This document describes the current situation faced by many children with mental and intellectual disabilities in institutional (including mental health and social care facilities) settings in different parts of the world. It provides information on the types of violations occurring against children with mental and intellectual disabilities in these settings, the consequences of institutionalization, and examines barriers and solutions in countries to address this situation. Using the international human rights framework, including the UN Convention on the Rights of the Child (CRC) and the UN Convention on the Rights of Persons with Disabilities (CRPD), the report provides guidance, based on promising practices from around the globe, on the key services and supports that need to be in place to ensure that children are able to live and thrive in the community.