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Justice

Can Treating ADHD Behind Bars Reduce Reoffending?

In some prisons overseas, inmates diagnosed with ADHD are offered targeted treatment — and the results are changing the way we think about rehabilitation.

Andrew Thompson

• 2 min read
Can Treating ADHD Behind Bars Reduce Reoffending?
If rehabilitation is truly the goal of incarceration, addressing ADHD cannot be optional.

The Untapped Opportunity

ADHD is one of the most common yet least addressed conditions in correctional settings. Globally, around 26% of adult prisoners have ADHD[1], with the figure rising to 41% in New South Wales prisons[2]. Despite this, routine screening and treatment remain rare in Australia’s prisons.

Untreated ADHD can drive impulsive decision-making, emotional dysregulation, and poor planning — traits that not only increase the risk of offending, but also lead to behavioural incidents behind bars. This combination makes ADHD both a justice problem and a public health opportunity.

What the Research Says

International evidence is promising:

  • Sweden: A randomised controlled trial found that medicated prisoners with ADHD had significantly fewer critical incidents and better participation in rehabilitation programs[3].
  • Norway: Introduction of stimulant medication in correctional health services was associated with improved emotional regulation, reduced aggression, and higher rates of program completion[4].
  • Netherlands: Prisoners who received combined pharmacological and psychological ADHD interventions demonstrated lower rates of disciplinary action and better post-release adjustment[5].

Meta-reviews — including the Australian ADHD Professionals Association’s 2022 factsheet[6] — conclude that while large-scale data is limited, existing studies consistently point to reductions in in-prison incidents and likely decreases in recidivism when ADHD is properly treated.

Barriers to Treatment in Australia

  1. No Routine Screening: Without systematic screening at prison intake, most ADHD cases go undiagnosed.
  2. Stigma: Misconceptions about stimulant medication in correctional settings fuel resistance among staff and policymakers.
  3. Regulatory Complexity: Prescribing and managing Schedule 8 medications in secure facilities involves additional legal and administrative hurdles.
  4. Training Gaps: Many correctional health professionals receive little or no specialist training in ADHD assessment and management.

Potential Benefits

  • Improved In-Prison Behaviour: Reduced incidents of aggression and rule-breaking.
  • Higher Rehabilitation Engagement: Greater participation in education, vocational, and therapeutic programs.
  • Lower Recidivism: Treated ADHD may reduce the impulsive and risk-taking behaviours linked to reoffending.
  • Cost Savings: Fewer behavioural management costs in custody, reduced burden on the justice system post-release.

Policy Implications

If rehabilitation is truly the goal of incarceration, addressing ADHD cannot be optional. Key steps include:

  • Mandatory ADHD Screening at intake for all correctional facilities.
  • National Clinical Guidelines for ADHD assessment and treatment in prisons.
  • Integrated Care Models linking prison-based treatment to community health services for continuity after release.
  • Staff Training to improve recognition, diagnosis, and management of ADHD in correctional populations.

The bottom line: Evidence suggests that treating ADHD in prison isn’t just about improving individual wellbeing — it’s a strategy with the potential to reduce crime, improve community safety, and save taxpayer dollars.

  1. Young, S., Moss, D., Sedgwick, O., Fridman, M., & Hodgkins, P. (2015). A meta-analysis of the prevalence of attention deficit hyperactivity disorder in incarcerated populations. https://pubmed.ncbi.nlm.nih.gov/25066071/ ↩︎

  2. Moore, E., Sunjic, S., Kaye, S., Archer, V., & Indig, D. (2016). Adult ADHD among NSW prisoners: prevalence and psychiatric comorbidity. https://pubmed.ncbi.nlm.nih.gov/24134874/ ↩︎

  3. Ginsberg, Y., et al. (2012). Methylphenidate treatment of adult male prison inmates with attention-deficit hyperactivity disorder: randomised double-blind placebo-controlled trial with open-label extension. https://pubmed.ncbi.nlm.nih.gov/22075648/ ↩︎

  4. Ginsberg, Y., et al. (2013). Methylphenidate treatment of adult prison inmates with attention-deficit hyperactivity disorder: Randomized double-blind placebo-controlled trial. https://pubmed.ncbi.nlm.nih.gov/22075648/ ↩︎

  5. Philipsen, A., et al. (2015). Effects of group psychotherapy, individual counselling, and pharmacotherapy in prison inmates with ADHD. https://www.ovid.com/journals/japs/abstract/10.1001/jamapsychiatry.2015.2146~effects-of-group-psychotherapy-individual-counseling. ↩︎

  6. Australian ADHD Professionals Association (AADPA). (2022). ADHD in the Correctional System Factsheet. Retrieved from https://adhdguideline.aadpa.com.au/ ↩︎

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