ADHD: Impact on Prison Rehabilitation and Reoffending

Clive Jones Excerpts

Tuesday 1st July 2025 Westminster Hall

[Tessa Munt]

Indeed, there is no consistent data collection. That is a problem not only in Northern Ireland, but in England and Wales, which the debate is primarily about. If someone is identified and diagnosed, it can be hard for them to access the right care and support due to fragmented care pathways. That is compounded by limited awareness and understanding of ADHD in the prison services.

[Clive Jones (Wokingham) (LD)]

I think all Members present will have heard from desperate parents whose children cannot get the ADHD medication that they need. Does my hon. Friend agree that the scandalous failure to provide care sets those children up to fail and that, tragically, the consequences are that some end up as the offenders we are discussing, instead of fulfilling their full potential?

[Tessa Munt]

I could not agree with my hon. Friend more. His point is similar to the one made by my hon. Friend the Member for Yeovil (Adam Dance): the earlier we screen, the better we will be able to understand how people learn. In the long run, if life is not education, I do not know what it is—I am sure the Minister will have some sympathy with that point, because he and I both served on the Education Committee between 2010 and 2015. We need to make sure we have far better screening so that people can understand how both young and older people learn. We should never finish learning.

The report observed that only 24% of prison staff had received some level of training about neurodiversity. I accept that that was back in 2021, but I doubt it is much different now. A basic level of awareness of neurodiversity and the needs of neurodiverse people was lacking among frontline staff. The lack of training, combined with staff shortages in prisons, can impact the management of neurodiverse prisoners. Those working in prisons must be able to recognise that the behaviour of some prisoners may be linked to ADHD, and a lack of training for those in mental health teams can result in misdiagnoses or suboptimal treatment. There is an ongoing need to better embed training for prison officers and extend the establishment of neurodiversity support managers across prisons in England and Wales, as mentioned earlier.

The structural changes that are taking place in NHS England, which has commissioning responsibility for offender health services, might provide an important opportunity to consider some of the challenges, and to develop new models for supporting people with health and care needs to access the right care and treatment in the community. That is particularly important where an unmet need has the potential to have a direct impact on an ex-offender’s likelihood of reoffending. Will the Minister outline the measures that are currently in place, and what he plans to offer, in the way of support and continuity of care for neurodiverse prisoners after their release, particularly in healthcare settings?

The Ministry of Justice’s cross-Government neurodiversity action plan, published in 2022 in response to the independent review, was a step forward in the official recognition of the unmet need around neurodiversity in the criminal justice system. Some promising steps were taken to advance the commitments in the plan, such as the recruitment of more than 100 neurodiversity support managers in prisons and the roll-out of neurodiversity training in some settings. But data remains insufficient and fragmented, as the hon. Member for Upper Bann (Carla Lockhart) said, and that poses challenges to the effective assessment of the impact of interventions. Will the Minister outline what steps the Government are taking to monitor the number and availability of neurodiversity support managers in prisons across the country, and what measurements are being used to assess the impact of their work?

It is important to keep up the momentum behind the neurodiversity action plan. However, the 18-month review and update committed to under the action plan, which was due in early 2024, has not been published. I would be grateful for further details from the Minister on his plans to continue the implementation of the neurodiversity action plan. Will he outline what steps were taken last year and will be taken to implement the plan? When will the 18-month review, which was due in early 2024, be published?

The ADHD taskforce was established in 2024 and recently published an interim report on the state of play in ADHD care, with its final report due this summer. The taskforce has taken a cross-Government approach, rightly recognising criminal justice as a key focus. The taskforce interim report highlights a number of important and pressing issues, particularly the need for better data to understand where and how people with ADHD are interacting with public services; the relationship between education, health and wider support in relation to outcomes for people with ADHD, including contact with the criminal justice system; and the value of earlier intervention.

What steps have the Government taken and will they take to engage with the ADHD taskforce and wider stakeholders to address the barriers and implement the recommendations highlighted in its interim report and forthcoming final report? Many reports show us that people with ADHD are more likely to struggle with impulse control, emotional regulation and memory recall. We understand that those behaviours can lead to early school expulsions, unstable employment and contact with the criminal justice system.

Once someone is in the system, ADHD can affect how they interact with the police, legal advisers, the judiciary, court staff and probation officers. That can increase exponentially the risks around unreliable statements, misunderstood behaviours and disproportionate sentences. Responses to their environment can lead neurodiverse people to exhibit challenging behaviour that could result in their being disciplined or sanctioned, and affect their engagement or consideration for rehabilitation programmes.

Other reports, such as that published in December 2024 by Takeda, on reforming justice and tackling the unseen challenge of neurodiversity in the criminal justice system, have concluded that there is a need to reassess our approach to managing offenders and consider more innovative ways to interrupt the cycle of reoffending. That includes better approaches to addressing the unmet needs of neurodiverse individuals, where conditions such as ADHD may have a direct impact on offending. Does the Minister agree that, in the light of the challenges, criminal justice services should adjust the way people with ADHD are managed, to improve rehabilitation and reoffending outcomes?

Will the Minister address the matter of women who meet the criteria for ADHD in prisons? ADHD in women is often misdiagnosed or missed altogether. Women are more likely to mask symptoms, presenting as anxious, depressed, having eating disorders or as emotionally distressed. That means that for many women and girls their ADHD is often diagnosed late or not at all. More work is needed to understand the experience of women in the criminal justice system who have ADHD. They are likely to experience multiple barriers and may be impacted by co-occurring mental health issues or other disadvantages. For example, one in three women in prison self-harms—the rate is eight times higher than that on the men’s estate—and there is a strong correlation between ADHD in women and self-harming.

These issues are directly relevant to the Government’s wider ambition to reform the way female offenders are managed in England and Wales, including the intention to close one women’s prison and increase the management of female offenders in the community. That in part recognises that many women are imprisoned for lower-level offences. For example, in 2023, theft from shops was cited as the most frequent offence committed by female offenders, accounting for 40% of women’s prison sentences shorter than six months.

Evidence also demonstrates that the incarceration of women can have a broader impact on families and children. Many women are primary carers, and their imprisonment can result in children being displaced, amplifying cycles of trauma and disadvantage over the generations.

The establishment of the Women’s Justice Board presents an opportunity to address these issues, so will the Minister outline whether the board is currently considering neurodiversity and the impact of ADHD on women in prison within its remit? Will the Minister commit to ensuring that ADHD is meaningfully embedded and accounted for in the work of the board in order to ensure that the experiences of women with ADHD in the criminal justice system are a priority? The Government have stated an ambition to address the challenges of prison capacity and to shift the approach taken to women offenders. It is important to recognise that ADHD screening, a coherent care pathway and improved awareness and training in prisons could play a part in achieving that ambition.

In summary, my current membership of the Justice Committee and my membership of the Education Committee during my service here between 2010 and 2015, along with my meeting experts in ADHD and criminal justice more recently, has emphasised to me the need to take a different approach to identifying and supporting neurodiverse prisoners to help those individuals to make new lives and thereby to help the Government to make sure that prison is effective and efficient at turning prisoners’ lives around.

A new campaign focusing on the unique experience of neurodiverse individuals with ADHD in the criminal justice system explores evidence-based opportunities to improve support and outcomes. Will the Minister meet me and representatives of that campaign to discuss the challenges facing individuals with ADHD in the criminal justice system and the steps that might be taken to meet people’s needs and improve outcomes in relation to rehabilitation and reoffending? I have asked a number of questions, which I provided to the Minister and his team. I recognise that he will not necessarily be able to answer eight questions right now, but would he possibly give me the honour, first, of a meeting and, secondly, of a response to my questions?