Impact of AIDS-related cases on an inpatient therapeutic milieu

As more individuals whose lives are affected by acquired immune deficiency syndrome (AIDS) begin to need psychiatric hospitalization, psychiatric staffs must be prepared to handle the strong feelings aroused by the disease. The authors present case vignettes of four patients with AIDS-related problems admitted to a voluntary acute-stay ward of a teaching hospital. They then discuss the largely indifferent reaction of the other ward patients to the AIDS-related patients, the tense and fearful reaction of the staff, and the subsequent interruption of the usual functioning of the therapeutic milieu. To develop an optimal management plan, the authors recommend attention to specific principles of patient and milieu assessment.