#043 Dr. Susan Rich: Calling a Spade a Spade 

fasd success show Nov 16, 2020




I have the honour today of talking with Dr. Susan Rich. This is a fascinating interview that contains some very real and frank discussions about fetal alcohol spectrum disorder and reasons why Dr. Rich thinks that despite all the knowledge we are still struggling with prevention, awareness, recognition, and support. 


Susan D. Rich, MD, MPH, DFAPA is a practicing child/adolescent & adult psychiatrist who holds a Bachelor of Science in microbiology from North Carolina State University, a Master of Public Health in health policy, and a Doctorate of Medicine from the University of North Carolina at Chapel Hill. She completed psychiatry training at Georgetown University Medical Center as well as a child/adolescent fellowship at Children's National Medical Center.  

Dr. Rich first learned about the effects of prenatal alcohol exposure on the early embryo while working in pharmaceutical research in April 1992 after reading a book called The Broken Cord. She began writing grants and developing programs in Native American communities in North Carolina, New Mexico, and Arizona. Dr. Rich has written and spoken widely internationally on the topic of Neurodevelopmental Disorder associated with Prenatal Alcohol Exposure and is author of the book, The Silent Epidemic: A Child Psychiatrist's Journey beyond Death Row. She is also the founder of a non-profit, 7th Generation Foundation, Inc. and operates a green care farm animal sanctuary in Potomac, MD for individuals with FASD and related neurodevelopmental conditions.  

As a psychiatrist, she has some amazing insights into that field. Did you know she was also one of the team of experts that created the recently published FASD Psychotropic Medication Algorithm?  

We dive right in and talk about her and others’ efforts to get recognition of FASD/PAE in the psychiatric community. 

Why is it that this topic, which is the most important topic in psychiatry today, is being held on the very last day of the conference, first thing in the morning. – Dr. Carl Bell 

She provides insight into what it will take to change this recognition as well as her thoughts on:  

  • What causes and why she feels we need to focus on what causes neurodiversity; and the cumulative factors that play a role in a child with a neurodevelopment disorder; 
  • Why she calls FASD/PAE the chameleon of all other diagnosis and why she feels individuals with PAE can continue to develop versus someone with a genetic condition; 
  • How recent research on anxiety and depression could help individuals with FASD/PAE; 
  • Where a shift in society is needed to support birth moms and families; and 
  • When are we going to make the billion-dollar alcohol companies accountable? 

Why are we making the most vulnerable individuals pay?

I have followed Dr. Rich on Twitter for some time now. I love her spunk and say it as it is attitude. She calls a spade a spade. She has the educational background and experience to voice very strong opinions on how we respond to FASD/PAE. She talks about how caregivers can play a part.  

This was a jam-packed interview, but we also managed to touch on her project Dream Catcher Meadows and her book, The Silent Epidemic: A Child Psychiatrist’s Journey Beyond Death Row Understanding, Treating and Preventing Neurodevelopmental Disorder Associated with Prenatal Alcohol Exposure.  

Being I’m Canadian, she wanted to mention her deep interest and connection to Canada. She had the opportunity to live in the Kahnawake Mohawk community in Quebec, Canada the summer of 1998 to develop a train-the-trainer series for youth, then presented grand rounds at the University of Manitoba Department of Family Medicine and spoke at the Northwest Territories outpost near Lake Winnipeg later that year. She presented at the joint Canadian and American Child and Adolescent Psychiatric Society annual meeting in October 2011 and the joint American and Canadian Psychiatric Association annual meeting in May 2015 in Toronto, Canada, presented at the Vancouver FASD conference in March 2017, and at the Child and Parent Resource Institute in London, Ontario and at the Children's Aid Society in June 2018.   

Please Note: In the introduction for the podcast I erroneously refer to Dr. Rich as a psychologist. She is a psychiatrist. I knew that. My apologies. 

I invite you to check out the links in the Show Notes and follow her on Twitter and Facebook. I will be inviting Dr. Rich back as there is so much more to unpack and learn. Let me know what you think. 

Show Notes: 

Contact: Susan D. Rich 

Book:  The Silent Epidemic, YouTube Channel and Documentary 

Non-profit Farm: 7th Generation Foundation Inc 

Social Media: Twitter: @SusanDRichMD and Facebook 



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