Mental Wellness and FASD

Mental wellness is a state in which we are able to respond appropriately to stressors and to connect with others who support us in healthy living. Mental wellness includes mental health. It may look like connecting with others, appropriately regulating our emotions, doing things that bring us joy, and building relationships that make us feel fulfilled.

For individuals with Fetal Alcohol Spectrum Disorder (FASD), mental wellness can be influenced by a variety of biological, social, and environmental factors. Research shows that people with FASD are more likely to experience mental health challenges, including anxiety, depression, trauma-related concerns, substance use disorders, and suicidality. However, with evidence-based strategies, proactive supports, strengths-based approaches, and FASD-informed care, individuals with FASD can build resilience, improve well-being, and achieve positive outcomes across the lifespan. Mental health and wellness strategies and supports should build on the individual’s unique strengths and address their specific areas of need.

Major Projects

Mental Health Resource and Practice Guide

People with FASD are capable of significant change and personal growth. As mental health professionals, we need to adapt our supports so that individuals with FASD can benefit from practices suited to their unique strengths, challenges, and neurodevelopmental needs. The Mental Health Resource and Practice Guide is a helpful tool to start this journey.

This guide was made specifically for frontline mental health counsellors/therapists, prevention mentors, crisis workers, community mental health providers and those who work directly with individuals with FASD. It gives you the resources to better understand FASD throughout the lifespan and outlines promising practices for working with this population. This guide is broken up into sections:

Moving Towards FASD-Informed Care in Substance Use Treatment

People with FASD have high rates of substance use challenges, but often treatment programs aren’t equipped to handle their unique needs. These documents outline best practices to support people with FASD who are in treatment for substance use. They are based on research done between 2020 and 2023, which was subsequently updated in version two (2024) to provide more insight into the distinct needs of youth FASD. These resources are available in both French and English.

Medication Algorithm for FASD

People with FASD are often prescribed too many medications or are prescribed medications that don’t work for them. Out researchers alongside other experts spent years reviewing the evidence about psychotropic medications and people with FASD and came up with a decision-tree style algorithm to support physicians when prescribing medication for those with FASD and prenatal alcohol exposure. Some of the resources from this project include:

Learn more about this project here: https://canfasd.ca/algorithm/

Key Topics

Use the buttons below to navigate key topics related to FASD and mental wellbeing and to find available research and resources within each subject area.

Mental Health

FASD and Mental Health and Wellbeing

Mental health and well-being is essential to our quality of life. Individuals with Fetal Alcohol Spectrum Disorder (FASD) may experience more mental health challenges compared to the general population. Access to appropriate supports, early and effective interventions, and FASD-informed care can lead to positive outcomes. Here you can explore research, resources, and best practices related to mental health and FASD.

Resources and Reports

Addiction and Mental Health Care: Resources to Support Collaboration
The Canadian Centre on Substance Abuse (CCSA), the Mental Health Commission of Canada and the Canadian Executive Council on Addictions have collected a list of examples and resources to support collaboration between addictions and mental health systems and service delivery in Canada.

Research

Fetal alcohol spectrum disorder (FASD): A beginner’s guide for mental health professionals
Jerrod Brown, Aaron Trnka, Diane Harr, Kimberly D Dodson, Hon Anthony P Wartnik & Kristy Donaldson
J Neurol Clin Neurosci, February 2018

The Implementation of the 2012 Mental Health Strategy for Canada Through the Lens of FASD
Tara Anderson, Mansfield Mela, and Michelle Stewart
Canadian Journal of Community Mental Health, 2017

A systematic review of interventions to improve mental health and substance use outcomes for individuals with prenatal alcohol exposure and fetal alcohol spectrum disorder
Katherine Flannigan, Kelly D Coons‐Harding, Tara Anderson, Lindsay Wolfson, Alanna Campbell, Mansfield Mela, Jacqueline Pei
ACER, December 2020

Recent advances in fetal alcohol spectrum disorder for mental health professionals
Mansfield Mela, Kelly D Coons-Harding, Tara Anderson
Current Opinion in Psychiatry, July 2019

Issue Papers

The Unique Complexities of Fetal Alcohol Spectrum Disorder (2020)
FASD is a unique and multifaceted disability, associated not only with complex brain- and body-based challenges, but also with high rates of environmental adversity, diverse sociocultural contexts, and lifelong difficulties with daily living, including related to mental health. We need to consider these unique complexities when working towards healthy outcomes for people with FASD.

Suicide

Suicide and Suicidality in People with FASD

Research shows that people with Fetal Alcohol Spectrum Disorder (FASD) may face an increased risk of suicidal thoughts and behaviours compared to the general population. Understanding the factors associated with suicidality in FASD is essential for improving prevention, intervention, and support strategies. Explore research, reports, and resources focused on suicide prevention and FASD.

Research

Suicidality and Associated Factors Among Individuals Assessed for Fetal Alcohol Spectrum Disorder Across the Lifespan in Canada
Katherine Flannigan, Carly McMorris, Amanda Ewasiuk, Dorothy Badry, Mansfield Mela, W Ben Gibbard, Kathy Unsworth, Jocelynn Cook, Kelly D Harding
Canadian Journal of Psychiatry, November 2021

Caregivers’ experiences and perceptions of suicidality among their children and youth with fetal alcohol spectrum disorder (open access)
Kelly D Harding, Kailyn Turner, Stephanie J Howe, Mercedes Jayne Bagshawe, Katherine Flannigan, Mansfield Mela, Carly A McMorris, Dorothy Badry
Frontiers in Psychiatry, August 2022

Fetal Alcohol Spectrum Disorder and Suicidality: What Does the Literature Tell Us?
Katherine Flannigan, Andrew J. Wrath, Dorothy E. Badry, Carly A. McMorris, Amanda Ewasiuk, Alanna Campbell & Kelly D. Harding
Journal of Mental Health Research in Intellectual Disabilities

Issue Papers

FASD and Suicidality: Rates and Associated Factors (2022)
The rates of suicidality are higher in people with FASD than the general population and many other disability groups. This paper explores the recent research on suicidality and FASD and provides recommendations for research, policy, and practice to mitigate risk

Reports and Resources

Stakeholder Perspectives on Risk factors and Opportunities for Suicide prevention among individuals with FASD (2021)
Dr. Dorothy Badry, Dr. Kelly Harding, Dr. Carly McMorris, Amanda Ewasiuk & Stephanie Howe
FASD and suicidality is a major issue that warrants focused research, policy, and practice. Concerns start early in life and can be linked to the unique and interconnected complexities of FASD. Dedicated intervention plans and protocols for people with FASD at risk of suicide are sorely needed. [Executive Summary | Lay Summary]

Mental Health, Suicide, and Suicidality: Research and Intervention Strategies Part 1 (2023)
In part 1 of this two-part webinar series from 2023, presenters share their findings and implications of a multi-phase research project focused on stakeholder perspectives of risk factors and opportunities for suicide prevention in FASD populations.

Therapy

Therapies and Therapeutic Approaches to FASD

Therapeutic supports can play an important role in supporting mental wellbeing for individuals with Fetal Alcohol Spectrum Disorder (FASD). While research on therapy for FASD continues to grow, adapting therapeutic approaches to meet the unique strengths and neurodevelopmental needs of individuals with FASD is critical. Explore resources and evidence related to therapy and FASD.

Issue Papers

Broad Approaches to Psychotherapy for Individuals with FASD (2022)
Many individuals with FASD experience challenges with their emotional wellbeing and mental health. Despite the significant need for supports, there is very little evidence on the use of psychotherapy with individuals with FASD. In this issue paper, we review the literature on psychotherapy broadly and summarize potential psychotherapy approaches and adaptations to best support mental health and wellbeing for people with FASD.

Resources

Medication Algorithm for FASD
This decision-tree style algorithm to support physicians when prescribing medication for those with FASD and prenatal alcohol exposure.

Substance Use

Addictions and Substance Use Treatment in FASD

Individuals with Fetal Alcohol Spectrum Disorder (FASD) higher rates of substance use and unique challenges related to addiction. Effective substance use treatment for FASD recognize the complex interaction between brain development, mental health, trauma, and environmental factors. Learn more about substance use and FASD, including the latest research and strategies.

Resources

Addiction and Mental Health Care: Resources to Support Collaboration
The Canadian Centre on Substance Abuse (CCSA), the Mental Health Commission of Canada and the Canadian Executive Council on Addictions have collected a list of examples and resources to support collaboration between addictions and mental health systems and service delivery in Canada.

Substance Use and Treatment in FASD Populations (2022)
In this recording of a webinar from 2022, presenters will give an overview of the Substance Use and Addictions in FASD Populations study, detailing the results and outcome of the project.

Substance Use and Addictions Programs (2020)
An environmental scan of substance use treatment programs in Canada, including FASD specific services, based on a 2020 search.

Infographics

Recommendations Developed from a Qualitative Investigation & Clinician Survey infographic
Summary of Findings from a Qualitative Investigation infographic