Recently, I was asked by a colleague if I would be willing to go into a local detention center to provide medication management for a young adult she was counseling. This young man had been in and out of the detention center several times previously. But this time, he expressed to my colleague that he was ready to do whatever was necessary so that he would not return to the facility once he got out. Prior to his detention, he had been given two diagnoses: Attention Deficit Hyperactivity Disorder (ADHD) and Bipolar Disorder. He and his mother had concerns about medication so he had never tried them. Now, he was ready to take whatever medication was necessary.
I gave my colleague the “green light” in regards to prescribing him medication. But I had one condition: both the young man and his mother had to make a commitment to understand the foundational issue for what was going on in his life and had to be willing to do the work to fix it. Medication is never the answer; it is only a tool.
In the end, logistic issues prevented me from working with this young man, but it did get me thinking. Can we identify at an early age which juveniles are going to get caught up in the prison cycle? If so, how do we prevent it? The answer to the first question is “yes” but the prevention piece is hard. Some of you may be familiar with the phenomenon known as the “School to Prison Pipeline.” The “pipeline” speaks to the funneling of students from the school house to the jail house, most often because of the zero tolerance policies employed by school systems (which developed after the 1999 Columbine High School massacre) and the overuse of undertrained school resource officers in the schools. Comparatively speaking, the “pipeline” is disproportionately full of Black and Hispanic students, as well as students with disabilities. These students funneled into the “school-to-prison” pipeline often find themselves suspended (and sometimes expelled) from school for non-violent (though sometimes violent) offenses. Eventually, they will find themselves in jail. Let’s put that into perspective:
These statistics got me thinking. If 68% of incarcerated males didn’t finish high school, we can either ignorantly believe that they didn’t want to be in school or maybe school was just too difficult. But for most students, school is an awesome place to be, if they don’t get excited about the actual learning, then the social aspects are usually significant enough to keep most students there. I’m a firm believer that any child who hates school to the point of avoidance has some underlying issue. Is ADHD enough? Personally, I don’t think so. If you have noticed, it seems like everybody who is not successful in school has ADHD. It is true that a lot of people have it, but you would be amazed at how many other conditions exist with ADHD. These conditions include learning disabilities, processing disorders, mood issues like anxiety, depression and bipolar disorder and let’s not forget the neurodevelopmental disorders like autism. Far too often, it is these other conditions that impact learning and success in school far more often than ADHD alone. A recent study published by the American Academy of Pediatrics in September 2015 showed that a diagnosis of ADHD can forestall a diagnosis of Autism by up to 3 years.
So, here is my premise. We should re-describe the phenomenon from School to Prison Pipeline to Preschool to Prison Pipeline. Why? Because many of these children present as early as age 4 with behavior problems, focus issues and resistance to the learning environment. I’m wondering if we did a better job of identifying, treating and supporting these youths at as early an age as possible could be impact the number of individuals to find themselves in the pipeline. Not only that, I am finding that there is a genetic component to many of these issues and if we can treat parents and other family members could we finally break a cycle?
Only time will tell but I and my staff are working diligently one patient at a time to ensure that we don’t contribute to the pipeline.
I hope I got you thinking . . .