SC writes back, with everything you could want to know about ADHD. Is this impressive, or what?

Thank you for your kind words on your blog! Just wanted to offer some more detailed thoughts on the issue, since you asked…

First, I believe ADHD is often over-diagnosed. Second, I believe ADHD is a real disorder, and there is significant evidence using neuro-imagery to establish this (along with the functional and developmental data). When it is appropriately and accurately established that an individual has ADHD, it can often make a life-changing difference when it is treated.

However, what is proposed in that article is nuts, in my opinion. Proper diagnosis of adult ADHD requires that a lot of other things be ruled out as the cause of the problems: ongoing substance abuse, learning disabilities, subtle brain injury, bipolar disorder, anxiety, depression, borderline IQ….not to mention simple antisocial personality disorder. All that testing is time-consuming and expensive, and I doubt that it will be thoroughly done on the entire criminal population. Thus, many non-ADHD inmates will likely be improperly diagnosed as being ADHD. Do these folks really need any more fodder for their internal justifications of having been “victimized” by a society “that just doesn’t understand” them and never gave them a “fair chance?”

The idea of doing this on every single inmate is such a massive proposition that it is almost a foregone conclusion that these “evaluations” will be half-assed and fraught with a massive false-positive rate.Also, the most effective treatment for this disorder is psycho-stimulant medication. Works great when taken as prescribed, but if a person were to crush it and snort it, it acts on the system much like cocaine. Even if you believe that prison medical professionals will provide enough supervision to keep this from happening in the incarcerated population, what about when they are released? The whole point of this “scheme” (as the author of the article terms it) is to reduce recidivism…so obviously we can’t stop their medication upon parole. Yet we also cannot carefully monitor its administration.

One other problem that comes to mind: if a bipolar individual is misdiagnosed as having ADHD and then treated with psycho-stimulants, these medications can elicit a significant manic episode. Never a good idea when one is prone to anti-social behavior and is confined to a small space.

The only common-sense solution I see is to do roughly what is done now in American prisons: When an inmate’s behaviors or status cause staff or medical professionals to suspect a psychological evaluation is in order, one should be done. The idea of doing this on EVERY SINGLE inmate is such a massive proposition that it is almost a foregone conclusion that these “evaluations” will be half-assed and fraught with a massive false-positive rate.

Thanks, SC!

The Czar ain’t sure how they do it over in the UK, but does know how these things are done here in the States. The Mandarin and the Czar share a good friend who works in corrections, and his role (as an experienced social worker who incidentally throws a wicked punch) is to assess arriving inmates (as SC describes) and split them into three groups: (a) people with obvious drug problems, (b) people who need psychiatric evaluations, and (c) convicts who are faking one of the other two to get out of general population. He is able, with a high accuracy rate, to do this in about fifteen seconds each. The Czar can only assume that ADHD will be diagnosed overseas in this broad, brute-force manner—resulting in exactly the half-assed and false-positive method SC fears. Our pal over here would naturally object to such a requirement, since it requires him to subvert item (b), and make a judgment he is not qualified to do.

Inane.

The Czar of Muscovy

Божію Поспѣшествующею Милостію Мы, Дима Грозный Императоръ и Самодержецъ Всероссiйскiй, цѣсарь Московскiй. The Czar was born in the steppes of Russia in 1267, and was cheated out of total control of all Russia upon the death of Boris Mikhailovich, who replaced Alexander Yaroslav Nevsky in 1263. However, in 1283, our Czar was passed over due to a clerical error and the rule of all Russia went to his second cousin Daniil (Даниил Александрович), whom Czar still resents. As a half-hearted apology, the Czar was awarded control over Muscovy, inconveniently located 5,000 miles away just outside Chicago. He now spends his time seething about this and writing about other stuff that bothers him.