Disabilities and rehabilitation

Violence against adults and children with disabilities

Both children and adults with disabilities are at much higher risk of violence than their non-disabled peers, according to two systematic reviews recently published in the Lancet. The reviews were carried out by Liverpool John Moores University’s Centre for Public Health, a WHO Collaborating Centre for Violence Prevention, and WHO’s Department of Violence and Injury Prevention and Disability. These are the first studies to confirm the magnitude of the problem and they provide the strongest available evidence on violence against children and adults with disabilities. They also highlight the lack of data on this topic from low- and middle-income countries.

The review on the prevalence and risk of violence against children with disabilities, published in July 2012, found that overall children with disabilities are almost four times more likely to experience violence than non-disabled children. The review indicated that children with disabilities are 3.7 times more likely than non-disabled children to be victims of any sort of violence, 3.6 times more likely to be victims of physical violence, and 2.9 times more likely to be victims of sexual violence. Children with mental or intellectual impairments appear to be among the most vulnerable, with 4.6 times the risk of sexual violence than their non-disabled peers.

The systematic review on violence against adults with disabilities, published in February 2012, found that overall they are 1.5 times more likely to be a victim of violence than those without a disability, while those with mental health conditions are at nearly four times the risk of experiencing violence.

“The results of these reviews prove that people with disabilities are disproportionately vulnerable to violence, and their needs have been neglected for far too long,” notes Dr Etienne Krug, Director of WHO’s Department of Violence and Injury Prevention and Disability. “We know that specific strategies exist to prevent violence and mitigate its consequences. We now need to determine if these also work for children and adults with disabilities. An agenda needs to be set for action”.

Factors which place people with disabilities at higher risk of violence include stigma, discrimination, and ignorance about disability, as well as a lack of social support for those who care for them. Placement of people with disabilities in institutions also increases their vulnerability to violence. In these settings and elsewhere, people with communication impairments are hampered in their ability to disclose abusive experiences.

"The impact of a child's disability on their quality of life is very much dependent on the way other individuals treat them,” stresses Dr Mark Bellis, Director of the Centre for Public Health at Liverpool John Moores University, a WHO Collaborating Centre for Violence Prevention, and lead researcher on the review. “This research establishes that the risk of violence to children with disabilities is routinely three to four times higher than that to non-disabled children. It is the duty of government and civil society to ensure that such victimization is exposed and prevented."

Proven and promising programmes to prevent violence against non-disabled children and adults – reviewed in WHO’s Violence prevention: the evidence, Preventing child maltreatment, and Preventing intimate partner and sexual violence against women – should be implemented for children and adults with disabilities, and their effectiveness evaluated as a matter of priority.

The United Nations Convention on the Rights of Persons with Disabilities reinforces the need to protect the rights of children and adults with disabilities and ensure their full and equal participation in society. This includes avoiding the adverse experiences resulting from violence which are known to have a wide range of detrimental consequences for health and well-being. When prevention fails, care and support for children and adults who are victims of violence are vital to their recovery. The WHO/World Bank World report on disability outlines what works in improving health and social participation of people with disabilities and promotes deinstitutionalization.

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