During the last few years there has been a tremendous rush of policy development and activity in prison mental health services, conveying the impression that great improvements are in progress. However, what is seen is the intractability and scale of the problem of mentally disordered individuals in prison as much greater than assumed. This article provides a review of the literature which indicates that the prevalence of mental disorder in prisons has remained high and there continues to be intractable difficulties in achieving more transfers. In addition, the article references three studies in order to illustrate the failure to substantially reduce the level of morbidity in prisons. The first study, in 2001, evaluated Close Supervision Centers which were designed to deal with the most dangerous and uncontrollable men in the dispersal prisons. The second study was a national study of access to medium secure care. Lastly, the third study concerned community services and the pervasive problems in delivering basic mental health care to prisoners. The article concludes with a discussion of National Health Service (NHS) policies. The current NHS policy states that individuals should have written care plans that include suitable occupational activity, adequate housing, and appropriate entitlement to welfare benefits; a requirement that should hold for those individuals with mental illness in prison. Today, there continues to be a gap between the policy aim of moving the mentally disordered from prison and the means of achieving it. References