Challenges in Developing an Inpatient Psychiatric Program for Patients With AIDS and ARC

The presence of patients with AIDS and AIDS-related complex (ARC) on a psychiatric unit requires education of and adaptation by staff and otber patients as well as changes in the psychiatric milieu. The authors describe their experiences with 36 AIDS and ARC patients admitted to a psychiatric unit over an 18-month period. They address issues related to staff reactions to terminal illness and to increased demands to provide physical care, milieu management that takes into account the limitations of AIDS patients suffering from dementia, diagnostic complications arising from mixed psychopathology in some AIDS patients, and the increased susceptibility of AIDS patients to side effects and toxicity from psychotropic medication. Other issues relating to infection control, ethical concerns, needs of friends and family, and disposition planning are also discussed.