Approximately 94% of people with Fetal Alcohol Spectrum Disorders (FASD) experience mental health problems. Unfortunately, mental health disorders among individuals with FASD often go unnoticed, as healthcare professionals are not typically formally trained to identify FASD. In order to address this gap in mental healthcare, this study looks at the novel Canadian National Mental Health Strategy implemented in 2012 – ‘Changing Directions, Changing Lives’ with a FASD-informed perspective.
Characteristics of the 2012 Changing Directions, Changing Lives strategy:
- Accessible to all – “provides equitable access to a full range of high-quality services, treatments and supports for all people”1
- Inclusive to all – “regardless of their origin, background, experience or circumstances”1
- Extending the ‘inclusion’ to FASD
- Emphasize the recognition of FASD in DSM-5 as a ‘diagnosable mental disorder’
- Neurodevelopmental Disorder Associated with Prenatal Alcohol Exposure, 315.8 [F88]
- Describe the spectrum of mental health concerns co-occurring with FASD as a major secondary disability
- Committing suicide or attempted suicide
- Alcohol and substance use disorders
- Psychiatric disorders
- Highlight the complicated relationship between FASD and mental health disorders
- Identify the consequences of lack of diagnosis or misdiagnosis of mental health disorders associated with FASD
- Outlining the strategies to include FASD-specific or FASD-informed services and resources
- Providing currently available FASD-informed strategies to use as evidence for practice
- Associating the FASD-informed mental health strategy with the recommendations from the Truth and Reconciliation Commission of Canada
- Considering the inclusion of FASD-informed psychiatric training programs in Canadian medical school curriculum
- Streamlining the FASD and mental health disorders identification and diagnostic processes
- Mental healthcare professionals should be trained properly to identify and diagnose FASD and associated mental health disorders
- Improve the currently available treatment and intervention strategies in an FASD-informed way to increase their efficacy
- Establishing programs to identity, diagnose and manage FASD and associated mental health conditions among individuals who have been incarcerated
- Implementing evidence-based, community-based, and multi-disciplinary service delivery programs that consider FASD, all the associated mental health conditions, influencing factors and side effects of treatments
As any other Canadian citizen, individuals with FASD also deserve the best mental healthcare available. The current study elaborates how the 2012 Changing Directions, Changing Lives strategy should be expanded to include FASD. Thereby, it is anticipated that best FASD-informed mental health services are provided to individuals with FASD. Further success of this national strategy could be achieved if service delivery, research, knowledge translation, practice and policy occur in a dynamic manner within the community.
Authors: Tara Anderson, Mansfield Mela, Michelle Stewart
Journal: Canadian Journal of Community Mental Health
1 Mental Health Commission of Canada. Changing Directions- Changing Lives: The Mental Health Strategy for Canada. (Calgary, AB, 2012).
FASworld Canada fully supports the recommendations here. However, we have also advocated that instruction at higher education levels should not stop wth medical faculties. No one should graduate from the faculties of Medicine, Law, Education or Social Sciences without a clear understanding of the dangerous outcomes from Prenatal Alcohol Exposure. Children, starting in the primary grades need to be informed of the hazards of drinking in pregnancy and not be misled by erroneous reports that “light” drinking is acceptable. We must influence a change in the drinking behaviours of fertile women and their partners. FASD is already at pandemic levels and nothing will change until every drinker understands what can happen to the developing brain of the fetus when alcohol is present.