intent.

According to Dr. Robert Eme, Professor of Clinical Psychology at Argosy University, one possible answer to this behavior might be Attention Deficit Hyperactivity Disorder (ADHD). 

“There is little, if any, work being done with ADHD in corrections,” Eme says. “The prevalence is at least 25%, if not more. That means one quarter of the individuals in corrections have a significant disorder that has contributed to their criminal activity.”

Eme, who recently co-wrote a book entitled ADHD and the Criminal Justice System: Spinning Out of Control, says that while some corrections facilities are properly addressing the disorder, the majority of them are not. Eme and co-author Patrick J. Hurley presented their findings at the American Correctional Association's 2006 Winter Conference, in hopes of raising awareness in the field.

“If you identify, diagnose and properly treat individuals with ADHD, you greatly reduce the chance of recidivism, and you great increase the chance of success. If you leave this disorder untreated, it certainly increases the risk of inmates becoming recidivists.”

The Corrections Connection recently spoke with Eme about his work with ADHD in corrections, and how officials can address it.

Q: How do you identify ADHD?

Eme: ADHD is a disorder which causes sufferers to feel distracted often, and other symptoms include forgetfulness, difficulty following conversations and restlessness. After conducting a number of case studies, and evaluating the trials and tribulations of inmates with ADHD, Eme sees a ray of hope after proper diagnosis and treatment.

“Ordinary life tasks can be very difficult and challenging for people with ADHD,” says Eme. “But with proper treatment and medication, they can begin to live like everyone else – and make their way in the world.”

Q: How does ADHD contribute to criminal activity?

Eme: There are three main ways in which ADHD impacts criminal activity.

First, ADHD has a major impact on academic functioning. That means students with ADHD are more likely to fail in academic classes, then drop out of school and become depressed.

Once depressed and out of school, they increase their likelihood of developing a substance abuse problem. Substance abuse is an anti-social activity that is especially appealing to people that are failing in school. It's also a form of self-medicating, as the individual feels positive effects because it alleviates the symptoms of ADHD temporarily.

This brings us to the third avenue, which is that people with ADHD bump up against authority. They are risk takers, and they rebel against the school system and authority in general. This also encourages anti-social activity. Add these problems to things like work failure and you have many individuals who have ADHD during childhood and take it with them into adulthood.

Essentially, this makes them chronic failures, either at work or at school, and that encourages overall discouragement with life – and then makes criminal activity more likely.

Q: How is ADHD dealt with during incarceration?

Eme: Basically, ADHD isn't recognized in corrections. Sometimes, ADHD is harder to diagnose in corrections because the structure of prison life can allow some inmates with ADHD to function pretty well; they get used to the schedule of every day life and that is positive for them. Meanwhile, some inmates with ADHD can be taken advantage of by other criminals and that's something that really needs to be looked out for.

In terms of recidivism, the biggest threat is the release of inmates with ADHD who have not been diagnosed. Once you release an inmate with ADHD, they still have to follow the rules of probation and parole. That poses a problem; they are often late to meetings, they tend to be forgetful, and in effect, they violate parole. That's a huge problem with ADHD inmates and recidivism.

Q: What can be done in corrections to help inmates with ADHD?

Eme: If you identify, diagnose and properly treat these individuals, you greatly reduce the chance of recidivism, and increase the chance of success post-release. Treatment typically involves medication and counseling.

The thing about inmates with ADHD is that once they have been properly treated, they can hold a job and live a relatively normal life with a combination of medication, good counseling and self-motivation. These people can turn their lives around.

Q: Can you discuss the relationship between substance abuse and ADHD?

Eme: At least a quarter of the individuals in substance abuse programs have ADHD. This is another sad fact that people just aren't addressing. ADHD is typically a really big problem for individuals with substance abuse – it makes it much harder to kick an addiction, if they can do it at all.

Again, substance abuse for individuals with ADHD ties right back to this idea of self-medication. When they use drugs, the symptoms of ADHD are alleviated, so they feel better. But it comes with an addiction, and that usually leads right back to criminal activity.

Q: Why did you decide to focus your efforts on ADHD in corrections?

Eme: You would think that the field of ADHD has covered every issue under the sun. But we realized that nobody had covered ADHD in corrections. In a sense, it's kind of sad. This is one of the most common disorders of childhood and adolescence. It continues to pose a problem well into adulthood as well.

I think there is a lack of formal education on this topic for many people in the medical field. Ask teachers, clinical psychologists, even medical doctors – they do not take courses on this, and neither do psychologists as far as I know. I really believe there is an ignorance surrounding ADHD. In terms of recidivism it's crucially important – something like two thirds of released offenders will commit a new crime within three years after their release. And those are just the ones that get caught – those numbers are horrendous. This issue needs more attention, for both male and female inmates. There was a huge lack of case studies for this issue in corrections.

Q: What impact do you want to have on corrections?

Eme: In corrections, I am hoping people will be receptive of this information. They should be educated about ADHD. We hope this book will have an impact – we just want to make people more aware of the issue. This has an impact on everything from recidivism to substance abuse, and it needs to be addressed in corrections.

Resources:

ADHD and the Criminal Justice System: http://www.allbookstores.com/author/Robert_Eme.html

More about ADHD: http://www.adhd.com/index.jsp