FETAL ALCOHOL SPECTRUM DISORDER (UPDATE 2009)
Fetal Alcohol Spectrum Disorder (FASD) is a leading cause of environment-related birth defects and developmental disabilities in North America. The Canadian Medical Association (CMA) believes that the prudent choice for women who are or may become pregnant is to abstain from alcohol, and encourages their partners to support them in this endeavour. The CMA urges Canadian governments to enact legislation that requires alcoholic beverages sold in Canada to be labelled with warnings of the hazards of consuming alcohol during pregnancy. The CMA also calls upon the federal government to examine the role that advertising plays in promoting the consumption of alcoholic beverages and to review existing policies and regulations in this area.
Fetal alcohol spectrum disorder (FASD) is an umbrella term used to describe the range of disabilities and diagnoses that result from drinking alcohol during pregnancy. It is estimated that more than 3,000 babies in Canada are born with FASD every year.
Those who live with FASD may have mild to very severe problems with their health. They may have delays in their development, intellectual problems and problems in their social lives. Examples of these include:
* skeletal abnormalities such as facial deformities
* physical disabilities such as kidney and internal organ problems
* depression or obsessive-compulsive disorder
* difficulty understanding the consequences of their actions
These disabilities are lifelong and those affected may need lifelong support.
The drinking patterns of teenagers and the potential for women of reproductive age to consume alcohol mean that the health care system must actively address the prevention of FASD. Also, alcohol use may play a considerable role in unplanned pregnancy and inadequate prenatal and postnatal care.
The CMA strongly supports all activities that encourage Canadians to moderate their alcohol consumption. The association encourages the public to be aware of the issues related to alcohol consumption, particularly the adverse effects on the fetus.
In a continued effort to support the reduction of alcohol consumption, the CMA urges Canadian governments to enact legislation that requires alcoholic beverages sold in Canada to be labelled with warnings of the hazards of alcohol consumption during pregnancy.1 Appropriate agencies should also adopt regulations and/or policies to ensure that warnings about the adverse interaction between alcohol and both prescription and non-prescription products are prominently displayed or distributed wherever alcohol and drugs are sold or dispensed.2 The CMA also calls upon the federal government to examine the role that advertising plays in promoting the consumption of alcoholic beverages and to review existing policies and regulations in this area.
The adverse effects of alcohol consumption by pregnant women are preventable. The CMA believes that the prudent choice for women who are or may become pregnant is to abstain from alcohol and encourages their partners to support them in this endeavour. Physicians should use appropriate screening methods to identify alcohol use in their patients. Physicians can play a leading role in educating and counselling women, spouses and family members about the dangers of alcohol to the fetus. The CMA also recommends that alcohol and drug addiction treatment services give high priority to the needs of pregnant women seeking help.
1 General Council resolution 89-67: That the Canadian Medical Association urge Governments in Canada to enact legislation requiring that all alcoholic beverages sold in Canada be labelled with warnings on the hazard from the consumption of alcohol during pregnancy. Note: this motion was rescinded because it was superseded by the Policy on Fetal Alcohol Syndrome (2000).
2 General Council resolution 87-31
A National Action Plan for Mental Illness and Mental Health : A Call for Action
This consensus statement was drafted at the National Summit on Mental Illness and Mental Health held on October 3, 4, 2002. The consensus statement was ratified subsequently by each of the signatory organizations.
We envision a country where all Canadians enjoy good mental health. Canadians with mental illnesses*, their families and care providers must have access to the care, support and respect to which they are entitled and in parity with other health conditions.
We are committed to a National Action Plan that upholds the following principles:
1. Mental illness and mental health issues must be considered within the framework of the determinants of health and recognizes the important linkages among mental, neurological and physiological health.
2. Given the impact of mental health issues and mental illness (i.e. on the suffering of Canadians, on mortality, especially from suicide, on the economy, on social services such as health, education and criminal justice), Canadian governments and health planners must address mental health issues commensurate with the level of their burden on society.
3. Mental health promotion and the treatment of mental illnesses must be timely, continuous, inter-disciplinary, culturally appropriate, and integrated across the full life cycle and the continuum of care (i.e. physical and mental health; social supports and tertiary care to home/community care).
KEY ELEMENTS OF A NATIONAL ACTION PLAN
1. National Mental Health Goals. These goals would provide a framework to, for example, evaluate both processes and outcomes, set minimum standards, and assess systemic change.
2. A Policy Framework. The framework must provide for a comprehensive health promotion and service delivery plan, an enhanced research program, a surveillance and national data/information system, a public education strategy, a health human resources plan, and an innovations fund that embraces both mental illness and mental health promotion as well as the principles of recovery and citizenship.
3. Dedicated, Sustained and Adequate Resources tied to the National Mental Health Goals and specific outcomes.
4. An Accountability Mechanism, such as annual reporting on, for example, access, mental health status, systemic change and the application of best practices.
* NOTE: The use of the term "mental illness" in this "Call for Action" includes diseases, disorders, conditions or problems. It also includes the spectrum of addictions.
A CALL FOR LEADERSHIP AND ACTION
We, the undersigned, urge the federal, provincial and territorial governments to work together with federal leadership to recognize and act upon the compelling moral, social and economic case for mental health promotion and mental illness care.
Canadian Medical Association
Canadian Psychiatric Association
NATIONAL ORGANIZATIONS REPRESENTED AT THE OCTOBER 2002 SUMMIT
Autism Society of Canada
Canadian Academy of Child Psychiatry
Canadian Alliance on Mental Illness & Mental Health
Canadian Association for Suicide Prevention
Canadian Association of Occupational Therapists
Canadian Association of Social Workers
Canadian Coalition for Seniors Mental Health
Canadian Council of Professional Psychology Programs
Canadian Federation of Mental Health Nurses
Canadian Health Care Association
Canadian Medical Association
Canadian Mental Health Association
Canadian Psychiatric Association
Canadian Psychiatric Research Foundation
Canadian Psychological Association
College of Family Physicians of Canada
Mood Disorders Society of Canada
National Network for Mental Health
Native Mental Health Association of Canada