Skip to 0 minutes and 13 secondsMorgon: Violence is a serious public health concern. Worldwide, violence is a major cause of death and injury, and can have long-term consequences on mental and physical health. Violence can also lead to disability. Violence can take many different forms. It may be physical, sexual, or psychological in nature, or may involve exploitation or neglect. While violence can affect anyone, people with disabilities are particularly at risk. For example, in a recent systematic review, it was estimated that one in four children with disabilities experiences some form of violence. Compared to their peers without disabilities, children with disabilities were three to four times more likely to experience violence.

Skip to 1 minute and 1 secondWhy do you think people with disabilities are more likely to experience violence?

Skip to 1 minute and 7 secondsThere are many different reasons why people with disabilities are more likely to experience violence. For example, discrimination and marginalisation of people with disabilities can lead to violence. Additionally, people with disabilities may be seen as easier targets by perpetrators, because they may face difficulties defending themselves, communicating what has happened to them, or being believed by authorities. Finally, lack of adequate care and support increases the risk of violence. For example, many children with disabilities are excluded from school. If their parents have to work during the day, they may be left without supervision, and therefore vulnerable to violence from others. As mentioned earlier, violence can have far-reaching impacts on health and well-being.

Skip to 1 minute and 54 secondsLet's look at two examples from studies conducted by the International Centre for Evidence in Disability that demonstrate some of the consequences of violence against people with disabilities. While these examples focus on children and young adults, most of these consequences of violence are applicable to people with disabilities of all ages. The first example is from the mother of a teenager with an intellectual impairment in Malawi. It says, "people beat him up, and sometimes he comes back home crying and with bruises on his face, and his body swollen from the beatings. He goes straight in bed, and cries himself to sleep." Here we can clearly see the impact of violence on physical health, as this man has suffered painful injuries.

Skip to 2 minutes and 37 secondsThere are also emotional impacts. This young man comes home crying and upset. Continued violence can lead to low self-esteem, depression, and anxiety. Let's look at another example. A girl with a profound hearing impairment in Nepal who recently dropped out of school reported, "I didn't like anything about school. I had no friends. Other children would lock me in a room and call me names. And my teacher would beat me because I couldn't understand what he was saying." Here we see how violence impacts social participation, as this girl is being isolated and excluded by her peers.

Skip to 3 minutes and 15 secondsThe violence she experienced at school from both her teacher and peers was a major reason for dropping out, which can have long-term economic impacts for her, as it will likely affect her ability to get a job. Finally, for both these cases, violence can have political consequences. If violence is not addressed, people could withdraw from their communities or lose faith in the people and institutions that are supposed to protect them. What do you think are some of the challenges to addressing violence against people with disabilities? A major challenge to preventing and responding to violence against people with disabilities is that services such as police, branches of the justice system, social welfare, and health care are often not disability inclusive.

Skip to 4 minutes and 2 secondsFor example, services rarely have strategies in place or resources available for working with people with different types of impairments. People with profound hearing and communication impairments face particular challenges due to difficulty sharing what has happened to them or receiving information if it is not provided in accessible formats. Another challenge is getting to key services. In many places, particularly in low and middle income countries, these services are located in urban areas. People with mobility limitations or who live in remote areas may struggle to reach services. Similarly, accessing services can carry costs. People may have to pay directly for services, or forego time and other activities to travel and attend services.

Skip to 4 minutes and 51 secondsAs people with disabilities are more likely to be living in poverty, meeting these costs is more difficult. Finally, just as discrimination and stigma increase the risk of violence, it is also a barrier to addressing violence. For example, violence against people with disabilities may be less likely to be reported, or cases involving people with disabilities may be de-prioritized by service providers. Still, there is some evidence of interventions that have been effective at reducing violence against people with disabilities. For example, the Good Schools Toolkit is a programme that works with students and educators to create safe and healthy school environments.

Skip to 5 minutes and 33 secondsIn a study in Uganda conducted by the London School of Hygiene and Tropical Medicine and Raising Voices, this intervention was found effective at reducing violence against all children while at school. Children with disabilities also benefited. Children with disabilities who were attending schools with this programme were about half as likely to experience violence compared to children with disabilities in other schools. While results from this intervention are promising, more work is needed to prevent and respond to violence against people with disabilities. Concerted action by policymakers, civil society, and researchers will be essential for implementing evidence-based policies and programmes to tackle the widespread violence faced by people with disabilities.

Violence case study

In the first of our case studies looking at health and wellbeing challenges for people with disabilities from different perspectives, Morgon Banks (LSHTM) presents data and case studies of violence perpetrated against people with disabilities.

In this video, she describes how different types of violence against adults and children with disabilities can affect their health and wellbeing, as well as solutions to minimise or overcome these risks.

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This video is from the free online course:

Global Health and Disability

London School of Hygiene & Tropical Medicine