Without screening or supports, offenders with FASD face revolving door of justice

Without screening or supports, offenders with FASD face revolving door of justice

TRC called for reforms to address needs of offenders with FASD, and for prevention to be made a priority

By Kelly Malone, CBC News


Russ Hilsher’s criminal record goes back more than a decade, to an assault charge in 2003. The 40-year-old has been in and out of jail for breaching conditions, other assaults and theft since.

On paper, Hilsher’s background tells a different story than the one the father of two talks about when he explains how he struggles to understand rules, laws and how to interact with police.

Originally from Ghost River, near the mouth of the Cheepay River in northeastern Ontario, Hilsher’s birth mother drank during her pregnancy. He was taken from her soon after and was diagnosed with Fetal Alcohol Spectrum Disorder as a baby.

As a teenager he landed in a foster home in Winnipeg and struggled to adapt to city life. Hilsher often has a wide smile on his face, but his eyes take on a serious expression when he explains how he interprets the world differently. When Hilsher was younger, if he saw something on the street he would take it. He didn’t think it was theft.

“Like you guys [who don’t have FASD] are knowing it’s not yours, but to someone who has FASD it’s just lying there, so it has to be mine. Why can’t it be mine, right?” Hilsher said.

Eventually that landed him behind bars. Hilsher said the routine and structure of prison worked for his FASD but it also meant he was sharing a space with people who were taking advantage of him. Hilsher said that he would just say “Yes” when people asked him to do things and he would end up getting in trouble, not really understanding that we he had done was not OK.

“It’s almost like if I could [serve my time] by myself in my own little space I would be alright,” he said.

In the prisons and jails it’s easy to mistake somebody’s behaviour as antisocial or oppositional when it’s really a result of having FASD, said Howard Sapers, the independent advisor on corrections reform to the Ontario provincial government and former Correctional Investigator of Canada. And in prison when people don’t follow orders or don’t seem to learn from mistakes, they face more discipline.

“This just creates a very, very negative cycle. And it just reinforces bad behaviour,” Sapers said.

The first thing to do in corrections is to recognize that FASD is a real and profound issue, Sapers said.

Pregnant belly

Fetal Alcohol Spectrum Disorder is a brain injury that is caused when a mother drinks alcohol while pregnant. (Radio-Canada)

Signs of FASD

Fetal Alcohol Spectrum Disorder (FASD) is a brain injury that is caused when a fetus is exposed to alcohol. It is the leading known cause of preventable developmental disability in Canada, affecting at least one per cent of Canadians, according to Health Canada.

FASD can range from mild to severe. Some people show physical signs, like a smooth ridge between the nose and upper lip and a smaller head, but many of the conditions associated with FASD are cognitive and those can “have important legal and practical implications for the criminal justice system,” the Correctional Investigator’s annual report said in 2015.

Many people with FASD have difficulty understanding the consequences of their behaviour, struggle to connect cause and effect, have impulsivity, drug or alcohol problems and struggle to learn from mistakes.

Research is not clear just how large the impact of FASD is in Indigenous communities but a link has been established between substance abuse and people who went to residential schools or were separated from families through the Sixties Scoop — Indigenous children who were removed from their families and adopted to non-Indigenous families — along with the generations that followed them.

Research suggests up to a quarter of inmates in federal corrections could have FASD. But in the three years since the Truth and Reconciliation Commission (TRC) issued its report, which included 94 Calls to Action, there has been little action on developing a national strategy or plan.

In Call to Action #34, the commission called on federal, provincial, and territorial governments “to undertake reforms to the criminal justice system to better address the needs of offenders with fetal alcohol spectrum disorder” including increasing resources for FASD diagnosis, bringing in exemptions from mandatory minimum sentences for offenders with FASD and providing parole resources so people with FASD can live in the community.

Call to Action #33 also called on governments to “recognize as a high priority the need to address and prevent fetal alcohol spectrum disorder.”

“Very little is actually being done to address the issues and we are quite disappointed,” said Ivan Zinger, the Correctional Investigator of Canada.

Within Correctional Service Canada, which deals with federal inmates, only seven specialized assessments for fetal alcohol spectrum disorder were funded across the country in 2016.

When it comes to provinces and territories, each has a different approach, but most do not do FASD screening upon entry and do not keep statistics.

Even outside of the criminal justice system, funding is extremely limited.

In May 2017, then-federal Minister of Health Jane Philpott, now the Minister of Indigenous Services, announced $3.6 million in federal funding from the Public Health Agency of Canada for five projects “aimed at preventing and screening for alcohol use in pregnancy.” It was also dedicated to better identify “individual and population groups most in need of support.”

But the funding was not new at the time. It was the same $3,650,206 earmarked in 2016 to fund certain projects over a period of five years.

Nor is it an increase in funding. It is actually a decrease compared to the previous federal government.

From 2008 to 2014 — also over a five year period — the Public Health Agency of Canada spent a total of $12.45 million on the Fetal Alcohol Spectrum Disorder Initiative.

For the families and communities dealing with FASD, the results of inaction are severe. Every time a loved one with FASD intersects with the criminal justice system, research shows they will likely be failed by it.

In prison, people with FASD are more likely to be involved in institutional incidents, are more likely to get charges while behind bars, typically spend more time of their sentence incarcerated and are less likely to complete programs, Zinger said.

“The correctional outcome is actually quite poor,” he added.

Invisible disability

In a Winnipeg provincial courtroom last August, defence lawyer Wendy Martin White told a judge that while everyone knew her client, a young Indigenous man sitting in a chair staring at his red running shoes, had FASD — his mother even confirmed she was drinking while pregnant — he had not been formally diagnosed.

Even without the diagnosis “what we think of normally for rehabilitation has to be thought of differently for someone like [my client],” she said.

Martin White’s client rocked back and forth in a chair placed between lawyers and in front of the provincial court judge. When asked if he had anything to say, he slowly responded “I don’t know what to say.”

“I just focused on listening. I never thought about what to say.”

Up to 60 per cent of Martin White’s clients are either confirmed to have, or are suspected of having, FASD, she said in an interview with CBC News. It means that a lot of her time is spent navigating the challenges that brings.


She talks about a client with FASD who was charged with a serious offence. He was from northern Manitoba but was being held at a remand centre just outside of Winnipeg. Martin White had been sending him materials to review before his trial and she was told he seemed to understand what was going on.

Finally Martin White was able to go and review the materials with her client and quickly realized that something was wrong.

“Not only could he not read or write, he was legally blind,” she said.

People with FASD will agree with things even if they don’t understand them, Martin White said. Often that means they can plead guilty without understanding the charges or implications.

She said it’s an invisible disability that affect their every interaction with the justice system — from encounters with police to plea deals to probation — but the system still doesn’t understand what it is, how it affects offenders and what can be done to reduce recidivism or divert people from the courts altogether.

“Are they manageable in the community? If they had the right supports would this have happened? Can we get them on the right system of support so that they are better at reintegrating into the community?” Martin White said.

“Is that not better for them than being in custody, where nine times out of 10 they are going to end up in segregation and their suicide rate goes up or other things go up because they just can’t handle that kind of environment well.”

To read more please visit http://www.cbc.ca/news/indigenous/without-screening-or-supports-offenders-with-fasd-face-revolving-door-of-justice-1.4536103


Want to predict a child’s future health? First measure their stress, says researcher


CBC News

We’ve all been told that stress is harmful to our health. But new evidence suggests that children who suffer stressful or traumatic events could suffer life-long consequences.

The events are known as adverse childhood experiences (ACEs), which range from parental separation to sexual abuse. Researchers have discovered that they’re clear indictors of a child’s future health outcomes.

The culprit is the stress hormone cortisol, which is toxic to a child, said Jennifer Mervyn, a psychologist and ACE consultant.

“The impact on the brain is significant,” Mervyn said during an interview on CBC’s The Early Edition.

One study found that a male child with an ACE score of six is 4,600 per cent more likely to become an injection drug user versus a male child who has an ACE score of zero.

The findings were presented this week in Surrey’s health and technology district, which hosted a week-long event on advancements in brain research.

Listen to the full interview below. 


Brains ‘want to change’

Researchers have discovered that cortisol can have a structural impact on a child’s brain, Mervyn said.

Children who accumulate trauma tend to develop a larger amygdala, which is the brain’s emotional response centre.

The good news, Mervyn said, is that children’s brains are malleable, meaning that damage inflicted by stress and trauma can be offset as a child matures into puberty.

“[Brains] want to change, they want to heal,” she said. “The capacity to do so when you’re young is incredible.”

Treatments for kids can be found through various therapies and caring relationships with adults, Mervyn said.

Parents, too, can learn techniques that help them cope with their own stress and support and nurture their child.

“It really comes down to creating an environment where that child has been removed from that toxic stress,” Mervyn said.

Mervyn said the findings also point to the need for greater investment in youth mental health and substance abuse programs.

Retrieved from http://www.cbc.ca/news/canada/british-columbia/kids-stress-brain-health-1.4576187

CDC: Collaborative for Alcohol-Free Pregnancy, training and resources

fasd3 with logo

The CDC has made available free, online trainings for healthcare providers who care for women at risk for an alcohol-exposed pregnancy, and for those who work with individuals living with fetal alcohol spectrum disorders (FASDs). These online trainings provide strategies to improve the delivery of care related to FASDs and their prevention.

For more information please visit: https://nccd.cdc.gov/FASD/ 

Have You Seen This Resoource…Teaching Sexual Health


Who We Are

Teachingsexualhealth.ca is an innovative website developed by Alberta educators and health professionals. We offer up-to-date, evidence-based information and strategies for teachers and educators teaching the Alberta Education Human Sexuality curriculum and for parents of children from birth up to 18 years of age.

Our Mission

To help teachers, educators, and parents achieve excellence in teaching sexual health.

Our philosophy reflects the approach to sexual health education embodied in Health Canada’s (2008) Canadian Guidelines for Sexual Health Education. The Guidelines are based on the principle that sexual health education should be accessible to all people and that it should be provided in an age appropriate, culturally sensitive manner that is respectful of an individual’s right to make informed choices about sexual and reproductive health. We believe that sexual health education honours the self-worth and dignity of the individual and does not discriminate against race, gender, gender identity, gender expression, sexual orientation, religion, ethno-cultural background or disability.

Education in sexual health needs to be structured so that attitudinal and behavioural changes arise out of informed choice. Effective sexual health education encompasses a lifespan approach, providing information, motivational support and skill-building opportunities that are relevant to people at different ages and stages in their lives. It instills awareness of the impact of one’s own behaviour on others, stressing that sexual health is an interactive process that requires respect for the self and others.

Please visit the website at https://teachingsexualhealth.ca/about-us/



Separating newborn babies from mothers with addiction does more harm than good, says doctor


Rebecca Dowds was suffering from opioid addiction when her daughter Sephira was born, but a new initiative allowed them to stay together from birth. (Submitted by Rebecca Dowds)

Removing newborn babies from women who are suffering from addiction helps neither mother nor child, says a doctor at the forefront of a movement to keep them together.

The stress of that separation, Dr. Ron Abrahams believes, has been confused for withdrawal symptoms in the past.

“Whenever you put a baby in an abnormal environment, it’s going to exhibit abnormal behaviour,” he says.

“And that was interpreted by the medical system in those days as the baby withdrawing, when it was actually withdrawing from the mother.”

Dr. Abrahams is the medical director of perinatal addictions at B.C. Women’s Hospital in Vancouver.

He is also the co-founder of the Families In Recovery (FIR) Square combined care unit, an initiative that keeps these mothers and babies together in a program called rooming-in.

Babies born into circumstances of addiction have usually been whisked away from their mothers immediately after birth.

The newborns were then brought to neonatal intensive care units, to be monitored and treated for withdrawal symptoms.

But babies are not born addicted, Dr. Abrahams says — they are born “exposed” to the drug.

“Addiction is defined as seeking out the drug,” he explains.

“These babies don’t seek out the drug, they are just experiencing some withdrawal from the drug that they were exposed to.”

That withdrawal can take about a week for these babies, he says, during which time there’s a greater benefit in keeping them with their mothers.

‘I didn’t feel judged’

Rebecca Dowds was taking seven Percocet pills a day when she discovered she was pregnant.

“I was excited but very nervous,” she says, “having knowledge about what narcotics could potentially do to a child while pregnant.”

She had become dependent on the pills, a combination of oxycodone and acetaminophen, after they were prescribed for back pain and sciatica.

Upon learning of her pregnancy, she spoke to her pain specialist and began to wean herself off her dosage.

That process was interrupted when she moved from Newmarket to Kingston, Ont., and was temporarily without medical assistance.

When her daughter was born, she and the infant were moved to the rooming-in program in Kingston General Hospital.

They had a room to themselves, with doctors and nurses regularly checking in to assess her daughter’s withdrawal symptoms, which receded over the five days they were there.

They also helped her to connect with programs that helped her adjust to motherhood in her situation.

Most importantly, Dowds says, she didn’t feel judged.

“All the people that were working with me were just amazing, compassionate people that didn’t appear to have a single judgment for my seeking help with the problem.”

Dowds is back at work and living a normal life, and she says her daughter Sephira, now 2, is an “incredibly lively, happy little girl who will talk your ear off.”

Breaking the cycle

Rooming-in has reduced the length of hospital stays and proven cost effective, Dr. Abrahams says, but there are also medical and social imperatives.

Keeping mother and child together helps to break a cycle of intervention.

“What we’re doing is we’re hard-wiring these babies to be socially competent human beings.”

“But the most important thing is that we’re rewiring the mothers to be socially competent, nurturing mothers.”

This segment was produced by The Current’s Kristin Nelson, Idella Sturino and Julie Crysler.

Retrieved from http://www.cbc.ca/radio/thecurrent/the-current-for-march-13-2018-1.4572942/separating-newborn-babies-from-mothers-with-addiction-does-more-harm-than-good-says-doctor-1.4572982



In approximately 100 days, Canada will legalize, regulate and restrict access to non-medical cannabis use. This transformation in our drug policy will require an intense educational campaign to inform Canadians, particularly young people, about the effects of cannabis use.

After alcohol, cannabis is one of the most frequently used substances among Canadian youth, with 20.6% of 15–19-year olds reporting past year use in 2015. Although use amongst school-aged youth in Canada has declined steadily over the past decade, Canada is one of the highest-ranking countries in the world for cannabis use.

How do we determine the next steps to educate young people about the effects of cannabis use? A good starting point is to better understand the perceptions that youth have around cannabis, their issues and their concerns. For example, what do they believe are the effects associated with the drug? What influences a young person’s decision to use or abstain?

To answer these questions, the Canadian Centre on Substance Use and Addiction (CCSA) conducted over twenty focus groups with young people aged 14-19 across Canada. Through this effort, we obtained baseline information about their perceptions on cannabis use and gained feedback on the information needed to effectively guide the conversation.

Our research revealed that young people are confused about the effects of cannabis, especially given all the vast and sometimes conflicting information that is available to them. Further, they are not having open and honest conversations with their families, peers, and trusted adults about cannabis use. They strongly believe that conversations about cannabis should avoid being “preachy” and exaggerated such as “you’ll die if you smoke cannabis.” Young people also reported that they are interested in being involved in peer-to-peer prevention efforts.

By understanding what and how youth think about cannabis use, CCSA was able to identify gaps in current education and awareness efforts and focus on how to have effective conversations about cannabis and inform youth decision-making. We have also been told by stakeholders from across the country – including doctors, nurses, coaches, teachers and many others – that this communication guide is urgently needed to equip them in engaging with young people regarding cannabis in an authentic, safe and judgment free conversation. With cannabis legalization approaching, it is increasingly important we talk to youth and find out what they need to live healthy and happy lives.

So, what’s the plan? This spring, CCSA will be releasing its Cannabis Communication Guide that was created for youth and designed by youth. It draws on CCSA’s made-in-Canada research and provides an evidence-informed approach to effectively communicate with younger Canadians about cannabis and cannabis use. Equipping parents, teachers, health professionals, coaches and young people themselves with a guide to have informed, unbiased and non-judgmental conversations is a vital way to prepare for the legalization of cannabis later this year.

Public awareness and education are critical to ensuring that young Canadians are well informed about the effects of cannabis use. We need to keep in mind that this discussion may not be entirely about preventing cannabis use but rather delaying cannabis use in younger Canadians. The Cannabis Communication Guide is just one of the many ways that CCSA generates the evidence for coordinated action on substance use.

Rita Notarandrea, , M.H.SC., C.H.E. is the CEO of the Canadian Centre on Substance Use and Addiction.

Contributed to the Sixth Estate – The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Sixth Estate.

Retrieved from https://sixthestate.ca/2018/03/14/opinion-100-days-to-cannabis-regulation-are-we-ready-to-guide-the-conversation-with-young-canadians-on-cannabis/?_cldee=bGlzYS5yb2dvemluc2t5QGNzc2FsYmVydGEuY2E%3d&recipientid=contact-fb04ede4f1d1e6118105480fcfeaa931-7c24d86149dd49a3902cb1fff91a21bd&esid=eb1c3fbf-6728-e811-8137-480fcfeab9c1

CBC News: Architect donates $3-million building for Edmonton women who are homeless, pregnant


Architect Gene Dub has donated a $3-million building to the Pregnancy Pathways project, for homeless and pregnant women. (CBC)

A  project to help women who are homeless and pregnant in Edmonton has found a home, thanks to the donation of a $3-million building by architect Gene Dub.

Dub has donated a three-storey apartment building in the McCauley neighbourhood to Pregnancy Pathways, a pilot program that will provide housing — and support — to  pregnant homeless women.

“At my stage in life, you’re looking at some way to use whatever you have saved up, and I’ve been lucky in that way, and this just seemed like such a great opportunity,” he said Thursday.

Dub, an award-winning architect best known for designing Edmonton’s city hall, was listening to CBC Radio when he heard about the Pregnancy Pathways project.

It’s a coalition of Edmonton groups that has been working for several years to open an apartment building for women who are homeless and pregnant.

The program will help women access medical care to ensure they have healthy pregnancies. And it will work with them to make decisions about raising their babies, choosing adoption or foster care, or finding other ways to become involved. The idea, however, is to have each woman make that decision herself.

It’s estimated about 100 pregnant women in the city experience homelessness every year. They may not be sleeping on the streets, but rather couch-surfing with friends and bouncing between apartments.

The building is a former hotel at 98th Street and 108th Avenue. More than 100 years old, it has been renovated into apartments.

Capital Region Housing will operate the building, while Pregnancy Pathways will offer the necessary supports.

Greg Dewling, CEO of Capital Region Housing, said his organization was initially thinking about buying the building for the program. But the finances to make it work were almost impossible.

“After hearing about the program, [Dub] called me back and said, ‘Can you make it work if I donated it?’ I almost fell on the floor,” Dewling said.

“In the 40-plus years our housing agency has been in existence, we’ve never had a building donated. It’s very rare.”

Nakoochee and Lilley

Dr. John Lilley talks to Marissa Nakoochee who, 10 years ago, was homeless and pregnant. She found a stable home, and has been a strong supporter of Pregnancy Pathways. (Peter Evans/CBC )

Helping babies succeed

When Dr. John Lilley was working as an anesthesiologist at the Royal Alexandra Hospital, he’d see a handful of homeless women give birth every year.

Their housing instability affected both their own health, and their babies.

Many women who lack housing don’t seek prenatal care, because they are focused on finding places to stay or because they know their children will be apprehended if someone in the health care system knows they don’t have a home.

But the lack of medical care can also contribute to premature births and small babies. That’s why helping women to eat well, seek medical care, and get addictions treatment if needed, is so important

“Everyone loves babies and everyone knows infants are very much in need of support,” said Lilley, who is now involved with Pregnancy Pathways.

“We’re helping mothers turn their lives around and babies succeed. And that’s just very heartwarming.”

Pregnancy Pathways is a three-year pilot project, with an expected annual operating budget of $500,000. Major funding has been secured from Merck for Mothers, the Royal Alexandra Hospital Foundation, the provincial government, and the Stollery Community Foundation.

Two women have gone through the prenatal support program already, have delivered their children, and will be among the building’s first tenants for the first year of their babies’ lives.

Dub had the chance recently to see photos of those babies.

“That alone was worth donating the building,” he said.

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