The Milieu Rating Scale developed at North Star Hospital allows staff to anticipate behavioral problems and respond decisively and immediately. Since a stable community is necessary for effective treatment to take place, the scale ensures superior patient care. Patient anxiety is reduced under a staff that is confident that they have control and are aware of inappropriate and secretive behavior. Use of the scale allows better staffing patterns, justification for acuity, control of expenses, and the opportunity for staff to identify potential problems. The scale also involves the patient community in determining positive and negative re-inforcers.