New Guideline Addresses Management of Adolescent ADHD in Correctional Settings

Posted Jan 13, 2014

Chicago (January 13, 2014) -- To assist in the treatment of attention-deficit/hyperactivity disorder in adolescents in correctional institutions, the National Commission on Correctional Health Care has issued a new guideline on Adolescent ADHD. According to a study by the Yale School of Public Health, children with ADHD are more likely to engage in criminal activity such as burglary, theft and drug dealing as they grow older. In fact, individuals involved with the justice system show significantly higher rates of ADHD than appear in the community. When this risk factor is identified in adolescents already involved with the justice system, it is especially important to help manage and treat ADHD so they can avoid additional behaviors that lead to further incarceration.

Specific recommendations in the guideline include:

• An appropriate diagnosis and evaluation should be completed with reference to the criteria described in the new American Psychiatric Association DSM-5 and standardized rating scales recommended by the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics.
• Alternative causes of disruptive behaviors should be ruled out. The clinician should evaluate the youth for primary and co-occurring conditions such as substance abuse or dependence or emotional, behavioral, developmental, autism spectrum, neurobehavioral or physical disorders.
• The health care professional should verify pre-existing ADHD medication prescriptions and compliance. Because of the degree of structure, supervision and behavioral interventions in correctional settings, an ADHD medication “holiday” may be considered while the youth is in custody.
• Clinicians should follow a chronic care model and reassess and evaluate on a regular basis.

Treatment of adolescents diagnosed with ADHD is complex. A youth’s presentation is likely highly variable around peer and staff interactions and conflict, other unit interactions, family communication and visits, legal and disciplinary issues and other stressful experiences. Behavioral management efforts with patients diagnosed with ADHD should be informed by an understanding of the challenges they are facing as well as their vulnerability to behavioral problems, impulse control and poor decision-making when faced with challenges. When determining the appropriate response to difficulties, a referral to unit mental health staff has the potential to be more effective than disciplinary action.

The guideline was developed with input from experts in juvenile health in corrections. It is available for free download at

About NCCHC: The National Commission on Correctional Health Care is a not-for-profit 501(c)(3) organization working to improve the quality of care in our nation’s jails, prisons and juvenile detention and confinement facilities. Programs and resources include standards for health services, mental health services and opioid treatment programs in correctional facilities, voluntary accreditation programs for facilities that meet these standards, educational trainings and conferences, publications, and professional certification. NCCHC is supported by the major national organizations representing the fields of health, law and corrections. Each of these organizations has named a liaison to the NCCHC board of directors. Learn more at

NCCHC Supporting Organizations: Academy of Correctional Health Professionals, Academy of Nutrition and Dietetics, American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Academy of Physician Assistants, American Academy of Psychiatry and the Law, American Association of Public Health Physicians, American Bar Association, American College of Emergency Physicians, American College of Healthcare Executives, American College of Obstetrics and Gynecology, American College of Neuropsychiatrists, American College of Physicians, American College of Preventive Medicine, American Correctional Health Services Association, American Counseling Association, American Dental Association, American Health Information Management Association, American Jail Association, American Medical Association, American Nurses Association, American Osteopathic Association, American Pharmacists Association, American Psychiatric Association, American Psychological Association, American Public Health Association, American Society of Addiction Medicine, Association of State and Territorial Health Officials, International Association for Correctional and Forensic Psychology, National Association of Counties, National Association of County and City Health Officials, National Association of Social Workers, National Medical Association, National Partnership for Juvenile Services, National Sheriffs' Association, Society for Adolescent Health and Medicine and Society of Correctional Physicians.


For more information, 

Contact: Kimberly Sterling, CAE

773-880-1460 ext.284,