The following personal reflection is written by Laura Bousquet, a passionate FASD advocate, Family Navigator for FASD United, and Board Member of the Texas FASD Network, a FASD United affiliate.
My son is a young adult with multiple diagnoses, including a brain-based disability, and he is currently experiencing severe and persistent depression. He frequently describes feeling flat, disconnected, and without care or motivation. Despite being under psychiatric care for medication management and participating in weekly therapy, his symptoms—depression, agitation, and unresolved trauma—continue to escalate.
He has a significant history of adverse childhood experiences that have evolved into ongoing adverse life experiences. These challenges, combined with anxiety and his neurodevelopmental disability, result in profound functional impairment. He becomes overwhelmed by routine daily tasks, and his difficulties with emotional regulation can rapidly escalate into agitation and, at times, aggression.
This is not a matter of differing perspectives—this is a clear and documented decline in functioning. To ensure objective data is available, I developed a structured daily tracking tool that captures sleep, mood, anxiety, overwhelm, triggers, behaviors, recovery time, and medication observations. This tool is completed consistently and reflects ongoing, significant concern. Families should not have to create their own data systems to be taken seriously by providers.
There is a critical systemic gap in appropriate care, without any sort of supports paradigm in place. In moments of crisis, emergency response systems are immediate, yet often ill-equipped to safely support individuals with neurodevelopmental disabilities and trauma. At the same time, accessing appropriate, informed mental health care requires navigating extensive barriers—long waitlists, lack of provider expertise in neurodivergence and trauma, and limited treatment options that are not designed for individuals like my son.
Families are left navigating impossible choices. Waiting over two months to discuss next steps with psychiatric providers is not a responsive system. Nor is me having to leave our home—dogs in tow—to create space and maintain safety for both my son and myself while hoping that an oral emergency sedation medication, with significant risks and precautions, begins to take effect. These are not solutions; they are measures taken to get through the moment. This is not care—this is survival, often holding on by a thread.
We are left with a system where incarceration, emergency departments, or unsafe crisis responses become the default pathways—not because they are appropriate, but because there are no viable alternatives. This is unacceptable.
Caregivers are expected to coordinate complex care systems, identify appropriate providers, and manage ongoing crises, all while facing limited access to qualified professionals. There is a critical need for integrated, neurodiversity-informed, trauma-responsive systems of care that recognize the lifelong and whole-body impact of conditions like Fetal Alcohol Spectrum Disorder.
I am working to build a competent and informed care team for my son, but the severe lack of appropriate resources highlights a broader systems failure—not an individual one. Individuals like my son deserve access to care that is informed, accessible, and responsive to their needs.
This is not an isolated experience. It is a systemic issue that requires urgent attention, coordination, and accountability across healthcare, mental health, and crisis response systems.
Legal professionals, mental health providers, law enforcement professionals, medical professionals, and the community collectively must do better. It is unacceptable that case managers are reporting that jails and prisons are often used as de facto mental health institutions, and that many law enforcement agencies may not have adequately training provided to them to respond to individuals with intellectual and developmental disabilities or those experiencing a mental health crisis.
The purpose of this writing is to bring awareness to what we already know is happening—to acknowledge it and to act on it. It is not enough to remain frustrated with the system. We must actively inquire, collaborate, and develop viable, informed solutions that move us beyond crisis response and toward appropriate, compassionate care.