Recent advances in fetal alcohol spectrum disorder for mental health professionals

Unfitness to stand trial and fetal alcohol spectrum disorder: Understanding and responding to FASD within the criminal justice system in New Zealand

Fetal alcohol spectrum disorder (FASD) is an increasingly important issue in the New Zealand (NZ) Criminal Justice System (CJS). FASD may impact an offender's ability to participate meaningfully in the trial process, giving rise to the issue of unfitness to stand trial. Capacity to apprehend, comprehend, participate in, make decisions about and communicate within legal process intersect with the complexity and severity of charges. Courts are required to make a nuanced analysis of multiple and complex factors, merging medical and legal expertise into decisions made. We explore the nature of FASD and its implications for criminal justice in NZ. The legal and clinical issues in relation to fitness and FASD will be discussed.

Rates and implications of fetal alcohol spectrum disorder among released offenders with mental disorder in Canada

Fetal alcohol spectrum disorder (FASD) is prevalent among individuals involved in the justice system. However, many of the characteristics of justice-involved individuals with FASD remain unknown. We assessed patients in a forensic mental health hospital (n = 26) for FASD before their release. The two objectives were to establish the prevalence of FASD in this unique environment and to describe the mental health and neurocognitive characteristics of individuals with FASD compared to patients with complex needs and those without FASD. The prevalence of FASD was 46%. We found the FASD group to have more than six impaired brain domains, greater than the other groups, and a higher prevalence of ADHD. Given the high prevalence of FASD reported in this study, along with the complexities and adversities associated with FASD and criminal justice involvement, this is a population that requires screening, assessment, and intervention.

Fetal alcohol spectrum disorder (FASD) and suggestibility: A survey of United States federal case law

This article summarizes four federal criminal cases that illustrate how suggestibility can impact defendants with FASD in the criminal justice system. Four cases were identified via a Google Scholar search of "suggestibility" and "fetal alcohol" in the federal case law database. These cases are illustrative of how FASD can affect legal defendants, including vulnerability to peer pressure, being easily manipulated, insufficient comprehension of legal proceedings, difficulty in assisting legal counsel, learning impairment, acquiescence or higher levels of suggestibility, and difficulty understanding consequences. The cases presented here provided the most comprehensive discussion of FASD and suggestibility issues but are by no means an exhaustive review of case law. Because defendants with FASD are the focal point of this article, we intentionally excluded cases involving eyewitness suggestibility, the suggestibility of child witnesses, and the suggestibility of those under hypnosis. Therefore, this review has been developed to explicate and illustrate problems common to FASD defendants within legal settings, especially regarding risk for suggestibility. The information provided from this discussion may better guide legal professionals who regularly come into contact with persons affected by FASD on how to more readily detect this neurodevelopmental condition and mitigate the likelihood of injustice during criminal proceedings. Additionally, we include suggestions on how to attenuate miscarriages of justice as a result of faulty confessions, wrongful convictions, and vulnerability of suggestibility in persons affected by FASD.

A Systematic Review of Interventions to Improve Mental Health and Substance Use Outcomes for Individuals with Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder

Individuals with fetal alcohol spectrum disorder (FASD) experience remarkably high rates of mental health and substance use challenges, beginning early in life and extending throughout adulthood. Proactive intervention can help to mitigate some of these negative experiences. Although the literature on FASD intervention is growing, there is currently a lack of consolidated evidence on interventions that may improve mental health and substance use outcomes in this population. Informed by a life course perspective, we undertook a systematic review of the literature to identify interventions that improve mental wellness through all developmental stages for people with prenatal alcohol exposure (PAE) and FASD. A total of 33 articles were identified, most of which were focused on building skills or strategies that underlie the well‐being of children with PAE and FASD and their families. Other interventions were geared toward supporting child and family wellness and responding to risk or reducing harm. There was a notable lack of interventions that directly targeted mental health and substance use challenges, and a major gap was also noted in terms of interventions for adolescents and adults. Combined, these studies provide preliminary and emerging evidence for a range of intervention approaches that may support positive outcomes for individuals with FASD across the life course.