The English "ward-in-a-house" for new long-stay patients (NLS) is described. NLS are usually defined as (a) aged between 18 and 65, (b) continuously in hospital for between 1 and 5 years, and (c) individuals for whom it has not been possible to find alternative accommodation outside hospital, despite repeated attempts to do so. The "ward-in-a-house" combines the best features of high quality hospital care with the best features of community-based residential units. The "Koike-dormitory" which was set up more than 20 years ago in Maebashi city had many of the characteristics of the English "ward-in-a-house" and this is also described. The possibility of developing a "ward-in-a-house" in Japan is then discussed.