A/HRC/40/50 shortages of schools, inadequate facilities, insufficient qualified teachers and a lack of learning materials, are just some of the reasons for this situation. 32 120. Although education facilities are required to be child-, disability- and gendersensitive and to provide safe, non-violent, inclusive and effective learning environments for all,33 school violence against students with disabilities – by teachers, other staff, and fellow students – is common. Students with disabilities often become the targets of physical and verbal threats, and abuse and social isolation. Their risk of being bullied can be high, and they may prefer to attend special schools because of the fear of stigma or bullying in regular schools. In this regard, the attitudes of teachers are critical in valuing diversity and providing a safe and supportive environment, and in ensuring the genuine participation of children with disabilities in school and classroom activities. 121. In some communities, disability is perceived as a curse, a source of shame for the family and a misfortune. At times, it is believed to be the result of possession by evil spirits, and the child’s liberation is thought to be achieved through starvation, exposure to extreme heat or cold or to fire, or severe beatings. As a result, under pressure from influential actors in the community, “mercy killings” may take place to put an end to the child’s perceived suffering. 122. When used as beggars, children with disabilities are subject to violence to keep them on the streets, and they may suffer physical abuse to attract attention and encourage charity. 123. Exposure to such situations of violence can have serious consequences on the mental health of children with disabilities, leading to an increased risk of low self-esteem and depression; post-traumatic stress disorder; anxiety; hallucinations and memory disturbances; sleep and eating disorders; health-risk behaviours, including substance abuse; and self-harm and suicidal ideation. 124. For adolescents, these risks may be particularly high, as half of all lifetime mental health disorders appear by the age of 14, depression is the primary cause of illness and disability among adolescents, and suicide is the third leading cause of death. 34 125. According to a UNICEF review35 in industrialized countries, there is a close link between adolescents’ mental health and the experience of bullying, and between mental health and health-risk behaviours. That study notes that the proportion of children and adolescents with mental health symptoms is on the rise, and on average, almost twice as many girls as boys reported symptoms related to their mental health at 13 and 15 years of age. 126. Despite their importance, mental health-related services for children often receive inadequate budgets and lack good-quality standards of care and staffing, thus creating an environment where abuse is common. 36 But for children with an intellectual disability, institutionalized approaches, including in psychiatric institutions, and excessively medicalized practices, may seriously compromise their development and well-being.37 127. Placing children with disabilities in institutional care can have devastating consequences. Children lack the caring support, stimulation and social engagement that are crucial to their health and development; they also often experience isolation and overmedication. In many cases, staff are ill-trained and ill-paid and are also undervalued and stigmatized by the community. At the same time, children are at increased risks of physical violence and of verbal and emotional abuse, and may be subjected to violence as part of their purported “treatment”. In some cases, drugs may be used to control children’s behaviour and make them more compliant. 38 32 33 34 35 36 37 38 18 See www.who.int/disabilities/world_report/2011/report.pdf. Target 4.a of the Sustainable Development Goals. A/HRC/32/32, paras. 67–73. See www.unicef-irc.org/publications/pdf/IRB_2017_12.pdf. A/HRC/35/21, para. 74. Ibid., para. 62. Available at www.unviolencestudy.org, p. 188.