Semistructured interviews including questions about practices related to HIV risk assessment were conducted on 53 psychiatric units of general hospitals in New York State in 1992 and 1993. Few units have adopted practices across the board. Assessment of risk for many or almost all patients was reported by 25 units (47 percent). On three units (6 percent) all patients received information about HIV, and on 13 (25 percent) many patients did. Twenty units (38 percent) reported counseling only a few patients about risk, and eight (15 percent) counseled almost none. Twenty-eight (53 percent) urged only a few patients to get an HIV test, and nine (17 percent) urged almost none.