there are also payments related to placement of nursing staff for overnight staybased training for independence support and placement of health care professionals for disability welfare services and they make it possible for individuals to live in the community while receiving healthrelated support nursing outreach visits and community oriented services in private hospitals and clinics have been established in order to support early discharge the numbers of psychiatric day care centres private psychiatric outpatients clinics and social rehabilitation facilities have also increased in addition the mhlw provides subsidies for child mental health care network projects implemented by prefecture however there is a shortage of hub hospitals which specialise in care for children s mental health with just hospitals with specialised child and adolescent wards across japan hikikomori a group identified in japan generally understood to be reclusive adolescents or young adults who withdraw from social life often seeking extreme degrees of isolation and confinement are a particular cause for concern