When child maltreatment is reported and the child guidance center determines the necessity of separation of the child from his or her family, the child is taken into social protective custody such as child welfare facilities and foster family homes. The residential treatment center for emotionally disturbed children is one type of child welfare facilities. This facility is characterized by the practice of "comprehensive environment therapy", which makes use of the child's entire daily life in the facility as a means of providing treatment. Welfare, educational, psychological, and medical specialists cooperate to employ comprehensive environment therapy to treat children who suffer from psychological difficulties and inflictions.
 The conditions of children subject to social protection are becoming more complicated due to the increased reports of child maltreatment and the broadened views of neurodevelopmental disorders. Approximately half of the children in child welfare facilities have experienced maltreatment, and 20% have some kind of disorders. In residential treatment center for emotionally disturbed children, 70% of the children have experienced maltreatment, and an increasing number have been reported to have neurodevelopmental disorders. The number of residential treatment center for emotionally disturbed children in Japan is one-tenth of the number of child nursing homes and one-twentieth of the number of children under protective measures. There are 43 residential treatment center for emotionally disturbed children as of October, 2015, although more are being built. Some prefectures do not have residential treatment center for emotionally disturbed children. Management organization varies among facilities. It is a minimum standard that each facility is staffed by a doctor; however, full-time employment of a doctor is uncommon. The need for enhancement of capability for treating children in social protective custody at the residential treatment center for emotionally disturbed children has been demonstrated, but many difficulties must be overcome to achieve that goal.
 Nagano-ken Matsumoto Asahi Gakuen is a residential treatment center for emotionally disturbed children in 1967 as a prefectural facility. It was relocated and reconstructed and was privatized on April, 2011. I was assigned the position as a full-time doctor when the relocation took place. However, the facility does not function as a clinic. Children admitted to the facility are exposed to various problems such as maltreatment, parents with features of neurodevelopmental disorders, and fragility of family functioning due to psychiatric disorders of the parents and financial difficulties. The backgrounds of these children and parents must be frequently dealt with in clinical practice of psychiatry. The presentation reports the progress made in the 5 years since the relocation of Asahi Gakuen. Two cases are reported and the need for cooperation with psychiatrists is suggested.
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