ADHD its links to criminal justice and how practitioners...
Transcript of ADHD its links to criminal justice and how practitioners...
![Page 1: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/1.jpg)
ADHD – its links to criminal justice and how practitioners can reduce
the risk
Sergeant Steve Brown & Phil Anderton, PhD
![Page 2: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/2.jpg)
A day in the life of Lancashire Constabulary
•Over 3,500 police officers, 368 special constables and nearly 1,900 non-police staff
– get 4366 calls – deal with 415 crimes – arrest 185 people – go to 15 road accidents – responds to 2,111 incidents – handle 21 motorway breakdowns – breathalyse 28 people – solve 124 crimes – recover £28,610 worth of stolen goods
![Page 3: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/3.jpg)
Phil Anderton / Steve Brown • Over 50 years combined
police service
• Qualified police trainers
• Qualified academically
• Have been working in the field of mental heath disorders and crime for the past 9 years
![Page 4: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/4.jpg)
•2003 Lone voice – little understanding and lots of prejudice
•2004 CHADD as first police speakers
•2005 Advised Prime Minister on ADHD and crime
•2006 Invited to speak to all police youth experts and chief officers in UK
•2007 national article in UK leading police journal (on invitation)
•2008 Youth Crime Action Plan
![Page 5: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/5.jpg)
A phone call recently…
• Accountant
• Step daughter
• 12 years old
• At their wits end
• Feeling abandoned
and alone
• “Nowhere to go”
![Page 6: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/6.jpg)
Choice…?
![Page 7: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/7.jpg)
And here’s what we have done
• Direct one to one with a parent support group
• Asked the couple to prepare their ladder
• Put them in touch with ADDISS
• Provided them with some literature
![Page 8: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/8.jpg)
The relevance to today…
• Bright parents
• Confused
• Unable to provide advocacy
• Increasing the risk for their child
• Unaware of all of the risks
• Doubting their own abilities.
![Page 9: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/9.jpg)
And tackling quite a lot…
![Page 10: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/10.jpg)
Which if not gripped goes wrong…
![Page 11: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/11.jpg)
ADHD and crime patterns - Phil
Likelihood of being arrested
• 20% in control group
• 48% in ADHD group (inc’ CD)
(Barkley, Secnik, Swenson, Buesching, Fisher and Fletcher)
0
10
20
30
40
50
60
Control ADHD / CD
Arrest chances
![Page 12: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/12.jpg)
Arrest prevalence…
ADHD and arrest profiles
• Control group 2.1 arrests
• ADHD cohort 6.4 arrests
(Barkley, Secnik, Swenson, Buesching, Fisher and Fletcher)
0
2
4
6
8
ADHD / CD Control
Arrests
![Page 13: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/13.jpg)
Which leads us to conclude…
• Twice as likely to be a criminal
• Three times as many offences each
• Prolific, predictable and therefore
ultimately preventable
• Satterfield also concludes that when ADHD is combined with conduct disorder:
“Hyperactive subjects have significantly higher arrest, conviction and incarceration rates compared to controls”
Satterfield J et al, May 2007 Jm Acad Child Adolesc Psych
![Page 14: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/14.jpg)
![Page 15: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/15.jpg)
The conduct of the ADHD sufferer
• Just imagine:
– You’re struggling to get to work on time tomorrow
– Your next piece of work, maybe a report, will be rejected by you line supervisor / the board, you know this
– Your peers are shunning you, more and more
– You know you will be alone at lunchtime
– You have never felt part of the team
![Page 16: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/16.jpg)
Growing conflict
• You feel alone
• You feel misunderstood
• EVERY DAY
• You are also confused as how you can change this – is this ‘me’ you ask yourself
![Page 17: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/17.jpg)
And that’s you as a grown adult
• What about the ADHD child?
– Immature
– No friends at these important times
– No ‘future’ or feelings of self worth
![Page 18: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/18.jpg)
And let’s just look at maturity
•Delayed emotional development by a third
•Synaptic pruning is delayed
•Desire to challenge
•Thrill seeking, ‘the neural buzz’
![Page 19: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/19.jpg)
But conduct disorder is NOT inevitable
• We can work with these children
• We can alter their pathway
• We can make things better for them
• And if we don’t…
![Page 20: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/20.jpg)
We have some startling facts…
25% 5%
![Page 21: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/21.jpg)
So if this is the case un-medicated
• It can only get better…
• On meds parents and children report a ‘controlling of symptoms’ we know this…
![Page 22: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/22.jpg)
A case study
• “I was a regular burglar, druggy, thief and once I was described as an utter shit. I did everything, you name it, I did it. No one understood me, including myself. The cops all knew me, I was in and out of prison from the age of 10. I had a social services record that is unbelievable.
• Then someone diagnosed my ADHD, now I understand ‘me’ – and as long as I comply with my treatment regime I am OK – a good guy. A good father, husband and I know how sorry I am now, I really do”
![Page 23: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/23.jpg)
![Page 24: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/24.jpg)
But what about girls?
• From a ‘good background’
• Was not understood by her parents
• Took cocaine and heroine
• Earned money through prostitution
• Married and divorced at the age of 20
• Incarcerated for her own well being at the age of 23
• Was diagnosed with ADHD at the age of 28
• Now runs a successful international photography business
![Page 25: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/25.jpg)
Or…
![Page 26: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/26.jpg)
And families…
• ‘His Dad was a problem’
• ‘We have been expecting him to be a problem and he is’
• What will his kids be like?
• ADHD is an inheritable as height
![Page 27: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/27.jpg)
And lets get some basics out there…
It is safe to describe ADHD-ers as:
• Difficult at times
• Confrontational
• Risk takers
• “Unable to learn”
![Page 28: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/28.jpg)
But for the ADHD-er its easy - Phil
![Page 29: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/29.jpg)
And maybe it’s time to look at behaviours…
• And the effects this can have, long term on parents
• Who may well have the disorder
• Who may well be disorganised themselves
• And may well be confrontational, it’s a trait..
![Page 30: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/30.jpg)
But we need to know why…
And only then can we truly treat ADHD
![Page 31: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/31.jpg)
And they struggle to function…
Executive functioning is often described as:
• Organising and prioritising work
• Focus and sustaining a task focus
• Regulating alertness
• Managing frustration
• Utilising working memory
• Monitoring self regulatory action
![Page 32: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/32.jpg)
And to use a simple example…
![Page 33: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/33.jpg)
And these all produce vulnerability…
• Loneliness
• Abandonment feelings
• Vulnerable to predators
• Unable to correctly gauge risk
![Page 34: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/34.jpg)
Which are component parts of offending behaviour…Steve
•Drug taking and abuse
•Criminal behaviour
•Driving risks
•Suicide risks
![Page 35: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/35.jpg)
In adults with ADHD at least 20 – 30% abuse drugs (Willens 2004) Over use of nicotine leads to self treatment and acceleration to harder drugs (Biederman (1991)
Drug taking and abuse
![Page 36: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/36.jpg)
Adults with ADHD • Alcohol abuse/dependence 45% against 17% in general population
• Drug abuse/dependence 30% against 9% in general population
Wilens E.A. Harv Rev Psychiatry 1995;3;160-162
Drug taking and abuse
![Page 37: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/37.jpg)
Criminal behaviour
• Easily led etc
• Impulsive
• Risk taking
• Need ‘friends’
![Page 38: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/38.jpg)
Reports of criminal activity
Arson – 15% v 6%
Runaway – 31% v 16%
Assault – 22% v 7%
Stealing money – 50% v 36%
Burglary – 20% v 8%
Criminal behaviour
![Page 39: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/39.jpg)
Driving risks
Young drivers with poorly treated ADHD are:
• 2 to 4 more likely to have traffic accidents 1-3
• 3 times as likely to have injuries 2
• 4 times as likely to be at fault 1
• 7 times more likely to be in two or more incidents 1
1 - Barkley RA. et al. Pediatrics 1993; 92: 212–218 2 - Barkley RA. et al. Pediatrics 1996; 98: 1089–1095 3 - Cox DJ. et al. J Nerv Ment Dis 2000; 188: 230–234
![Page 40: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/40.jpg)
• Driving at age 17 is NOT a right that we should accept without mitigating the risks
• Deferring a few years maybe safer
• In clinical settings, this could be discussed
Driving risks
![Page 41: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/41.jpg)
0
0.5
1
1.5
2
2.5
2pm 5pm 8pm 11pm
Time
MPH IR tid OROS® MPH qd
Inappropriate braking when car is in 35 mph (56 km/h) and 45 mph (72 km/h) acceleration zones (p=0.04)
Nu
mb
er o
f in
stan
ces
Driving risks - medication
Long lasting MPD IR MPH TID
![Page 42: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/42.jpg)
02468
1012141618
2pm 5pm 8pm 11pm
Time
MPH IR tid OROS® MPH qd
Percentage of missed stop lights and stop signs, (p<.02)
Perc
ent
mis
sed
Driving risks - medication
Long lasting MPD IR MPH TID
![Page 43: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/43.jpg)
And here’s what we have done to help
![Page 44: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/44.jpg)
Suicide risk
• Children diagnosed with attention deficit
hyperactivity disorder (ADHD) at ages 4-6 face a 3
times greater risks for depression and suicide at ages
9 – 18
Archives of General Psychiatry - October 2010
![Page 45: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/45.jpg)
A true suicide story
"I don't feel sorry for myself and I'm not looking for you to care. The fact is that I'm glad I tried it [killing himself] and glad it didn't work because it showed me one thing. No one else has ever really believed in me--I mean I know my parents say they love me, but I'm not stupid, I know what they talk about and that they are scared to death I'm going to be a failure. I'm too big a pain for teachers and I don't blame them for the way they treat me. I never believed in myself, but when I realized that I had the guts to do it, it was really weird. It showed that I had a side to me that gave a **** about myself and that there is something good in there."
![Page 46: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/46.jpg)
So, for clinicians…
• You have patients that are at risk of criminal behaviour
• Patients who are vulnerable to the extreme
• And patients whose families are often unable to advocate or support them
![Page 47: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/47.jpg)
And that’s where we need to focus…
• On more than treating symptoms
• On more than judging performance from exclusively reviewing rating scales
• And focus entirely on increasing the outcomes for the patient and their families
![Page 48: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/48.jpg)
The patient / carer ladder…Phil
• A simple model
• Patient and family focused
• Easy to use and understand
![Page 49: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/49.jpg)
My example from last week
Absolutely no respect
Ineffective sleep pattern
Sexually active
![Page 50: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/50.jpg)
And examine each in turn…
Ineffective sleep pattern
• Cannot get to sleep
• Cannot wake up
• Wakes up very oppositional
• Consequently doesn’t take her meds till late
• And missed first three periods of school
![Page 51: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/51.jpg)
And her regime?
• 72 mgs longer lasting methylphenidate
• No coaching, counselling or support
• No CBT at all
• Nothing but the one pill
![Page 52: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/52.jpg)
A lot more can and should be done…
• Led by clinical practice
• In partnership with those around us
– Youth offending teams on prevention
– School nurse on pastoral care
– The social worker in Childrens’ Services
– The parents and parent support
![Page 53: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/53.jpg)
And this should all have an aim…
• To reduce the child / adolescents risk profile
• To increase the well being of the family environment
• To decrease the overall costs to society of ADHD
• To increase the outcomes for the individual sufferer
![Page 54: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/54.jpg)
For example…
• If the child is smoking a lot – what are your thoughts
• If the child is starting to drive – they are at risk
• If the child is not socialising fully – they are at risk
• There is a social outcomes aspect to medication regimes – thinking of the patient / carer ladder
![Page 55: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/55.jpg)
And here’s what we have done to help #1 …
![Page 56: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/56.jpg)
And here’s what we have done to help #2 …
![Page 57: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/57.jpg)
And here’s what we have done to help #3 …
![Page 58: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/58.jpg)
And here’s what we have done to help #4 …
![Page 59: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/59.jpg)
The app’ relationship
Angel Guardian
Mood Medication reminders
Behaviours Explanations
Web links
![Page 60: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/60.jpg)
And a few final words
What can you do?
• Raise awareness of the app and web site
• Manage the risks for parents and sufferers
• Seek better outcomes
![Page 61: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/61.jpg)
‘Michael can’t sit still, Michael can’t be quiet, Michael can’t focus,’ "Your son will never be able to focus on anything."
![Page 62: ADHD its links to criminal justice and how practitioners ...georgestillforum.co.uk/images/PDF/riskofoffending.pdf · – get 4366 calls – deal with 415 crimes – arrest 185 people](https://reader033.fdocuments.in/reader033/viewer/2022060217/5f06571e7e708231d41780fa/html5/thumbnails/62.jpg)
www.adhdandjustice.co.uk
ADHD Angel and Guardian in the app store - free