The analysis focused on inmates with acute and serious mental illnesses, as well as those with lower levels of disturbance. Responses came from 49 States, the Federal Bureau of Prisons, The Correctional Service Canada, Guam, and Puerto Rico. Results revealed great diversity in the management and treatment provided to inmates with mental health care needs. Corrections agencies generally devoted more mental health resources to inmates who met pre-determined criteria of mental illness or major mental health care needs than to those with lesser needs, regardless of the agency’s overall philosophy of care. Most agencies relied on a variety of staff positions to identify inmates with mental illness, usually during the intake process. All agencies reported using a psychopharmacological approach to treating mentally ill inmates. Forty agencies required all custody/security personnel to receive training on managing mentally ill inmates. Approximately 32 agencies also required training on managing inmates with other mental health needs. Twenty-two agencies provided inservice training on managing mentally ill inmates. Tables