ABSTRACT Children who grow up in institutional care are usually separated from their families. Separation from families can have lasting negative effects on the physical, cognitive and emotional development of these children. The study aimed to explore the perspectives of caregivers about the health and psychosocial wellbeing of the new generation of Hill Tribe Children in institutional care. Data collection involves both focus group interviews and in-depth one-to-one interviews. Thematic analysis was applied to derive key themes from the data. Four themes emerged from the analysis, namely, (1) Persistent health problems, including lice, scabies, and dental caries; (2) Challenging emotional and behavioral expressions of Generation Z children, including physical and verbal aggression, emotional suppression, and fading social and cultural etiquette; (3) Tensions between discipline and children “s rights; and (4) Emotional fulfillment accompanied by exhaustion. Caregivers” perspectives highlighted the challenges of working with Hill Tribe children. Further training may be needed to manage the balance between addressing the evolving needs of a new generation of Hill Tribe children and preserving their cultural background.