One in four prisoners in Britain are reckoned to have attention deficit hyperactivity disorder (ADHD), according to a report that describes the condition as ‘critically underdiagnosed’. The report published by the ADHD Foundation flags up academic literature point to ‘a five to tenfold’ increase in prevalence in jails compared to the general population rate. According to the new study if ADHD is recognised in prisons and ‘managed appropriately’, there can be a reduction in criminality of 32% for men and 41% for women

The report which draws on a roundtable event with experts enclosing psychiatrists, psychologists and GPs calls for consistent screening across the criminal justice system to identify people with ADHD. The current approach is ‘inconsistent and of an insufficient quality to accurately recognise people who might have ADHD’. ‘Screening should be introduced across all different parts of the criminal justice system, not just within the initial few days of entering prison,’ it says. ‘… There is currently no standard across the adult prison system.

According to the study, ‘around 96%’ of prisoners with ADHD have a comorbidity, including substance use, conduct and personality
disorders. Research indicates an increased link to aggressive incidents compared to other prisoners without ADHD, of up to eight times.

The report highlights the 2021 Neurodiversity in the criminal justice system: A review by the Criminal Justice joint inspectorate which called for the introduction of a neurodiversity strategy to address unmet need across the justice system. The Prisons Strategy White Paper, published in December last year, aims to increase understanding of the specific needs of people who are neurodiverse, including ADHD, and what is required to enable a successful transition back into society such as continuity of care post release and in prison.

The new report highlights ‘gaps’ such as improved screening, an appropriate care pathway ‘integrated into existing mental health and neurodiverse pathways as there is currently no consistent approach to diagnosing, managing and treating ADHD across the CJS’. ‘Care needs to be continued upon release from prison to reduce reoffending and to ensure optimal outcomes for the patient, with an integrated health and social care system providing an interface between the CJS and wider community services,’ the report continues.

The study points out there can be long waiting lists for treatment in the community ‘sometimes up to five years’. ‘This can mean that people with ADHD can face a cliff edge when they leave prison, with a postcode lottery in accessing appropriate care and continuing treatment,’ the report says. ‘A particular challenge when people leave prison is that they are often on medication, and only leave prison with a week’s supply.’