In this episode of The PSC in Conversation - The Next 20, Harris Lorie speaks with Mikoto Nakajima about the challenge of out of area placements in mental health – why they are so damaging for patients, families and staff, and what it takes to reduce them in practice. Reflecting on work with Sussex Partnership NHS Foundation Trust, they explore how operational improvement, clinical innovation and relational care came together to eliminate inappropriate out of area placements, create more hopeful, connected cultures of care, and what mental health care provision could look like in the next 20 years.