According to the mental health and welfare data, the implementation of seclusion and restraints (SR) in Japan is increasing, and this is recognized as an urgent issue that should be prioritized from the policy perspective. Among many factors inherent to this issue, treatment culture accounts for a major part, but it is difficult to grasp this through fact―finding surveys. The core strategy developed in the United States aggregates measures to minimize SR, and has achieved positive results in several countries, but its spread in Japan is still in progress.
 Against this background, we conducted a study titled "Research on the spread of effective strategies for minimization of SR in psychiatric practice". From the results of a questionnaire completed by nurses, activities in Japan to minimize SR are insufficient, and staff shortage is a decisive factor. Despite on-site workers' awareness of the problem and desire for improvement, knowledge, learning opportunities, and systems were found to be limited, as is awareness of the importance of administrative involvement. For this reason, we attempted to build a monitoring system that utilizes mental health and welfare data. Further, based on achievements in other countries, we developed a "policy package" as a specific deliverable, consisting of a disseminatable tool for effective SR minimization with administrative support. As a result, we clarified the specific situation in Japan regarding the issue of minimizing movement restrictions, and proposed measures likely to be effective, with maximum use of scientifically grounded knowledge and insight. While acknowledging the importance of the perception of the person in charge of administration, we hope that continuing efforts to spread these ideas will promote appropriate minimization activities and achieve positive results.
 Related to this, we also introduced our approach to minimizing SR. In "Zero restraint", leadership was used to promote organizational reform, which led eventually to the permeation of activities and awareness changes at the individual level, indicating a culture change along with effectiveness. Early occupational therapy is an intervention that starts during the intensive care period, which requires SR. It has been shown to be feasible, and to integrate treatment, improve assessment accuracy, reduce the burden on patients, and increase willingness to participate in treatment, testifying to its significance.
 Author's abstract