A/HRC/57/47 of persons with mental health conditions or psychosocial disabilities among First Nations People in Canada. 65 The Assembly of First Nations conducted a disability poll that demonstrated the collective struggle of First Nations persons with disabilities to access culturally safe and accurate mental health assessments. 66 59. Indigenous persons with psychosocial disabilities also face significant challenges and violence throughout the world, including forced sterilization 67 and violence and abuse in mental health institutions,68 with Indigenous women and girls being particularly affected. 60. In some countries, persons with disabilities are required to have disability cards, which is particularly challenging for Indigenous persons with psychosocial disabilities because of the lack of an accessible system for persons with psychosocial disabilities. They are often unaware of the benefits that a disability card provides and, in addition, the distance to application centres, a lack of access to transportation and an inability for applicants to seek services on their own make them inaccessible. VI. Indigenous women with disabilities 61. WHO has highlighted that Indigenous persons with disabilities often experience multiple forms of discrimination and face barriers to the full enjoyment of their health, based on their Indigenous status and on disability.69 62. Indigenous Peoples as a whole experience disproportionately high numbers of persons with disabilities; Indigenous women are even more likely to have a disability than Indigenous men. Moreover, the barriers faced by both Indigenous women and Indigenous men frequently have a more devastating impact on Indigenous women with disabilities. In addition to the discrimination that Indigenous women face because of their ethnic origin, they are also subject to gender discrimination, which exposes them to a multitude of risks that are not present in the lives of their male counterparts. These include lack of access to sexual and reproductive health services, or sexual and reproductive health services that inflict harm rather than improve health, and a distribution of household resources that favours men. 70 In many States, Indigenous women with disabilities face additional obstacles due to the patriarchal prejudices and domestic violence.71 63. Girls with disabilities are far less likely to attend school than boys, women with disabilities are far less likely to be employed than men with disabilities, and both girls and women with disabilities are far more likely to encounter both sexual and non-sexual violence.72 In Australia, Aboriginal and Torres Strait Islander women with disabilities are at heightened risk of family and domestic violence. They experience poorer health and social and emotional well-being outcomes, substance misuse, suicidal behaviour, lower life expectancy, insecure housing, insecure employment and intergenerational disengagement with education. 73 One third of Indigenous women are raped during their lifetime, and Indigenous women with disabilities are four times more likely than other women to suffer sexual violence.74 64. Sexual and reproductive health services have a long history of subjecting Indigenous women, in particular those with disabilities, to forced sterilization. The Committee on the Elimination of Discrimination against Women has highlighted the gravity of discrimination 65 66 67 68 69 70 71 72 73 74 GE.24-12379 Submission from Canada. Submission from the Assembly of First Nations. Submission from the National Indigenous Disabled Women Association Nepal. Submission from the Tilioq, Greenland, and the Child Rights Institution of Greenland. Global Report on Health Equity for Persons with Disabilities (Geneva, 2022), p. 86. United Nations Entity for Gender Equality and the Empowerment of Women (UN-Women), “Indigenous women with disabilities”, fact sheet, 2020. Submission from Guatemala. UN-Women, “Indigenous women with disabilities”. Submission from Australia. UN-Women, “Indigenous women with disabilities”. 13