This thesis aims at examining the processes that produces long-term placement of children and adolescents with mental disabilities in the shelter care facility network. The author begins hers analysis with the description of her own professional experience, driven by the contributions of Erving Goffman and Franco Basaglia. She introduces the concept of hibridismo assistencial (the idea of social assistance as an entangled reality) to analyze the problem of institutional disability looking at the interconnection between the areas of psychiatry and social work. Taking as her field of study the network of special purpose shelters (intended exclusively for children and youth with disabilities) in the State of Rio de Janeiro, the author combines quantitative and qualitative methodologies to analyze the current situation of the shelter care system for children and adolescents with disabilities, with the following corpus of analysis: (1) elements of the Brazilian historiography of child psychiatry, with reference to an analysis of the concept of power based on Michel Foucault. Under this perspective, the author discusses the historical figure of the Bourneville School - an institution linked to the National Asylum for the Insane and the founding landmark of the Brazilian child psychiatric for the hospitalization of the so called abnormal children, (2) Datasus data on hospitalization of children and adolescents with mental disabilities, highlighting the numerical dimensions of the problem, and (3) interviews with social agents connected to the System of Guarantee of the Rights of Children and Adolescents in the State of Rio de Janeiro, using as reference analysis the concepts of field by Pierre Bourdieu, and guardianship complex by Jacques Donzelot. Based on her study, the author concludes that: (1) there is a correlation between the existing shelters and the history of the institutionalization of children with mental disabilities as well as the presence of the ‘hybrid’ institution – the ‘shelter-hospital’, (2) the current policies aiming at closing down residential institutions have not included children and adolescents with disabilities, therefore it is necessary to critically review the concept of crônicos (chronically impaired) as referred to the young population that is hospitalized, and (3) based on testimonies of the social agents interviewed, it is possible to conclude that the presence of a disability becomes a factor of maximizing paternalistic practices. The author concludes her analysis linking some of the main issues to an agenda of academic and public interest, in an attempt to contribute to overcome old models centered on the long-term placement of children and adolescents with disabilities in institutions.