Following their concerns that physicians across the Japanese health system were not able to identify signs of psychological distress which could help reduce suicide, the Japanese Medical Association reports that they began sharing information and guidance on depression with all doctors, first in 2004 and then again in 2009. At present, only indicators on the rate of seclusion and restraint, and involuntary admission, are collected by providers and at a Prefectural level. Systematically collected information on the mental health care system is limited to structural indicators - facilities, staff numbers, bed numbers.