Efforts to establish adequate mental health systems in U.S. prisons accelerated during the late 1970's as a result of successful class action lawsuits. These efforts have been assisted by the development of standards for correctional health care programs by various national organizations. Clearly established basic principles for the delivery of psychiatric services in prisons have been promulgated by the American Psychiatric Association and the National Commission on Correctional Health. Efforts to obtain financial resources for providing psychiatric services have been facilitated by the U.S. Supreme Court's determination that prisoners have a constitutional right to receive treatment for serious mental illnesses. A framework is described for establishing an adequate mental health care system in prisons. Basic principles for the delivery of psychiatric services in prisons are reviewed, as well as administrative models for such services, guidelines for correctional-based psychiatric treatment, and issues unique to correctional mental health care systems. 56 references