In the past decades, several epidemiological changes have been observed in the demand for child mental health care with an increase in the number of visits as well as hospitalizations due to mental causes. These changes, together with the sanitary guidelines related to mental health, lead to the implementation of a mental health care unit at a pediatric hospital, which required the adjustment of the infrastructure as well as the professional resources available. The diagnosis of the situation and the sanitary context that led to the implementation of the care unit are presented. The performance/management indicators of the psychiatric unit for the period 2009-2015 are: hospitalization cause, psychopathological diagnosis and prolonged hospitalization cause. The hospitalization of children with mental disorders at a pediatric hospital occurs at the crossroads of two paradigms: mental health and pediatrics.