Conclusions reached from my involvement with the Canadian criminal justice system. 2011. amd- 2021 References of papers published by Dr Mansfield Mela, and others regarding FASD, PAE, Mental Health, and the Justice System. Dr Mela is one of the very few Forensic Psychiatrists who understands and advocates for those with FASD.

1. Barry Stanley: Conclusions reached from my involvement
with the Canadian criminal justice system. 2011.
The Justice System is confronted with the consequences of
prenatal and pre conceptual alcohol exposure on a daily
basis.
Unlike other institutions, such as education, the justice
system has little opportunity to evade the issues that it is
presented with; at least at the higher levels of the system.
Psychiatry provides the Justice System with the experts to
testify when issues concerning mental conditions occur.
With few exceptions such expert forensic psychiatrists /
psychologists witnesses have had no training or acquired
knowledge of FASD: the forensic tools used to assess
compliance and recidivism have never been validated for the
neurodevelopmental disabilities of FASD.
The increasing awareness and understanding of FASD by
Judges and court lawyers is in conflict with the testimony of
such witnesses, whom the courts rely on in cases involving
persons who have FASD. The one situation that exemplifies
the issue more than any is the charge of murder. This is
because the crime and the consequences for all are so severe
and tragic.
In such cases when FASD is raised in mitigation it is the
Forensic Psychiatrist or Psychologist who is the witness for
the crown. With few exceptions they know little about FASD.
Yet the judicial system is increasingly becoming more aware
of FASD.
This contrary situation will likely be the one that will
eventually force Psychiatry to recognize the nature of FASD
and the role of prenatal and pre conceptual alcohol in the
development of psychiatric conditions. [ behaviours ]. This
will mean a profound shift away from behaviour as the
criteria for psychiatric diagnosis, to where such behaviours
arise - the brain.

2. It will also mean that the justice system, psychiatry and
society as a whole will have to redefine the meaning of
culpability and responsibility.
This is the point to which we should be directing all our
effort. We need to focus on educating the legal profession
about FASD and appropriately challenge any erroneous
testimony relating to FASD.
Amd. Those who take up this difficult challenge deserve our
support: 2021
Mansfield Mela scholar.google.ca
“We propose that a diminished responsibility defense and
verdict that recognizes the ‘grey zone’ between ‘knowing’
and ‘not knowing’ based on neurocognitive disparities in
FASD serves the individual, legal system and the society
better than the current practice.”
Fetal alcohol spectrum disorder: Can diminished
responsibility diminish criminal behaviour? Mansfield
Mela, Glen Luther. International Journal of Law and
Psychiatry.
Volume 36, Issue 1, January–February 2013, Pages 46-54
“Residency training in psychiatry, as in other medical
specialties previously based on an apprenticeship model, is
undergoing dynamic change. This change is necessary to

3. meet societal expectations and community’s changing
clinical needs (1–3). Modernization in medical practice and
the role of polity in vocational training were instrumental in
the development of current competency based outcomes (4).
These competencies inform the various educational
methods, evaluation, and accreditation standards in
training.
Methods of training, when sufficiently developed, introduced
early and effectively evaluated, can provide additional
benefits in competencies as well as better care for patients
(2).
There are different ways to expose psychiatric residents to
law-related materials, including didactic training (5),
problem-based training (6), mock trial experience for
residents, taking a law course during the psychiatric “
Mansfield Mela, Glen Luther Law and Psychiatry Seminar:
An Interprofessional Model for Forensic Psychiatric
Training. Acad Psychiatry 37, 421–425 (2013).
https://doi.org/10.1007/BF03340084
“Evidence is accumulating as to the effective
psychotherapeutic and pharmacological interventions
applied to those with Fetal Alcohol Spectrum Disorder
(FASD). Such interventions have not been studied in the
criminal justice system. Yet results of studies among youth
with FASD and those involved with the criminal justice
system should be transferable to adults. Similarly, when
dealing with an offender with FASD, changes in or
modifications to the legal framework and approaches are
suggested as potential additional interventions to be
considered. Education of and increasing FASD knowledge
among key officials in the criminal justice sys- tem are
pivotal for understanding the disability and how to intervene

4. in offenders with FASD. To improve outcomes therefore,
offenders should be promptly identified and existing forensic
mental health teams should be trained in both FASD
assessment and intensive case management. Interventions
with scientific evidence should inform the management of
offenders as they pass through the different stages of the
criminal justice system. Appropriate expectations, positive
relational approach, and the provision of support, structure
and supervision are critical especially when offenders are in
the community. A collaborative team effort is needed to
reduce the consequences of the disability of FASD and
reduce victimization of both the offender and the members of
the society.”
Medico-Legal Interventions in Management of Offenders
with Fetal Alcohol Spectrum Disorders (FASD) Mansfield
Mela M. Nelson and M. Trussler (eds.), Fetal Alcohol
Spectrum Disorders in Adults: Ethical and Legal
Perspectives, International Library of Ethics, Law, and the
New Medicine 63, DOI 10.1007/978-3-319-20866-4_8
“It is the current authors’ perspective that the successful
implementation of Changing Directions, Changing Lives,
which seeks to improve mental health and well-being in
Canada, cannot be realized effectively without considering
FASD. Given that 94% of individuals with FASD also have
mental disorders, practitioners in the mental health system
are encountering these individuals every day. Most mental
health professionals have not been trained to identify or
diagnose FASD, and therefore it goes largely “unseen,” and
individual treatment plans lack-efficacy. Implementation of
FASD-informed recommendations, such as those of the Truth
and Reconciliation Commission of Canada [2015], can

5. provide a more effective approach to mental health services
and improve mental health outcomes.”
The Implementation of the 2012 Mental Health Strategy
for Canada Through the Lens of FASD Tara Anderson,
Mansfield Mela_University of Saskatchewan Michelle
Stewart University of Regina _CANADIAN JOURNAL OF
COMMUNITY MENTAL HEALTH, VOL. 36, NO. 4, 2017
“Finally, many individuals with mental disorders and FASD
do not engage in criminal activity, and these are crucial
populations for further study. Exploring the factors that
differentiate these individuals from those who offend would
greatly improve our ability to develop strengths-based
interventions, promote resilience, and support positive
outcomes for at-risk populations.”
Mansfield Mela, MB, BS, MSc, Katherine Flannigan, PhD,
Tara Anderson, MSc,
Monty Nelson, PhD, Sudheej Krishnan, MA, MPhil, Chibuike
Chizea, MB, BS, MPH,
Sarah Takahashi, MA, and Rohan Sanjanwala, MD, MPH
Neurocognitive Function and Fetal Alcohol Spectrum
Disorder in
Offenders with Mental DisordersJ Am Acad Psychiatry Law
48(2) online, 2020. DOI:10.29158/JAAPL.003886-20