A correctional policy of medically mandated, constitutionally guaranteed, and legally enforced mental health treatment for persons with mental illness sounds both humane and like good public policy. The widely assumed presumption is that such a framework exists and can be applied in correctional settings. Unfortunately, the piecemeal nature of current programs often interferes in addressing special offender populations such as persons with psychotic illness, sex offenders, psychopaths, substance abusers, domestic violence perpetrators, or any admixture thereof. This article concludes with a review of six cases that illustrate how clinicians, line staff, and administrative personnel in a typical prison milieu manage to finesse treatment under challenging conditions.
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