FASD and suicide

There are many aspects of the topic Indigenous people that I would like to talk about but I would like to focus my attention on two main ideas, Fetal Alcohol Syndrome (FAS) or also known as Fetal Alcohol Spectrum Disorder (FASD) and suicide in Aboriginal children and Aboriginal communities. I have had the unfortunate experience working with children with severe (FASD) and children facing suicide/suicidal ideation on a daily basis through the ‘system’ with Children and Family Services in Ontario. FASD is a term that “describes a range of disabilities that may affect people whose mothers drank alcohol while they were pregnant.” This lifelong disability has also been called the ‘invisible disability.’ Suicide is suffered by its victims who decide to take their own lives, families and friends and unfortunately it is most commonly occurring in aboriginal communities. The statistics are alarming.


In my opinion, I think the awareness needs to start with women who are at the child bearing age about drinking during pregnancy and FASD is incurable! Too many children are encountering health problems that affect every aspect of life such as mentally, physically, behaviourally and emotionally throughout their lives right from birth. These children have a setback in life right from the first breath they take from no fault of their own. The Public Health Agency of Canada reported that approximately 1% of people living in Canada or about 300,000 people are living in Canada today with FASD.


Although it has been reported that there are no statistics to date for how many aboriginal children or adults have FASD, Paul Masotti et al. (2006) reported in Preventing Fetal Alcohol Spectrum Disorder in Aboriginal Communities: A Methods Development Project that “not surprisingly, FASD is more common in communities with high prevalence rates of drinking, such as some Canadian Aboriginal communities.” In aboriginal communities, the Canadian Community Health Survey observed that “16.1% of women in the 15–44 age group, and 26% in the 20–24 age group, reported binge drinking 12 or more times in the previous year.” Binge drinking is important to note because it often leads to women continuing to binge drink while pregnant. “The Ontario First Nations Regional Population Health Survey indicated that significantly more Aboriginal females reported binge drinking than their counterparts in the general Canadian population.

Although the statistics may be alarming, I have failed to look at FASD through a social work lens which is why I am adding the following paragraphs in to see the difference on how an ‘outsider’ may see this problem and then from the lens of a social worker. Reading over the comments from this blog, I’ve realized that when looking through the social work lens, there needs to be focus on how to solve this problem and it is not about pointing fingers at the mother. The focus needs to be on helping Aboriginal people heal in their communities when they have suffered for so many years. Silvia points out a good point in her comment that we need to help women, children AND men heal from the traumatic events that have happened either in their lives or problems in their family that has resulted in them suffering.  Yes, everyone knows there is a problem but we now need to come up with solutions on how to fix this problem.

Fetal Alcohol Spectrum Disorder (FASD) Prevention: Canadian Perspectives explains four different levels of how we can start with just basic awareness and then gradually work at the prevention area. The Public Health Agency of Canada reported that "in Canada over the last decade, health promotion and prevention specialists have been learning about how to prevent FASD using multi-sectoral, holistic approaches. Beyond advice to not drink while pregnant, these newer, holistic approaches have demonstrated that helping women plan their pregnancies, obtain prenatal care, improve their nutrition, reduce stress in pregnancy and heal from root causes of addiction such as experience of violence – all contribute to improving women’s health and reducing the risk of having a child affected by FASD." (Poole, N 2008)

I believe that we do need to also focus on healing but just as much on prevention because the cycle will only continue. The healing process it not easy and according to Mabel Nipshank (2001) who did a report called Aboriginal Women: No Rights to Land or Children she reported that:

“As a result, Aboriginal Women attempting to escape violence are often forced out of the family home and community and into cities, where they encounter a multitude of systemic barriers. They are constantly being re-victimized by racism in the system. Aboriginal Women are often forced to live in extreme poverty and with these additional barriers it is almost impossible to fight for Child Custody and Access rights. The Social Development Department within a band is modeled after the child protection act, and the ‘best interest of children’ is seen through this lens - usually who has access to family home, extended family, and to traditional culture and financial stability. The patriarchal structure of today's band policies entitles men to all of these, leaving women with few resources. The residential school syndrome and the destruction of the matriarchal system have led to the normalization of violence. Men can have a history of wife assault but their right to child custody and access is never questioned. Allegations of child sexual abuse are being dismissed, without investigation, as false and vengeful charges. Mothers have lost custody of their children because they dared to breach a court order by refusing unsupervised visits with fathers who have abused the children. Custody and access issues expose the true values of our society. We need a society based on fairness, and a system, which accounts for the real social, political and economic realities for Aboriginal women. We need to put the safety of women and children first.”

While suicide can be tied in with mental health, suicide is not recognized as a psychiatric disorder but as an action or behaviour. I believe this can be tied in with physical disabilities because dating back from the residential school days, Aboriginal children were taken from the home and put through a great deal of abuse and neglect. Now, if you throw a physical disability into the mix of your culture being stripped from you, alcohol, drug and sexual abuse in your family etc, you are already under a great deal of stress trying to cope with a physical disability. Aboriginal people with a physical disability may feel overwhelmed and hopeless that they cannot provide for themselves or others and feel that life is not worth continuing. This is not equality and no one deserves to be treated or to be made felt this way. For every suicide victim, how many Aboriginal people make suicide attempts, are depressed, experience anxiety and want to end their life? I can only imagine that the number is very high and again we need to focus on prevention, prevention, prevention! In a study that is being done in Manitoba by the Swampy Cree Suicide Prevention Team called Community-based Suicide Prevention Research in Remote On-Reserve First Nations Communities (2009), it states that “while the process employed for this study may not be unique in regards to Aboriginal health research, it is to our knowledge the first of its kind for a suicide prevention project in Manitoba and perhaps Canada. This is very shocking to see that it is the first of its kind. In working with children and adults in a hospital, I’ve seen that many suicide attempts are not only a mental health issue but can turn into a physical disability. Areas in the brain can be affected from an overdose or by attempting to hang themselves which may affect areas of the brain that cause specific muscle movements or permanent nerve damage to limbs.

Laurence J. Kirmayer et al. (2007) reported in The Aboriginal Healing Foundation- Suicide Among Aboriginal People in Canada that the “overall suicide rate among First Nation communities is about twice that of the total Canadian population; the rate among Inuit is still higher— 6 to 11 times higher than the general population. For Aboriginal people, suicide is an affliction of the young. From the ages of 10 to 29, Aboriginal youth on reserves are 5 to 6 times more likely to die of suicide than their peers in the general population. Over a third of all deaths among Aboriginal youth are attributable to suicide.”

In conclusion, although FASD seems to be more apparent in Aboriginal communities and Aboriginal children, there are no statistics to date to give an approximate number of people living with this disability. It is most shocking to me that there are many clinics to diagnose FASD children and many resources for looking for the signs in young children but where is the prevention? There is not enough emphasis on the prevention of Fetal Alcohol Syndrome in Aboriginal communities and it needs to be addressed. As for suicide in Aboriginal people, especially youths, you can see that indeed the statistics are alarming. There needs to be more focus on prevention and support in both FASD and suicide and not just after the fact. This needs to be a continuous process from the government and the government needs to continue their part in what was created from the horrible historical events of residential schools.


References:


Isaak et al., C. (2009). Community-based suicide prevention research in remote on-reserve first nations communities. International Journal of Mental Health and Addiction, 8(2), doi: 10.1007/s11469-009-9250-0

Kirmayer et al., L. (2007). Aboriginal healing foundation: suicide among aboriginal people in canada (Adobe Reader), Retrieved from http://www.ahf.ca/publications/research-series

Masotti P, George MA, Szala-Meneok K, Morton AM, Loock C, et al. 2006 Preventing Fetal Alcohol Spectrum Disorder in Aboriginal Communities: A Methods Development Project. PLoS Med 3(1): e8. doi:10.1371/journal.pmed.0030008

Tiffany