 The patient population will consist of psychiatric inpatients at the Beth Israel Medical Center and the St. Lukes-Roosevelt Hospital Center, who meet criteria for the DSM-IV diagnosis of Bipolar Mood Disorder I, manic episode. At present, the patient ethnic and racial mix is 26 Hispanic, 30 African American, and 45 Caucasian. The gender distribution is 46 male, 54 female. The inpatient payer mix is 26 Medicare and 50 Medicaid. The average length of stay for the three units is 19 days for all patients and 26 days for patients without co-morbid substance use. 