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Writer's pictureDr. Leilani Sharpe

Psychiatric Hospitalization: "The Milieu"


Dr. Leilani Sharpe is a licensed and board certified psychiatrist in Santa Monica, California. She specializes in adult psychiatry as well as child psychiatry.

Almost all psychiatric hospitals have a large, open, lounge area that is shared by all patients. But instead of this space being called something predictable, like a lobby or a break area, most psychiatric hospitals refer to this space as the milieu.

One goal of this space is more obvious. It provides a place for patients to hang out and relax when they are not meeting with a member of their treatment team. Which makes sense, because no one wants to stay in a hospital room all day, every day. However, that still doesn't explain why psychiatric hospitals choose to use this somewhat odd, historical French term for an open area. Well, a milieu is, by definition, a physical or social setting in which something occurs or develops. To a psychiatric care team, the ability to observe and interact with someone in a more casual social setting is incredibly valuable. Many who are struggling with a decompensation from a psychiatric illness struggle with multiple aspects of social functioning, and the inpatient milieu provides a very helpful compromise. It's a place where patients can navigate interacting with others, solving social problems, and needing to make executive decisions. But a hospital milieu, compared to an area outside of the hospital, also provides the safety limits and supports of the hospital staff. As a result, the milieu is a critical tool in determining how a patient is doing overall and what other challenges might need to be addressed in a treatment plan.

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