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Neurodiversity in the Criminal Justice System with William Packard, Ph.D. | EXPLORING DIFFERENT BRAINS Episode 18


In this episode, Hackie Reitman, M.D. speaks with jail diversion team facilitator William Packard, Ph.D., author of “Intellectual Disability and the Criminal Justice System: Solutions through Collaboration.” Dr. Packard discusses the inordinate amount of intellectually disabled prison inmates, the dangers the criminal justice system can pose for the neurodiverse, and the importance of community involvement in awareness and intervention.

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HACKIE REITMAN, M.D. (HR)

Hi, I’m Dr. Hackie Reitman and we’re here for another episode of Exploring Different Brains. Today I’m joined by Dr. William Packard. Bill is a practicing psychotherapist who deals extensively with the topic of neurodiverse and the criminal justice system. Dr. William Packard is the author of Intellectual Disability and the Criminal Justice System. Hello, Bill!

WILLIAM PACKARD, Ph.D. (WP)

Hey Hackie, how are you doing?

HR

I’m doing good, its good to see you. You know, Im so excited to be discussing different brains from the aspect of the criminial justice system because theres so many different facets of this coming to light nowadays, and youre one of the worlds experts. So introduce yourself to our audience here at Different Brains?

WP

Okay. Well Im not going to consider myself an expert, I dont do trial expert testimony, but I have had a lengthy career working with folks in disabilities; mostly developmental disabilities, which has lead me into becoming involved with the criminal justice system. So after a 30-something year career I was changing chapters; Im also, as you said, a psychotherapist and wanted to semi-retire, whatever that means, and so, just the culmination of a long career with a lot of interactions with law enforcement, criminal justice officials and the penal institutions. I decided to write a book, and so I would call myself a researcher, but mostly Im a practitioner and Im involved in community collaboratives, which aim to keep people safe, keep people from entering the criminal justice system and, when necessary, to intercept them at various junctures and keep them from penetrating further. So Im hoping to share more the community model that Ive been involved with for the last 15 years. So expert, not sure Im an expert–but I guess I know a lot.

HR

Well youre a modest guy. Now, what I like about what you just said, Bill, is that its not mutually exclusive. We can protect the community, we can do good for the community, we can intercept, we can help the people who may stray and go afowl a little bit, if Im hearing you say that also?

WP

Exactly. Its a win-win for everyone, Hackie. You know, the police are thankful, the courts who havent really known what to do–its not that they just wanted to prosecute, they just havent known. Problems with identification, lack of screening, theres just a host of problems. But when different organizations come together and work together, the job can get done.

HR

Lets talk about, from your point of view, in the community–the first stage, Im talking an extreme–is the prevention. The prevention. From your point of view, how do we prevent having everybody end up incarcerated?

WP

Well, theres a lot of good programs happening in a lot of school systems. The DARE program–that community police come in, thats mostly drug-related. Prevention, think earlier the better. I like the examples of the boys club girls club, having activities so that theres not too much free time. theres a big problem in the, what we call the transitioning period, from high school to young adulthood, when, you know, pretty much–its been my experience, here in Massachusett’s, that services are pretty good, theres a lot of inclusion, lot of activities, lot of structured activities–in the high schools. And then, when people become 18 or 21, whenever they leave high school, the activities just completely stopped. Theres like this gap between the services.

So your question, you know, whats the best prevention? Well, lots of recognition that people might be having a difficult time, communication with families, churches, temples–a host of things that–where the community needs to come together. Basically, there are a lot of people–this is the people that I work with, having called the “hidden population,” or the “invisible population,” meaning that they look just like anyone else and they have special challenges, and they have the same vulnerabilities that other people, who end up in the criminal justice system, have, except that they have more difficulties dealing with these challenges. So any way that people can be recognized as having a special need, maybe needing extra attention, maybe needing to be helped to have some group-belonging, have a sense of belonging, anything we can to do help people–unvocational help. So Im not sure if Im answering your question, but–

HR

No, you are, because now well get into the intellectually disabled. Or those with intellectual disability, or those with unique talents, how do they fit in to–lets call it your model. Were talking about the Bill Packard model. Now we, ideally, I guess one thing we have to do is have law enforcement be able to recognize those whose brains are a little bit different. Would that be a fair statement?

WP

Yes, but we cant just saddle law enforcement to do that. We need to reach out to law enforcement. Those of us who work with people who have challenges in a way thats helpful–not to identify somebody as a potential perpetrator, or you know, somebody whos engaging in petty crimes, but to work informally with community police, and it really comes down to sharing communication, sharing information–I know theres a lot of serious misunderstandings about sharing such information, but there’s–with HIPAA–but it really doesnt preclude sharing information with law enforcement and court officials, not to prosecute but to help educate people on positive options and to avoid the negative.

HR

Well, I mean if Im a police man, I want to at least know what some of the hallmarks are of–lets just pick out autism and asperger’s, okay? So that I can have some kind of recognition factor. If Im going to–if I get a call and have to deal with somebody whose brain might be a little bit different, I want to be able to recognize some of the hallmarks a bit, so that I dont misjudge them or take inappropriate action.

WP

One of the things I do, Hackie, is I–a co-founder and an active participant in an organization called Community Crisis Intervention Team, and on the team theres a number of police court officials, clinicians, educators, administrators, and one of the things we do, is we conduct–twice a year, three-day training for police, not specifically, this is taken after another model that many people have heard of–Crisis Intervention Team–which came out of Memphis in the early 90’s as a result of an unfortunate shooting of a mentally-ill man that police didnt know was experiencing hallucinations. So we have taken our model and its similar to the CIT model, Crisis Intervention, but weve added community, because we need to not only teach police officers the signs and symptoms of mental illness and developmental disability and neurodiverse folks and how they might present–whether its spectrum or–you know, we have a three-day training.

I do the component on mental health, mental illness and developmental disabilities, and that includes spectrum and asperger’s. Theres a lot of training specifically on aspergers or spectrum folks for police. But we have a more kind of eclectic approach. So part of it is training. Part of it is reaching out. The trainings are completely free, the evaluations we get from the police are fantastic. We very importantly include other types of professionals in the classes so the police actually start meeting people in their own communities; therapists, substance abuse clinicians, court officials, pastors, citizens of all sorts–I’m forgetting tons and tons of people. And the whole idea is not just to–is obviously to help, you know, this is the problem–I didnt know what you have, know what youre working with, know what youre seeing–it may appear criminal but it may be a mental health disturbance or it could be related to somebody’s–another type of disability–we call that criminalization–criminalizing, where its an offensive behavior, its not a criminal offense. So we teach that. we teach some of the hallmark characteristics of somebody with a developmental disability, for example, how they might identify them. Importantly, we give them the resources and the numbers to call when theyre interacting with folks on the street. I had mentioned that we like to include a host of professionals in these classes so people start talking to one another, you know?

We first used the concept networking, where were trying to develop a network of collatorals and professionals who can–we realize the term networking is not sufficient. “Partnering” is the word we use now. So these three-day trainings, for example, the primary goal is to help identification, help know what resources are available and, when possible, to use diversion from the criminal justice system just as important as establishing relationships that people can actually usein their jobs. And I guess just–police dont really like to sit down for three days at a time. So we do mix it up. We use exercises, we have a field trip, we have a segment on auditory hallucinations, where the police actually wear headphones of somebody having auditory hallucinations and we have them go through several tasks so that they can have a greater empathy or appreciation. Im trying to come up with something similar for someone, say with Asperger’s, so that they can try to have the experience of being in their shoes. One things that comes out of these trainings is that everybody is psyched. You know, people leave with each others numbers and I think, I’m forgetting the actual question–

HR

That’s all right, this is all–this is all good. This is the way you do it. You get everybody involved, you get everybody talking to each other, you get the law enforcement involved with other community people there, and, you know, familiarity and understanding makes things a lot safer and better all around.

WP

Thats right.

HR

What are some of the issues that youve seen arise when the neurodiverse individual comes in contact with the criminal justice system?

WP

If I have time to give a short history of how I got involved, I think it might explain some of the things that Ive noticed and become aware of. I started in ’78, 1978 at a state school for developmentally disabled adults, and it was a time of de-institutionalization and there were lots of people who had been secluded from society, where by reason of court mandates and court decrees, were literally being forces back into the community. The same thing happened with mentally ill patients at state hospitals throughout the country.

So most of the infractions–so we actually saw what was actually coming: the evolution of the Community Crisis Intervention Team actually started when the police started calling me and having me come to the front gates to retrieve somebody that had shopflited or had a negative interaction with a store clerk or just, you know, said something inappropriate and there was a complaint, and the–maybe Im going too much into this–the police basically said, “Look, you know, you guys have to teach these people or you need to have somebody with them.” So that wasn’t happening. So I actually made some calls–first called the police chief, he was sympathetic, but he said talk to the probation chief, talk to him, who sent me to the local judge, who sent me to a man who was working at the Mass Bar Association, Alex Moscella. Alex and I developed an educational forum, almost like a mock-trial, to be used to stay out of the legal system but to try to impart a knowledge and an appreciation of consequences for these individuals. And well, we had a meeting, finally, with our local officials, and it was a no-go. You know, the public defenders woman said we were violating peoples’ rights just by virtue of being in the same room with law enforcement. So long way of getting to your question, I later took a job as a community psychologist and was amazed at the other end, out in the community, how many people in my case load were actually involved in the criminal justice system.

Some were adjudicated, some were awaiting trial, some were in detention, some were serving lengthy prison sentences. One thing that was common amongst all of them was that they were naive offenders–many of them were naive offenders. Many of them really didn’t know what they were getting involved in. Many of them, in some of the characteristics of somebody with developmental disabilities is maybe youre a little gullible, easily manipulated, searching for a sense of belonging, highly suggestible, you tend to acquiesce to what others tell you or try to give them the right answer. Youll do anything for acceptance–so theres what I call a perfect storm that can happen. You started the interview by talking about, you know, say older adolescents who, you know, hopefully we can channel in the right directions and help with employments and so forth. But these individuals are basically easily lead. The biggest problems I saw when I was in the community, and definitely when I was researching for my book, was that they are not on the equal playing field as anyone else. So lets say the police are called to a certain location and theres this guy thats–looks like hes showing inappropriate affect in behavior, and hes just–you know, they ask him some questions and he looks like hes copying his attitude and saying, I dont know, I dont know, well, actually, he doesnt want to let on that he really doesnt know whats going on, and that he is in over his head and maybe somebody has asked him to stand there and be a patsy and watch out for them–quite often, these people are the people that are left holding the bag, so-to-speak. They are the last to leave the scene of a crime, first to confess and most likely be prosecuted.

And that speaks to their executive functioning problems and lack of knowledge and experience. So I could go on and on explaining some of the traits and characteristics, of which there are many, which make this a serious problem. The most serious problem is, the deeper you get into the criminal justice system, obviously the more serious the matter. So even on a police interview, because of problems with memory and tendency to acquiesce and definitely police have used read technique, in terms of interrogating people, you know, good cop bad cop, listen just help us out, we know you did it, just tell us and well let you go, we can help you if youre honest with us. Those type of–although a good thing for your common criminal when the police are trying to interrogate, its just totally, totally counter-indicative of our folks. Theres an excellent netflix documentary–Making of a Murderer–which exemplifies this. I would ask everyone to watch that. You will definitely understand all of the negative–all of the terrible things that can happen. The travesties of justice and specifically, a young man, Brendan Dassey, the full police interrogation of a man who is probably functioning with an IQ of 50, 55–totally being mislead and now he is serving a lengthy prison sentence, and its pretty clear he had nothing to do with it. There are many examples of this.

HR

If you had to guess as to what percentage of the incarcerated population, the people in jails and prisons, what percentage of them might have neurodiverse or different brains, whatever the labels might be if you add them all up?

WP

Well, it’s–to the best of my knowledge its way over 50% if you really–if youre sampling is inclusive. So for–say for intellectually disabled folks, there’s 2-3% of the population. The best estimates in the penal system, people being held, not just for trial, but serving prison sentences. The estimates are around 10-12%. However, there is this whole other area of non-identified people. Those are people that we know about; people who have marginal or borderline intelligence, just for the sake of coming up with some numbers, say from 70-85, IQs 70-85, if you added them to the group of incarcerated, you’re jumping up to 35-40%. If you add people with higher intelligene, still, but learning disabilities, and I would add to that list people with Aspergers together with that–any type of learning challenge or disability–it’s way in excess of 50%.

HR

If we’re dealing with roughly half of the whole prison population who are–have different brains–neurodiverse–if you add up all of the different labels, and we take the position that I think the statistic for the percent of prisoners who actually get back out into society, I think its something like 95%, something like that–some point.

WP

Theyre coming back to the same communities that htye left, and quite often theyre coming back better criminals. I mean Im sure everybody is aware of some recent legislation efforts to support treatment over incarceration, or at least to minimize non-violent felony incarerations. So basically–but for somebody with issues, and with a need to try to fit in and try to pass as a normal inmate, theyre very unlikely to accept any type of rehabilitation thats there, for fear of looking and showing their deficits–

HR

..and being stigmatized and taken advantage of.

WP

Exactly–exactly.

HR

Now lets move to the staff what percentage of the staff would you say–because we all know in the general population of any place at work, X percent are going to be a little bit different. Again, whether its ADHD, whether its Asperger’s–whatever you want to call it–is it, in your opinion, higher or lower than the general population, or just give a guestimate of what percentage of the staff do you think might be on the spectrum?

WP

It would be a huge guestimate. It’s–I really couldn’t. What would you say? What’s your experience been?

HR

My experience in regular life as I look around my office here–I dont know how I would have been labeled. I got expelled once in the first grade once in the 10th grade. I cant seem to focus on very much. But Im going to guestimate, in todays world, were looking at a good, solid, 5%. I would say one out of 20 people has a really meaningful label of some kind, you know, if they were to be diangosed and everything.

WP

You see, I would have been up in the 30-40%, that’s why I–so I guess it’s really how we define–

HR

Its how you define it. Because I believe that if you add up all of the different types of “labels” or neurodiversities, that the so-called neurotypical is in the minority. In the general population. I dont have statistical proof of that, and again, it depends on how you define in, but I would imagine it would be very safe to say between–very conservative to say between 5% and 30% of the correctional guard staff has something.

WP

Definitely. Theres a lot of substance abuse problems, theres obviously some characterological problems of some officers. Some are fantastic. But there’s this–a certain mentality that can be pervasive. The–you know, theres this huge debate today about, you know, where–you know, with the private prison systems and the money making prison systems, they call it the industry–the penal industry. Its like a money making thing. Not to get political, but there’s a huge over-reliance on prisons and you hear about it with the drug-related non-violent charges today. Fortunately, there is less and less of that. People do better when they are in smaller environments and its more geared towards–its tailored to their own personal abilities and needs. So somebody neurodiverse, somebody who is challenged in any way mentally or emotionally, they really–Im being opinionated–but they really arent going to do well and are probably going to come out of prison a lot worse. So there are alternatives. There is community treatment centers–and the same communities the individuals will come back to, where their families are where they can be transitioned back into a more successful life. I dont know–Im not here to make any negative statements about correctional officers–there are wonderful correctional officers, there are wonderful police–there’re mostly people who want to do a good job but there are always bad apples.

HR

Well there’s bad apples in doctors, I’m an M.D., theres bad apples in anything–but if we look at this another way for a minute–lets say you and I go, we get a meeting with a very large, successful money-making private prison system, and we get to their leadership, and Bill Packard and Hackie Reitman walk in and we say to them, “Look, guess what? If you embrace neurodiversity and recognize it and you let us come in and train your staff and the inmates, youre going to make more money. Youre going to get good press. Youre going to be in compliance with the newly emerging EEOC laws on neurodiversity and so-forth,” and you know, you’ll be doing the right thing, but dont do it for that reason. Do it to make more money. Let us come in and show you how we can do that. Is that possible to do?

WP

Its a novel idea and Im all for it. Show me the way.

HR

If we maximize everybody’s potential, whether they are a guard or any kind of staff in a prison, and the prisoners themselves, to be more productive and more independent, if you will, in a positive fashion and more lined up for what happens when you get out of prison–

WP

Right, right, which is important.

HR

Very important because theyre all going to get out.

WP

The recidivism rate is–you know, its terrible for a lot of the folks we work with. So I would even prioritize starting with people who are most vulnerable and most not on the fair playing field, as it were, coming out of prison and trying to–you know, you come out of prison, you have a felony charge, its hard to get a job. Start with people who are most down on their luck and are having the hardest time reintegrating into society.

HR

I was in solo practice and then I ended up founding this kind of huge orthopedic group back in the day, and ultimately, we had like five offices in three counties, and we were acquired by a publicly traded company, and I was able to convince the suits from the corporation as things evolved, and the doctors and the nurses and the staff and the patients, all around one table, that if you treat every patient like its your own family, the patient is happier, the doctor is happier, the staff is more fulfilled and the suits make more money. Okay? Its not–we always think things are mutually exclusive and theyre not, you know? Theyre really not. You can figure these things out, I think, anyway. I think you can.

WP

Its a win-win-win.

HR

Win-win-win, and thats the way I try to look at things because its not a zero-sum game. If the prisoner does better and becomes a productive citizen, and the gaurds feel better about themselves ad the behabior overall improves, and the litigation goes down and the fights and problems inside go down, all right, youre going to make more money. Makes more sense. The only negative would be if your recidivism rate goes down, which it will, then how are you going to replace that income and we’ll move them into outpatient so-to-speak. Well get them moving into the halfway.

WP

There’s a saying that, “A little money upfront saves a lot of money down the road,” and I think that applies here.

HR

I–that is very well said, Bill. Its about thinking clearly the way you are in the community, and getting everybody on the same side. Like you said, people come out of those meetings and they get in touch with each other, and why? They finally got exposed to each other. So thats what you do.

WP

Yeah, people need to know what limitations each other have, you know, in terms of their role–responsibilities, and recognize that they can both be helpful to one another. There are things that–limits on the job that I have, where somebody who is in another capacity can, you know, make up for my job limitation and vice versa. So yeah, its–

HR

Well have some fun with this. Well have some fun. And you certainly have devoted your life to this, with your book the Intellectual Disability and the Criminal Justice System, how do people get ahold of that book, Bill?

WP

I have sent a couple of links to the Amazon.com and to Createspace.com. You can find it on Amazon. By the way, thats the first part of the title of the book. Intellectual Disability and the Criminal Justice System. The second part is the part that’s exciting: Solutions Through Collaboration, which is everything that were talking about today. So Id be very happy for people to take a look at the book–

HR

And how do they get ahold of you, Bill? How do they get ahold of you?

WP

The website for the book, and theres the first chapter of the book and the clinical resources–theres a pretty involved website, IntellectualDisabilityInTheCriminalJusticeSystem.com or SolutionsThroughCollaborations.com. Can I make one more suggestion?

HR

Absolutely!

WP

Theres a great model for communities to consider if they find any relevancy to problems that theyre experiencing in their community, and if they think the community collaborative approach is the way to go, theres–the group that Im involved in is the Tauton Community Crisis Intervention Team, and the website is http//CCITTautonma.weebly.com. We are always wanting to share information and we are somewhat of a clearing house of information, and give people suggestions. You know, there is no cookie-cutter one-size-fits-all for community collaboratives, but, you know, were committed to sharing our experiences over the last 15 years and were also always wanting to learn from other communities, so I would–as much as Id like people to visit my book website, Im even more excited about people thinking about a community collaborative for themselves, for their communities.

HR

Well thats great. You know, we just interviewed one of your #1 fans who is in your community up there, who does so much–

WP

Who is that?

HR

You tell me who it was. Tell me who your #1 fan up there was who we just interviewed.

WP

Mari Nosal.

HR

Absolutely. She has nothing but great things to say about you.

WP

Yeah. She went to our program and shes very involved.

HR

Shes amazing. She is really amazing. She has been through a few things herself.

WP

She has been instrumental in helpng me understand this is something that were always learning. That the book that I wrote applies to people with Asperger’s–you know, I use the term intellecutal disability because thats the certain population I was assigned to work with as a psychologist, but never realizing that all of the people who have marginal, and even up to above average intelligence, have the same vulnerabilities if they have certain traits and characteristics, and the same clinical logic applies to everyone. So yes, kudos to Mari for helping me understand that its an all-inclusive topic.

HR

Bill, what training is currently available to judges, lawyers and law enforcement officers?

WP

Im actually part of an organization–its the National Center on Criminal Justice and Disability. Its out of the National Arc. Again, its the National Center on Criminal Justice and Disability. Using a grant from the department of Criminal Justice–Im sorry–Department of Justice, and they are actually looking for communities who want a spearhead approach to train–we do it on a very sporadic basis, where we’ll get together with public defenders and try to do an in-service or–judges, by the way, really want to do the right thing, if they only had the time. So a lot of what were talking about, preventatively, will unclog the court system and allow them to do their job better. But if you go to this website, the NationalCenterOnCriminalJusticeandDisability, you will find its a clearing house of trainings just for that. For lawyers, prosecutors, public defenders, judges, court officers, penal institution professionals, and of course police, that first line of who are basically psychiatrist by default–they are screening everyone because they have first contact. So its–I think thats a very good lead on terms of finding out what is going on and becoming part of that particular collaborative.

HR

That brings us to the end of another episode of Exploring Different Brains with Dr. Hackie Reitman here, that’s me. But the guy who really knows a lot of stuff, we just heard, Dr. William Packard–the author of Intellectual Disability and the Criminal Justice System. Bill, thanks again. Keep up the good work.

WP

You got it, thank you, Hackie.

HR

We’ve been speaking with Dr. William Packard, the author of intellectual disability and the criminal justice system. For more information, visit us at DifferentBrains.com

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This video is owned by Different Brains Inc, kindly donated by it’s original producer PCE Media LLC.

Author Image

Different Brains® Inc. founder Harold “Hackie” Reitman, M.D. is an author, filmmaker, retired orthopedic surgeon, former professional heavyweight boxer, the past chairman and president (and current board member) of The Boys and Girls Clubs of Broward County, and a neurodiversity advocate. However, it was his role as a father that led to the creation of the DifferentBrains.org website.

Hackie’s daughter Rebecca grew up with epilepsy, 23 vascular brains tumors, and underwent 2 brain surgeries before the age of 5. Her struggles and recovery put him on the road to, through 26 professional heavyweight boxing matches, raising money for children’s charities (to which he donated every fight purse).

Rebecca eventually went on to graduate from Georgia Tech with a degree in Discrete Mathematics, and Dr. Reitman wrote and produced a film based on her experiences there (The Square Root of 2, starring Darby Stanchfield of ABC’s Scandal). After graduation, Rebecca received a diagnosis of Asperger’s syndrome. Hackie, shocked at his own ignorance of the topic despite being an M.D., embarked on years of research that culminated with his book Aspertools: The Practical Guide for Understanding and Embracing Asperger’s, Autism Spectrum Disorders, and Neurodiversity (released by HCI books, publishers of the Chicken Soup for the Soul series).

This experience revealed to Hackie the interconnectedness of the conditions that fall under the neurodiversity umbrella, while alerting him to the in-fighting and fractured relations that often plague the organizations tasked with serving the community. Convinced that overcoming these schisms could help all of society, Hackie forged the Different Brains philosophy of inclusive advocacy: “Supporting Neurodiversity – From Autism to Alzheimer’s and All Brains In Between”.

In the company’s initial years of operation, Hackie self-financed all of the content on DifferentBrains.org, all of which offered free to view to the public. Currently he is the host of our weekly interview show Exploring Different Brains, writes blogs for the site, and tours the country speaking at conferences, conventions and private functions, all with the goal of improving the lives of neurodiverse individuals and their families, and maximizing the potential of those with different brains. Separate from Different Brains, Hackie is the founder and CEO of PCE Media, a media production company focusing on reality based content. He recently co-executive produced the documentary “Foreman”, the definitive feature documentary on legendary boxer and pitchman George Foreman.