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Fetal Alcohol Spectrum Disorder Prevalence Estimates in Correctional Systems: A Systematic Literature Review

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Abstract

Objectives: The objective of this study was to conduct a systematic search of the literature for studies that estimated the prevalence/incidence of Fetal Alcohol Spectrum Disorder (FASD) in correctional systems in different countries and, based on these data, to estimate a) the number of people with Fetal Alcohol Syndrome (FAS)/FASD within the criminal justice system population, and b) the relative risk of becoming imprisoned for individuals with FAS/FASD compared with those without FAS/FASD.

Method: A systematic world literature review of published and unpublished studies concerning the prevalence/incidence of FASD in correctional systems was conducted in multiple electronic bibliographic databases.

Synthesis: Very little empirical evidence is available on the prevalence of FASD in correctional systems. There were no studies estimating the prevalence/incidence of FASD in correctional systems found for any country other than Canada and the USA. The few studies that have identified incarcerated individuals with FASD estimate that the number of undiagnosed persons in correctional facilities is high. Based on available Canadian data, this study estimates that youths with FASD are 19 times more likely to be incarcerated than youths without FASD in a given year.

Conclusion: More studies investigating the prevalence/incidence of alcohol-affected people in the criminal justice system are required. There is an urgent need to raise awareness about the prevalence and disabilities of individuals with FASD in the criminal justice system and about appropriate responses. The criminal justice system is an ideal arena for intervention efforts aimed at the rehabilitation and prevention or reduction of recidivism in this unique population.

Résumé

Objectifs: Procéder à une recherche documentaire systématique pour répertorier les études ayant estimé la prévalence/l’incidence de l’ensemble des troubles causés par l’alcoolisation fœtale (ETCAF) dans les systèmes correctionnels de différents pays et, d’après ces données, estimer a) le nombre de personnes touchées par le SAF [syndrome d’alcoolisme fœtal] ou l’ETCAF dans la population carcérale et b) le risque relatif d’être incarcéré, pour les sujets touchés par le SAF/l’ETCAF comparativement aux sujets non touchés.

Méthode: Nous avons mené, dans de nombreuses bases de données bibliographiques électroniques, une enquête bibliographique mondiale systématique des études publiées et inédites sur la prévalence/l’incidence de l’ETCAF dans les systèmes correctionnels.

Synthèse: Il existe très peu de preuves empiriques sur la prévalence de l’ETCAF dans les systèmes correctionnels. Sauf au Canada et aux États-Unis, nous n’avons trouvé aucune étude estimant la prévalence/l’incidence de l’ETCAF dans les systèmes correctionnels. Les rares études qui identifient les personnes incarcérées touchées par l’ETCAF estiment que le nombre de sujets non diagnostiqués dans les établissements de correction est élevé. D’après les données canadiennes disponibles, nous estimons que les jeunes touchés par l’ETCAF sont 19 fois plus susceptibles d’être incarcérés que les jeunes non touchés par l’ETCAF au cours d’une année donnée.

Conclusion: Il faudrait que plus d’études s’intéressent à la prévalence/l’incidence des sujets affectés par l’alcool dans le système de justice pénale. Il est urgent de prendre conscience de la prévalence et des handicaps des sujets touchés par l’ETCAF dans ce système, ainsi que des réponses appropriées. Le système de justice pénale est un milieu idéal pour les interventions qui visent à réhabiliter et à prévenir ou réduire le récidivisme dans cette population particulière.

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Correspondence to Svetlana Popova MD, PhD.

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Acknowledgements: This work was supported by the Public Health Agency of Canada [contract # 6D016-081841/001/SS].

In addition, the Ontario Ministry of Health and Long-Term Care provided support to the Centre for Addiction and Mental Health for the salaries of scientists and for infrastructure. The views expressed in this manuscript do not necessarily reflect those of the Ontario Ministry of Health and Long-Term Care.

The authors also thank Charlotte Fraser and Marilou Reeve from the Department of Justice Canada and Dr. Igor Karp from the University of Montreal for their helpful comments.

Conflict of Interest: None to declare.

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Popova, S., Lange, S., Bekmuradov, D. et al. Fetal Alcohol Spectrum Disorder Prevalence Estimates in Correctional Systems: A Systematic Literature Review. Can J Public Health 102, 336–340 (2011). https://doi.org/10.1007/BF03404172

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