The High Cost of Undiagnosed ADHD with Sarah Templeton
Today, we’ve got a heavy but necessary topic. We’re looking at what happens when ADHD goes unsupported and the stakes get high. In this episode, I’m joined by Sarah Templeton, a counselor, activist, and author of The Prison Counselor. Sarah spent years working inside the UK prison system before getting her own diagnosis at age 51, which led to some massive realizations about the people she was working with.
In our conversation today, we look at the startling prevalence of neurodiversity in the prison population and how a lack of diagnosis fuels a cycle of reoffending. We explore the stark reality of the "school to prison pipeline" and the specific ADHD traits that land people in legal trouble. It’s not just about being a trouble-maker, but about impulsivity, risk-taking, and a heightened sense of justice. And I know that last one might sound counterintuitive, but don’t worry, we get into that in the episode.
This is an incredibly important episode to me because I believe that it’s one of my jobs to use my privilege as someone with an audience to highlight the struggles in our community from some of our most underserved populations. And our ADHD siblings in prison are definitely a prime example of people who had the system fail them and are now paying the price.
Before we get started, I also just wanted to mention that there is some talk of suicide in this episode, so if that is something you are sensitive about, I just wanted to let you know.
If you'd like to follow along on the show notes page, you can find that at HackingYourADHD.com/260
YouTube: https://tinyurl.com/y835cnrk
William Curb: All right, well, I am so glad to have you with us here today. I was wondering, could you just give us a little bit of a brief introduction to yourself and what you do and how you kind of got into doing that?
Sarah Templeton: Yeah, absolutely. My name is Sarah Templeton. I was a councillor in the prisons. And I absolutely adored working in prisons and got on brilliantly with everybody I worked with. And the reason for that became apparent when I was 51 and still working in the prisons, I was diagnosed with ADHD.
And at that point, I suddenly had about 300 light bulb moments and thought, oh, my God, this is why I get on so brilliantly well with all these people. I've never committed a crime. But I seem to have the same brain. I seem to think the same way as all these people I'm working with that sort of carried on over the next 10 years into me realizing that pretty much everybody has got ADHD in prison.
And a lot of them have also got autism. And I no longer work in the prisons. I came out in 2016 and started to work in private practice because my goal then was to catch these kids earlier before they ended up in the prison system. So I then worked for about six, seven years as a councillor. But then I started to write books.
What I would consider myself now is an author and an activist. So I now write books on ADHD for parents, teachers, anybody who's coming into contact with ADHD kids, basically, because my goal in life is to empty the prisons of ADHD. So I've written two books on parenting, young children with ADHD and teenagers with ADHD. My third book is for teachers, helping them understand ADHD and very importantly, keeping ADHD kids in the classroom. Because the minute you exclude them, you put them on the school to prison pipeline.
So it's all about understanding ADHD kids, keeping them in the classroom. And then my fourth book, my big passionate book is the one I've just written called The Prison Counsellor. And that's all about my time in the prisons. And it's how I discovered I was ADHD.
Then I discovered that most of them are ADHD and what I've done about it since. So I would describe myself now as an author and an activist, although I am a qualified councillor as well, but I don't do that anymore.
William Curb: That's fantastic. Yeah. And it's one of these ideas that I've always wanted to be able to help the more vulnerable populations with ADHD because I know I have a lot of privilege and opportunity to grow with my ADHD. But for a lot of people, it is something that sets them down some very bad paths with the impulsivity and just having problems with executive function that make it really easy to not fit into society and then also have these things where, yeah, you're going in a bad path.
Sarah Templeton: Yeah, I would say more than the executive function, though, it's some of the actual ADHD traits that get people into trouble and get them in prison. It's very, very clear when you've worked with as many as I have, and you've talked to as many as I have and dug deep into why they've done what they've done, it boils down to impulsivity. It boils down to not thinking of the consequences. It massively boils down to risk taking and thrill seeking. And it also comes down to boredom, having a low boredom threshold.
There are so many boys and men I've worked with. And I said, you know, why did you do that? Because I was bored. I was so bored. I just had to do something.
And then that happened. So boredom comes into it. Also, having a heightened sense of justice comes into it. A lot of people are in prison because of that heightened sense of justice. He looked at my girlfriend.
He deserved it. Simple as that. There's a few other traits that come into it. I would say the very, very big two are impulsivity and not thinking of the consequences. That is primarily why people are in prison.
And if I had to pick a third, it would actually be the heightened sense of justice. There are so many people that are in there. I met one the other day. He'd actually killed his best friend. And I said, what was all that about? Why did that happen? It was heightened sense of justice about something that the best friend had done. So many people, they don't know they've got heightened sense of justice because most of them don't know they've got ADHD. Even the ones who do know they've got ADHD in prison don't know about the heightened sense of justice because they've been diagnosed as kids. So they've been told, oh, it's hyperactivity and it's impulsivity and it's inattention.
It's all those things. So they've been told that. They don't know about all these other traits and ways of thinking that we know because we've done the deep dive into ADHD. So if you ask any ADHD person in prison, diagnosed or undiagnosed, if they've got a heightened sense of justice, they will not know what that means. But it's very probably what's got them there. So the lack of ADHD awareness in the prisoners is chronic. And that is something that my charity is changing as of this year. I can tell you more about that in a minute. But the raising ADHD awareness amongst prisoners is what we have decided is paramount because they're not understanding their own brains and how and why they do things is what makes them keep doing things over and over again.
They give up on themselves because they think, oh, I just can't stop doing this. One, for example, lovely, lovely, lovely, lovely boy, 21. And he could not stop nicking things out of people's handbags. And he said, when I sit here talking to Sarah, I like myself. I'm a nice person. I'm sensible. I'm grown up. I'm a man. And I'm polite. And I'm everything.
And I like myself. But he said, every time I walk past a handbag, he said, I'm telling you now, if I can see a purse, I'm having it. And he said, I don't like myself for it. But I can't stop doing it. Now, when I was counseling him, sadly, this was before I knew about ADHD compulsivity, because compulsivity comes into it as well.
Because he's got a buzz from stealing purses before, his brain is telling him, oh, that's good. You'll like that. Nick that one.
Nick that one. So they don't understand how compulsivity comes into it. So understanding their brains is what we have decided is going to help people most in prison and where we're spending all our time and energy at the moment. We're actually recording 31 videos. We're going to help every prison set up an ADHD support group with these very professionally made videos that the contributors are people like ADHD psychiatrist, ADHD psychologist, all diagnosed ADHD in cells, by the way, we've got ADHD social workers, ADHD psychotherapists and counselors, ADHD nurses, ADHD send teachers and teachers, ADHD prison officers.
So we've got all these amazing about 50 of them people that have recorded these videos, all on the different aspects of ADHD. So we can get these into the prisons and help people in there start understanding their own brains. Because we think I know, I mean, I work with people in prison all the time. There's a lot of people now in prison who've been diagnosed ADHD, but for a multitude of reasons, can't access the medication. But just knowing how their brain works, knowing about impulsivity, knowing about compulsivity. Now they know they can manage themselves so much better. Before they knew there was a reason for this, it's ADHD, they give enough on themselves, they think they're absolutely hopeless, you know, they're like, Oh, I just can't stop doing it. I'm a waste of space.
Lock me up, throw away the key. They've really lost completely lost self-esteem, like literally zero self-esteem. When you start explaining to them, actually, this is ADHD, a lot of them don't even want to know that it's ADHD. They think that's an excuse.
No, no, no, no, no, no, no. I'm not looking for excuse. And I'm like, no, no, it's not an excuse. It's not an excuse. If you've got ADHD, it's a different brain wiring. You were born with it, you'll die with it. And this is why you do the things you do.
It's not an excuse, but it might be the reason. When they start to understand that they're like, Hmm, okay. And they'll listen. And once you've explained their brains to them, it's amazing the change in people.
William Curb: When you just think, this is who I am versus because of this, these are the decisions I'm making rather than the, yeah, the, why did you do that? Oh, I don't know. It seems like the thing to do. But we're like, Oh, I just was doing that because that's how my brain's wired. And maybe I can have some strategies to maybe do things a little bit differently.
Sarah Templeton: 100%. What you've just said though is when you said, Oh, it's because it's what I do, what they would actually say is it's because I'm a piece of crap because I'm rubbish. I've always been told I'm rubbish. I'm hopeless.
I always do these. So the self, when I say the self seems on the floor, I mean it. They've actually quite self aware, a lot of them, some not, but most are quite self aware. And they hate themselves. They hate themselves because they can't stop doing what they've always done, whether that's getting into fights, whether it's getting drunk. I mean, there's a lot who have self medicated the ADHD. So there's a lot who again, they've given up on themselves because of that. They just can't stop drinking. They just can't stop doing whatever drug they're doing.
And they've given up on themselves. So I spent most of my time in the prisons trying to drag self esteem off the floor. And by telling people, I was very often the first person who told them that I actually liked them. You know, I'd say, I like you find you funny. I think you're hysterical because most of them are very, very funny, very witty, very quick. And I'd say, you're hysterical.
You're a very good company. Do you not realise? And they'd go, no, no one's ever told me that. They've just told me that I'm hopeless, useless. I belong in prison. I'll never get out of prison. I'll never be any different.
That's what I've been told. You'll never change. You're always going to be the same.
You're always going to be like this. So they've given up on themselves and it's tragic because if there was more ADHD awareness literally in the prisons, not just amongst the prisoners, amongst the staff. It's the staff who don't know about it as well. And it's the governors and healthcare. It's right through the whole prison system. And more recently, I've had quite a lot to do with the prison system in Australia, just about to start having something to do with the prison system in America. I've been approached by two different prisons in America and two different police forces.
And quite interesting, all of them literally word for word said the same thing. And that was, we've seen everything you're doing about ADHD in prisons. We've seen it. We think it's right. You know, we think you're right, you're bang on the prisons are full of ADHD. They've said their prisons are as full of ADHD, which of course they are. This is worldwide. But everybody in America says to me exactly the same phrase.
Yeah. And that phrase is, we agree, we know this is much ADHD in the prisons, but we are going to have a much tougher job of doing something about it here because we are much tougher on crime, word for word. And I've recently read a very good book called Just Mercy, which has just opened my eyes to the American criminal justice system, because obviously I'm very obsessed with the UK one.
But it's kind of opened my eyes to the American one. And now I realize what these people mean when they say they're tough on crime. I kind of thought they meant tough on crime, we give long sentences. Yeah. And that's right.
But there's a lot of other ways America is quite tough on crime. And I've only just begun to realize what it is by reading this amazing book. So yeah, I'm just about to sort of delve into the American criminal justice system, because as I say, every country I go to, every, I do training in different countries, I fly all over the world doing this. It's the same everywhere. There's the same ratio of ADHD people everywhere. And there's the same ratio in prison everywhere. This is a worldwide problem. It really is.
William Curb: Yeah. And it's something that when they don't understand why the like mechanics behind why this is happening, it's easy to write the person off. Just like the person is writing themselves off, the judges, the police, all that system is also writing them off because they're like, well, that's just if they don't know why they're being the way they are, it's going to just continue that way. And that's just who they are. And so we're going to let them stay in prison until they're fixed. I mean, I don't know that's really point of prison.
Sarah Templeton: But no, they certainly don't fix people in English prisons. I can't say about anywhere else that they don't. When somebody's in front of a judge, let's say, who doesn't understand their ADHD brain, their ADHD behavior, they can't explain that to a judge or even to their solicitor, Barrister, anybody, they can't explain it because they don't understand it themselves. So how would they expect a judge to judge them based on what they've done when they don't really understand why they've done it themselves? They don't understand about impulsivity, compulsivity, pattern sense, justice, all these things in these hundreds, hundreds of ADHD traits, not liking authority, all of it, they don't understand it that we want to push boundaries, we need to risk take thrill seek. If the person themselves doesn't understand that, how on earth can they explain that to their legal representatives or to a judge?
They can't. So that's why they end up in prison. So a lot of the training that we do is to judges, literally to courts, to judges, to magistrates, to solicitors, to Barristers, because once they all get it, we actually work now with some teams of solicitors who are ADHD themselves. So they're much more understanding of when an ADHD person presents themselves, you know, but it's interesting, I just went to Jersey, I do know Jersey, it's an island in the Channel Islands, just off Britain, sort of part of Britain, but near France. So I went there last week, and we trained everybody on the island, we trained the headteachers, teachers, child mental health teams, adult mental health teams, probation, police, and the youth justice court. Now on one whole table, they said, we're the youth justice courts.
And I said, fabulous, this is right at the end. And the man who was sort of representing, we said, he said, well, basically, everything we've heard today has blown our minds, and we need to take this away, and we need to change completely how we do things. And we were all like, yes, please, if you would, because if you could screen every person that comes up in front of you for ADHD, and find out in five minutes, whether there's enough indicators of ADHD to warrant further investigation, that will change how you deal with everybody who's coming up in a youth justice court. So very many moons ago, about eight years ago, I was saying to people that I was meeting, I want to get screening in all the prisons, I'm desperate to get ADHD screening into all the prisons. And a couple of police officers said to me, yeah, that's great. But actually, we need to get them before that, we need to get them when they first get arrested in a police station.
I was like, okay, yes, you're right. I don't know, I've never worked for the police. I don't know anything about the police. But yes, you're absolutely right. So we're now in this country, a lot of police stations are now screening for ADHD. A lot of them are doing pilots, a lot of them are just starting, you know, they're all doing it different ways. But screening in the police is where it has to begin. And if you roll it back even further, we need to be screening in schools. We need to be screening at the age of five for every neurodiversity. So not just ADHD, also autism, also dyslexia, dyspraxia, dysgraphia, all of those, it takes five, 10 minutes, it costs nothing. So anybody who says all funding, funding, funding, no, no funding at all, you've got to run one piece of paper off the internet and screen people, it's so easy. So if we can catch kids very, very young and get them screened and diagnosed and sometimes medicated for these conditions, but as I said, sometimes it doesn't take medication. Sometimes it just takes a lot of self awareness. We can change the whole prison system, not just here, but worldwide.
That's my goal now, worldwide, because this is exactly, I'm getting people coming to me from Southeast Asia saying, Sarah ADHD is a massive problem in Southeast Asia. And I'm saying, I don't doubt you. I don't doubt you at all. I'm sure it is. So it's a worldwide problem. Australia, I have to say, certain states in Australia are quite far ahead with this. Some states in Australia have been screening for ADHD and autism for three years. So hats off to Australia.
Yeah, they're great. England, we're catching up. Some of the people we talk to, I find this quite funny, well, funny, tragic, funny. When I was speaking to one of my local probation teams, they'd asked me to help them with something and I said, yeah, no problem at all, we'll do that. But then I said, can I ask you for a bit of help? And they said, yeah, of course, I said, I only want one thing. I said, I would like you to screen all your people coming into probation for ADHD.
Now, this probation officer, she was head of a whole areas probation. She looked at me and she's across her eyes. She said, well, I will Sarah, but you do know it's all of them. Yeah, I kind of know it's all of them or if not pretty much. I've always said pretty much all of it.
She said, well, I'll screen them, but it's just going to come out all of them. That's probation saying that. And that woman's not even ADHD herself. So we can't even say, oh, she's ADHD, she's picking it up. She's not ADHD, but she knows they're all ADHD. So, you know, there are lots of people. In fact, one was Jersey, one of the probation officers who'd watched, there were two.
And one of them, he came up to me at the end and he said, we're going to start screening Sarah. He said, how can we not? How can we not? Now we've heard this. I said, well, exactly.
How can you not? I always say to people, screening is nearly always life changing, nearly always. And sometimes it's life saving.
Because these people, as you know, are at a much higher risk of suicide, much higher risk of self harm. And we have lost people. I won't go into details, but we have lost people.
I've lost somebody, an old client of mine, to suicide in a prison, because they wouldn't put him on ADHD medication. And that is I actually met them at the inquest. I met the six officers at the inquest. I managed to get them on their own for an hour and a half. We were left in a room. The judge left me and these six officers in a room on my own with them for an hour and a half. And I gave them some very intensive 1.5 hours worth of ADHD training because they said they didn't know anything about it. Now this is the people that had let my ex-client die. And at the end of it, two of them were in tears. And I said to them, I said, be honest with me now.
Be totally honest. Did any of you know any of that? And they all said no. So there's six officers working on that wing where my very dysregulated, very emotionally all over the place had already set fire to himself two years before boy, they knew was a suicide suicide risk. Nobody realized how much of a suicide risk because they didn't understand ADHD until they listened to me that day. And then as I say, two of them, there were four men and two women. The two women were in tears. And the four men were just sitting there sort of shaking the heads going, oh my God, one of them said, why aren't we trained in this stuff? And I said, yeah, why aren't you? Anybody working in a prison, officers, anybody admin, governors, anybody, they should have ADHD training.
They need it before they work with all these ADHD prisoners. And the ones that you talked to this before I used to blame individual people. I thought you let my boy down, you let him die. You did that. No, no, no, I've realized now, no, I realized that day. This is a systemic problem, a mammoth systemic problem. You have got whole organizations, probation, police, youth offending services, prisons, there are pockets where this isn't true, right? But most of them are not ADHD aware. And it's not their fault, you know, they need the training. And funny enough, when we do training for these people, they are like sponges.
They suck it up, because they know they're like, this is pretty much everybody I've been working with for 20 years. Why didn't I know this stuff? You know, so it's not that they don't want to know this stuff. They really do. They really do. And they're very open to it when you train them, but they haven't been trained. And this needs to change literally worldwide. It needs to change.
William Curb: Because it seems like we're just failing this section of the population. And then instead of trying to help them, we're just further punishing them.
Sarah Templeton: Well, yes, we are. We're also we're not helping victims either. So, a lot of people say, oh, why are you always helping these people in prison? But I'm not only helping them, I'm helping the victims as well. You know, I'm helping the victims.
I'm helping there be less rapes, less murders, less muggings, less robberies, less burglaries. Don't we all want that? And something else I'll tell you.
Now, this is this is a very hot potato. But I will tell you, we have something called a neurodiversity support manager in every prison now. They put one of these into every prison. This is a step in the right direction.
It's a step, right? But they're overwhelmed because the prisons are just a lot. Yeah, they've got one neurodiversity manager and 600 ADHD people.
What are they supposed to do? So, what I found interesting, though, when we've trained some of these, we've trained them because they're not they know they're not as up in ADHD and autism as they'd like to be. But when we train them, every single one of them says one thing to me at the end, and they all they always lean in closer to the camera, like, I've got to say this very quietly, they lean in and they say, Hera, we think there's more ADHD on our sex offender wing than any other. And they all say it to me as if I'm not going to believe them. And I say, yeah, I'm sure you're right. I'm absolutely sure you're right. So, when you think about risk-taking and thrill seeking, of course, that's going to create some sex effect. Everybody says, oh, all ADHD in a second. No, of course not. But some people with ADHD, some, their traits will take them in that direction. It's just a given. So, my big line now is, if we want to protect children from sex offenders, then we need to start screening kids in class now for ADHD.
We need now. Because otherwise, if we're letting these kids grow up, these five year olds in school now, undiagnosed ADHD ones, a portion of those will grow up to be offenders. And a portion of them will be sex offenders. That's what we're allowing to happen by not screening kids in class. It's ever so simple. It's ever so simple.
William Curb: Yeah, I mean, it totally makes sense. Yeah, if you stop things before they become a problem is absolutely just big sense.
Sarah Templeton: Yeah, absolutely. And it also saves money. See, the governments look at this and go, oh, screening people, medication, oh, well, in England, it costs £48,000 a year to keep one person in prison for a year. Now, if even 60, 70% of the prison population are ADHD, that's a phenomenal amount of money that we're spending on keeping all those ADHD people in prison. If they're on the outside, if they're diagnosed and medicated, it might cost the NHS £1,000 a year against £48,000 a year. The saving to the government, even medium term. It's not long term. It's quite medium term because I've worked with numerous people that have come out of prison. My charity's gotten diagnosed ADHD.
They started the meds. None of them have ever offended again. None. And some of those have been out five years now. They don't offend.
They just don't. One of them, classic example, he'd been in prison. I'm allowed to talk about him as well. He's on our website.
He's very happy about being spoken about. He was a boy who by the age of 29 had been in prison 15 times. And when it got to the 16th time, I said to his mother, please, God, can I please, this is not a client, by the way, this is just actually the son of a friend of mine. So when he got arrested for the 16th time, I said to the master, please, God, can I see him? I'm sweating.
God, there's ADHD in that boy. I met him. This is an exceptionally long story into a sentence. I met him. He was diagnosed ADHD. He was medicated. That was five years ago.
He's never offended again. From 16 to 29, he'd been in prison 15 times. The cost of that, the cost of the courts, the judges, he'd been arrested 500 times, 500. He'd been convicted 53 times and in prison 15. You imagine how many courts, barristers, legal aid, all of that, prison time that had cost us a small fortune. Just on that one boy, he's now been out for five years, never offended again. It's so simple.
William Curb: And the cost to him as a person. being like, yeah, that's a lot of time that he will never get back. But now has so many possibilities of what he can do with that.
Sarah Templeton: Absolutely. And actually, talking about low self-esteem, he was one of the ones who did not want to believe me. When I was trying to say, I think you might be ADHD, I think you might have the same brain as me. He kept saying, no, no, I'm not looking for an excuse. I've done what I've done.
Every single thing I've done, I've deserved it. You know, it took me a very long time. It took me a very long time to even get him to think that he might be ADHD. Then he was diagnosed and it took about two years after that for him to really understand why he'd done all that stuff before.
And what he'd done before wasn't even that dreadful. He was one of the people that self-medicated with alcohol. So all his crime, all of it was to do with alcohol. It was either stealing alcohol, being drunk when he was on alcohol, getting into fights when he was on alcohol, domestic violence when he was drunk, and a fray that was all the things he'd been arrested. But he'd been arrested 500 times for all of that. But it was always connected to himself medicating his ADHD. Now he's out, diagnosed and medicated, he doesn't drink. He doesn't drink at all. He doesn't touch it because he knows that's his dangerous thing.
And he also doesn't feel he needs it because he's on a good dose of ADHD meds. That's an example. But that example, you could roll that out across tens of thousands of people in the English prison system and they would be the same. They're all self-medicating. A lot of them with drugs, a lot of them with alcohol.
The drug and alcohol problem connected to our prison system is huge. And the amount of people there that might be ADHD, I'll just tell you a quick story actually. One of the things we did was we went into an addiction service to train them in ADHD.
So this is a very sort of government funded addiction service. There were 20 people service users there, men and women, various ages, and two tutors, trainers that looked after them. We did the talk on ADHD.
And at the end of the talk, literally 19 out of the 20 had realized they were ADHD. There was only one man going, don't think this applies to me actually. You know, it's all interesting, but don't think it's me. The other 19 were either crying, googling ADHD, talking to each other, going, my God, is this you? It's me?
Is it you that this? And of the 20, 19 were definitely ADHD. And so were the two trainers, both of them. Yeah. So that's how big addiction is connected to ADHD.
You know, it's huge. And then obviously, I don't know if it's in America or the same, but certainly in England, we have drug and alcohol wings. Lots of wings, you know, where there's drug workers and all this support going in. They need to be trained in ADHD because if they're not picking that up in these people, I worked in an addiction service for a while. The big problem with addiction services, if they don't understand ADHD, is all the techniques they use, and I know because I've been trained in them, all the techniques they use won't work with an ADHD person. So what happens then is if you've got an ADHD person who's in with a load of, let's say, neurotypical people, they, again, the ADHD person feels even more of a failure.
Because what's working for the people that aren't ADHD, all these different reduction techniques and things that they do, they won't work for an ADHD person because as soon as they get one drink, whacked, they've had 10, you know, before they know it. And then again, you've got the self-esteem problem because their self-esteem plummet's even more, because everybody else is working for. And for them, it's not, which is why there's three areas that we focus on for training and for raising awareness. One is the school to prison pipeline and everything that involves. One is the criminal justice system. The other one is addiction services because it's huge.
The absolute link is huge. And if those trainers, teachers, tutors aren't aware of it, you can actually do quite a lot of damage to an ADHD person in your service. You need to be aware of it. You need to be able to pick it up.
William Curb: Because that's often where that self-esteem issue starts is with someone telling you that, yeah, you're, you know, they're being like, why did you do that? And then it being just this like pylon of like, they don't have a good explanation of why you do it, then they're going to make up one and they'll probably tell you and you're going to kind of start. Oh, yeah, you're just a bad kid.
Sarah Templeton: Absolutely. And I've known loads of, I used to work with teenage clients when I was counseling, loads of them like that. They just think they can't do anything right. They literally do everything wrong.
Everybody gets angry with them, frustrated with them, irritated by them. So they just, they think, I'll just have a drink because I feel better when I've had a drink. I've also worked with teenagers who've had to drink alcohol before they go to school because their anxiety has been so bad.
So social anxiety, anxiety, again, with undiagnosed, unmedicated ADHD, the anxiety came that bad that I have known teenagers who've had to try to have a swig of vodka before they can go into school because the anxiety is so crippling. So alcohol comes into it in lots of different ways. But yes. Yeah.
William Curb: Combine alcohol with already this impulsivity and you get so many or like having, I'm just thinking to me like, oh yeah, I've had all these like intrusive thoughts over the years, but it's like something that I can like not follow through on. But if you're really hitting that impulsivity, it's like, oh, I'm going to do that thing even because it's in my head. I believe what I think and I have to do it.
Sarah Templeton: Yeah, absolutely. I don't know. I mean, I'd love somebody to do sort of an official research thing on this, but it'll be interesting to know the difference in an ADHD person, not on meds, when they've not had a drink and then three drinks later. It'd be very interesting to know because I know I don't drink anymore at all, but when I did in my 20s and 30s, oh my, you know, it took two or three glasses of wine and, ah, anything.
I would say anything to anybody, do anything, you know, if somebody was annoying me, I'd go, oh, shut up. I was a risk, actually. Now I look back, I think it's a minor miracle that nothing happens to you because also when I'd had some drinks, if I was bored, I would leave and I would just walk.
I would just walk in the night down dark roads on my own, not really knowing where I was going, but determined to go somewhere more interesting than that, even if it was my own home. I put myself at risk a lot in my 20s and 30s and a lot more when alcohol was involved. So it would be very interesting to know somebody someday will do a research project on this, you know, when an ADHD person, not diagnosed, not medicated and self-medicating with alcohol, how much more at risk they are because I think they're massively more at risk. Just based on what I was like, I think they would be. I've had quite a few male and some female people in my therapy room when I was counselling, all ADHD and all very promiscuous. Now, a lot of them, the older men, I worked with two men, I can remember very, very well, both gentlemen in their 40s, both of them very happily married, but also going off and having extra marital things with either different women or the same woman or whatever. And both men absolutely distraught, terrified, terrified that they might lose their wife, didn't understand why they were doing what they can't just say when they came to me, they didn't know they were ADHD. They were terrified that they were going to lose their relationships, you know, they were going to lose their marriages, but they couldn't stop doing what they were doing. And it was destroying them. They weren't happy, they weren't blissfully happy doing what they were doing. They were a wreck because they knew they were putting so much at risk and they were so vulnerable, yet they just couldn't stop what they were doing. And promiscuity, I've worked with women as well, I've worked with young girls who've been out doing the most risky, dangerous things, really, really putting themselves at risk because of undiagnosed ADHD. It's a massive risk factor.
William Curb: Yeah, I mean, I think that is one of the classics of ADHD is just not understanding. We have this thing where it's like, I'm doing these things, but they're not making me happy. They're clearly making me unhappy. This is one thing I see common with just like on the products, like people being like, oh, I'm just so lazy and I can't get myself to do stuff. And I'm like, you're not lazy because it's making you unhappy. This is, you don't want to be doing this. And this comes up in so many other areas like this where you're like, I'm doing these things and I hate that I'm doing these things. I see so many people that have issues with food and dieting where they're like, I hate that I eat the way that I do, but I can't not do it.
Sarah Templeton: Oh, trust me, I know what about that. I mean, I was four times the size I am now, my height of my undiagnosed ADHD. I could never understand why when I was at a party, wedding, birthday party, any sort of function, I could never understand why I could not go near the buffet. And I'd say to people, oh, you know, I'm not that hungry or I'll eat later or whatever, you know, I wasn't that fussed about food. And then I would go off at the yet mainly it was because they didn't like queuing. I would never queue in a great big buffet queue.
God, no. So I'd always wait. So I'd say, well, I'll go at the end. I'll go at the end. And I'd go at the end. What I couldn't understand was, I would decide right, I'm gonna have one plate, maybe two, because that's what everyone is doing.
I would never understand why I put one thing in my mouth. And that was it. I was lost. I was gone. I was hoovering out. I was plate after plate after plate. Sometimes I would have like five, six plates when everybody else would have one or two. And I could never understand it.
Now I completely understand it. Because while I was sitting there with nothing going into my brain, my brain was calm. But as soon as I put one thing in my mouth, whoosh, this kicked in this, I want more, I want more.
I've not got enough dopamine, give me more, give me more. And I just couldn't understand it. It frustrated me hugely for literally for decades. Why I could stay away from a buffet, sit there with a cup of tea, be perfectly fine, go and have one thing. And then I just couldn't stop eating. Couldn't stop, couldn't stop, couldn't stop, never understood it. So I massively understand people with the drug and alcohol problems because mine was food.
It was exactly the same reason though. No control once I'd started, none. And I was extremely big. And it very annoys me actually looking back with hindsight when I went into my first diagnosis on the NHS here, when I walked through the door and as I said to you, I was four times the size I am now, I was a very large lady and I was very square.
And I had a big, big round face, very obviously overweight. When I walked in to him, the first thing, the first thing he said to me was, well, I didn't think you're ADHD, looking at me that just that size alone should have been a red flag, as it was, I was lucky, I typed out sheets and sheets and sheets of my traits by then this was about the third or fourth psychiatry I'd seen. And I put them in front of him and I just said, Oh God, we just please read those. He read the first page, he turned over the second, he went, Oh, well, you are ADHD then.
What annoys me about that? I'm going to write to him one day. I'm going to write, I know, it's shocking. I'm going to write to him and say, by the way, when somebody walks into your room and shuffles in because they can't really walk and they can barely sit on the chair because they're too wide for it, you know, that is a little red flag there that you should have thought, Oh, hello, we've got weight issue that could be compulsive eating. It should have been flagged up in his brain. Instead, he said, look to me, he said, well, I don't think you've got ADHD. Now, later on when I asked why, he said, because he said ADHD people, they've all got, they've all got scars, your self-harm marks up their arm and you've got nothing.
And I said, well, not all ADHD people self-harm. But that was what he was looking for. He was looking for self-harm scars.
And because they weren't there, he said, Oh, you can't be ADHD. That's the state of diagnosis in this country. I'm afraid I mean, the state of diagnosis in this country is shocking.
Our NHS can't cope. They've closed lists all over the place. They're just closing lists and chucking people off lists. Private people are having to diagnose. We're having to go privately now. And the private people on the whole are excellent and get it right every time. But the government, NHS, they're all slating the private diagnosis and saying, Oh, you shouldn't have to get a private diagnosis. It's not reliable. And they're offering nothing, nothing.
There's no alternative. Some if we actually, if people adhered to the waiting lists, there are some waiting lists in this country, wait for it 15 years, you'll have to wait for an ADHD diagnosis. A really, really, really short waiting list is two to three years. That's really.
William Curb: Yeah, I remember hearing someone telling me about a two year waiting list. And I just being like, like, how do you even cope?
Sarah Templeton: Like that is ironic, isn't it that they do that to people with no patients, to people who can't queue, to people who can't queue, they give the longest queue to get your diagnosis. We're not going to wait. We're going to go somewhere else and find out, for sure, which is what people do. So I need to find out more about America. I know quite a lot about Australia. I know a lot about England, but I need to find out more about America
William Curb: because, you know, I mean, our health system in general is a huge mess. Some people can easily get a diagnosis and some people, they're just, it's never going to happen for them because they're not going to be in the right system to be able to do it.
Sarah Templeton: Yeah, it's awful. I think one of the things, one of the ways they're getting rid of people over here now to get them off the lists, they're saying, we'll only see you if you're severe. Well, how do you know if you're severe until you've been assessed the starters? And also, that's not on, you know, severe for them. I don't know what they're, I do not know what the criteria is. I think it might be if you're in prison, if you've got a drug problem, those things.
That's not on because I'm diagnosed moderate to severe. I've never committed a crime and I've never done drugs. So I wouldn't have been flagged up. I mean, I've been thrown off the list because I've worked, I've had my own businesses, I've got my own properties. I'm what they would consider not severe, but I am severe. I'm moderate to severe, but I just don't do the criminal stuff. You know, I sailed close to the wind a bit in the past, but not criminal. I've done the odd dodgy, you know, adminny type, cock up type things. I'm quite known for them, but not criminal stuff.
So I'm lucky I've swerved it. But am I as a moderate to severe person who's also, by the way, since that diagnosis had to go on myself to find out that I've got severe dyspraxia with 1% processing, dyscalculia, sensory processing disorder and OCD. Now, I didn't know about any of those four until I got the ADHD diagnosis and then I got the ADHD diagnosis and was sent on my way eventually to four psychiatrists, but I got there.
And then, then working with all these clients as I was as a counselor, I'm talking to them and they're talking about the dyspraxia and they're talking about their sensory freight and I'm thinking, well, this is me. I've got all this. I'm sure I have. So I then went off and got private assessments and privately diagnosed with those four coexisting conditions. So I think with my moderate to severe ADHD and my four coexisting conditions, I would have had a right to be seen on the NHS. I don't think they see it that way.
I think they'd have said, well, you're working. You're not suicidal. And I hate to say it.
This is a terrible thing to say, but it's the truth. They look for people that have tried to kill themselves. If you've made suicide attempts, oh, you're severe, we'll see you. And some people are saying, whoa, whoa, you really want me to try to take my own life before you think I'm worth seeing? That's the state we've got to in this country. It's abysmal.
William Curb: So often the way ADHD is looked at is how are you affecting other people? Not how are you affecting yourself? And it's you're not even intervening on people that could really use the help because they haven't done something that has been- You're coping.
Sarah Templeton: You're coping. If you're in a relationship, if you've got a property, if you're not homeless, if you're not an addict of any description in this country, you're considered to be coping. Therefore, you're not severe. Therefore, we're not going to diagnose you.
William Curb: Yeah. And then now it's- And then if you're so bad, then we're just going to dump you in prison because now that's their problem.
Sarah Templeton: And I was going to say, and then what happens is you end up in prison. I had a- I run a support group and a lady came, lovely lady, and she said, oh, I have a terrible trouble.
I got miss son in front of the pediatrician and he was 17 and he was diagnosed and the pediatrician said, well, we're not going to medicate you because you're not in any trouble and you're okay at school. And I went, oh, God, oh, God, oh, God. I said, please don't tell me. And she said, I'm going to tell you.
She said within three months, he'd been arrested twice. Oh my God. Pediatrician needs shooting. You don't say to a 17-year-old, you're all right.
You don't need medicating. No, no, no. Teenagers are so at risk. And literally, before I could even get the words out of my mouth, I had my hands up like this. I said, but I know what happens next. She said, yes, I'm going to tell you.
She said, it is where you think it's going. He's now been arrested twice in three months. So that's the level of, is it ignorance or is it being blasé about it? But you don't sit in front of a 17-year-old and diagnose them and say to them, I don't think you need meds.
How do you know? How do you know what that 17-year-old is going to go off and do that's risky or thrill seeking or not thinking of the consequences because of their brain? You medicate that brain if you can, if they can tolerate meds and if you can, you medicate it because otherwise this is what happens. And it's just, this is our prisons are full of people like that.
When I worked in the prisons, I worked with several clients who told me that they'd been taken off their meds when they were 18 or 19 by doctors who told them, it's a childhood behavioral disorder. You're becoming an adult now. You don't need them. And where did I meet them in prison?
Because yes, they did need their meds. So I think at last, how is it in America? Here, we are at last dropping that childhood behavioral disorder thing. There's been so much press, PR, podcasts, television stuff about it being a different brain wiring, all that. That's quite accepted now here. Are there people in America who still think it's a childhood behavioral disorder?
William Curb: Six months ago, I heard a Senator talking about how you deal with ADHD is that you just hit him with a belt till it's done. Yeah. So there's people that just don't want to go with the times. And while the medical community is very much starting to get on board with it being a lifelong condition, because it's always been listed as only 20% grow out of it, which is a weird number.
That just means 20% is now coping with it very well. Because that's not how a genetic condition works. But yeah, it's very much there are people that, I mean, it's the same thing that where the person's like, I don't want the excuse. And it's not an excuse. It's an explanation of what's going on.
Sarah Templeton: Yeah, you're right, though, it's not only the prisoners that feel like that. The lack of awareness is in a lot of the trained medical staff. And I think the problem with that is that a lot of them were trained before we realized that adults could have ADHD, that it's a lifelong condition.
So a lot of them were trained that it is a childhood behavioral disorder. I get that. I get that. On the other hand, the pediatrician that we deal with most here, he's into his late 60s. And he's a pediatrician who specializes in ADHD.
So it's not impossible for older people to get with the program and realize that it's a it's a neurodiversity, like you say, it's massively genetic. Everybody needs to be aware of that because the worst case scenario of this is people lose their lives over it. People lose their lives often over it. And most often, that's in prison. The suicide rates in prison are high. They're high here. I from what I'm reading, they're high in America, I would imagine this is worldwide. But how many of those people are ADHD who are taking their lives in prison? How many I'd love to know, I would imagine it's a very high percentage. It could even be all of them. I don't know, because nobody's keeping any records.
Here's an interesting thing. Who was it? Somebody, an organization, a big organization, I know, wrote to every prison in the UK. I know who it was now. It was a pharmaceutical company. They wrote to every prison in the UK at about 140 odd and asked them this information, how many people have got ADHD in your prison?
How are you screening them? How do you know if people have got ADHD if they don't know all these questions? It wasn't massive, about five, six questions. Only 16 of the 140 plus prisons replied, only 16. And all of them said, sorry, we don't know because we don't keep any records. So we don't know how many are being diagnosed. We don't know how many, nobody, we don't know how many have been screened. We don't know how many have got it. Really, they're very polite, really sorry, but we don't know. So if we don't know that, how do we know how many of the suicides in prison are ADHD related? And I'm going to stick my neck out and say, if it's not all of them, it's nearly all of them.
William Curb: I was wondering if there are any final thoughts that you wanted to leave the audience with?
Sarah Templeton: I would just ask the audience, do your research. If you're ADHD, obviously do loads of research. But even if you're not, have a little Google into it because it might be very, very different to what you think. It certainly was me when I googled it.
It was nothing like I thought. So I think people, people who think, you know, just a few slaps of the belt and you sorted, have a read of what adult ADHD actually is. And you might change your mind. And I would beg people, I don't normally beg people to read my books, but I would beg people to read the last one, which is called the prison counselor. And I would love you to read that because it's the story of me going in age 51, not having a clue about ADHD, thinking it was all naughty boys. You know, I was as ignorant as a lot of people are.
I thought ADHD was badly behaved boys who hadn't been taught how to behave. That was what I thought it was. And then when I'm 51, somebody says, you've got it. And I googled it.
I was knocked over like 200 times. It was everything about my life made sense. So the prison counselor, that book is about my journey of finding out that I was massively wrong, that ADHD was not what I thought. Then finding out I've got it myself. And then realizing all these people I'm working with, they've got it as well.
And then what I've done about it. So if anybody's faintly interested in this, please read that one book, because I'm trying to change prison systems worldwide. It's a bit of a grand thing to say, but I'm trying to change prisons worldwide to wake up to this. Because if we just think of the deaths alone, the deaths in prison are probably all, if not all, due to undiagnosed or unmedicated ADHD. For that reason alone, things need to change.
William Curb: And it's a very admirable goal. I really enjoyed your conversation with you today. Thank you so much for coming on the show.
Sarah Templeton: Bless you. Thank you for having me.
This Episode's Top Tips
While we often associate trouble with malice, many people with ADHD end up in legal or social trouble purely because they reacted impulsively to perceived unfairness. Recognizing this trait as a heightened sense of justice can help you pause before intervening in situations that might escalate.
Severe boredom can physically feel like pain for the ADHD brain, leading to high-risk behaviors just to feel something. Acknowledging that boredom is a trigger state can help you find safer dopamine outlets before you do something regrettable.
When trying to tame an addiction, traditional reduction techniques often fail for ADHD brains because of our "all or nothing" dopamine response. If you are struggling with substance use, ensure your support team understands ADHD, as "just one drink" can trigger a massive dopamine cascade that neurotypical advice doesn't account for.
Work on reframing the idea of an excuse vs a reason. If we can understand that our brain wiring causes certain behaviors (like risk-taking), this isn't an excuse to keep doing them; it’s the explanation that gives us permission to stop hating ourselves and seek out tools and strategies that can help manage behaviors.