community care services would need to be easy to get to and allow individuals to live in communities where they have support systems friends family social services and health care services and opportunities to work socialise and pursue interests when existing psychiatric inpatient facilities are geographically isolated or difficult to reach a transformation of their function to emphasise outpatient care will not help secure high quality communitybased mental health care to make this happen the japanese government will have to take a strong stance in other oecd countries where many hospital beds and institutions were closed they were stateowned for example in the united states and the united kingdom while in japan hospitals are privately owned the japanese government will have the difficult task of reducing demand for inpatient care by improving community services and reducing the incentive for keeping beds open by cutting back on reimbursement for inpatient care without access to appropriate outofhours care hospital care is the default option after pm which can drive up unnecessary emergency admissions