A/HRC/28/68 marginalized groups, including street children and children with psychosocial disabilities, are reportedly detained in these centres. 55. Similarly, the involuntary commitment of children with mental disabilities, including those who have long-term intellectual or sensory impairments, to psychiatric and social care institutions, psychiatric wards, prayer camps, secular and religious-based therapeutic boarding schools, boot camps, private residential treatment centres or traditional healing centres has been well documented. Such children may live their whole lives in such psychiatric or social care institutions (A/HRC/22/53, paras. 57 and 68). Article 14, paragraph 1 (b) of the Convention on the Rights of Persons with Disabilities unambiguously states that “the existence of a disability shall in no case justify a deprivation of liberty”. The Committee on the Rights of Persons with Disabilities has found that legislation that allows detention in a mental health institution on the basis of a standard of danger to self or others infringes this provision. Indeed, the Committee has repeatedly urged States to ensure that no one is detained against their will in any kind of mental health facility. 17 Furthermore, the Special Rapporteur has observed the continued use of solitary confinement and prolonged restraint of children with disabilities in psychiatric institutions. The environment of patient powerlessness and abusive treatment of children with disabilities in which restraint and seclusion are used can lead to other non-consensual treatment, such as forced medication and electroshock procedures (A/HRC/22/53, para. 63). 56. One of the most egregious forms of abuse in health and social care settings is unique to children. Numerous studies have documented that a child’s healthy development depends on the child’s ability to form emotional attachments to a consistent care-giver. 18 Children need more than physical sustenance; they also require emotional companionship and attention to flourish. Unfortunately, this fundamental need for connection is consistently not met in many institutions, leading to self-abuse, including children banging their head against walls or poking their eyes. In reaction, care-givers use physical restraints as a longterm solution, or hold the children in cages or their beds, practices that have been linked to muscular atrophy and skeletal deformity. 57. Another form of ill-treatment of children in health and social care detention settings is inappropriate medical care, including the use of psychoactive medications on children for punitive purposes, such as injected tranquilizers, which immobilize children for days, and forced labour in the guise of medical necessity. During one mission, the Special Rapporteur witnessed appalling conditions and ill-treatment of children with mental disabilities in socalled prayer camps, which are alternative residential facilities. He documented cases of shackling to the walls, floors or trees and forced fasting, in some cases on children with neurological problems (see A/HRC/25/60/Add.1, paras. 74-77). 58. Unsanitary and unsafe conditions may also lead to a violation of the prohibition of ill-treatment. The Special Rapporteur observes that overcrowding is present in many institutions, leading to severe constraints on institutional resources, shortages of adequate food, clean drinking water, bedding and medical care. Overcrowding also increases the risk of disease transmission and infection. Furthermore, adults and children are often not segregated in institutional facilities, leading to issues of exploitation. 17 18 12 See for example CRPD/C/AUT/CO/1 paras. 29-30, CRPD/C/SLV/CO/1 para. 31-32 and CRPD/C/AZE/CO/1, paras. 28-29. See Marinus H. van IJzendoorn et al., “Children in institutional care: delayed development and resilience”, Monographs of the Society for Research in Child Development, vol. 76, No. 4 (2011), pp. 8-30; and Rebecca Johnson et al., “Young children in institutional care at risk of harm”, Trauma, Violence & Abuse, vol. 7, No. 1 (2006), pp. 34-60.