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 community-based 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 state-owned, for example in the United States and the United Kingdom, while in Japan hospitals are 90% 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 out-of-hours care, hospital care is the default option after 6pm, which can drive up unnecessary emergency admissions.