The number of inmates diagnosed and treated in correctional systems for mental health symptoms is growing at a rapid rate in both the United States and Canada. This survey was conducted to provide an overview of the numbers, staffing, treatment, medications, and release services as they related to inmates diagnosed with a mental illness, which for this survey is defined as a psychiatric illness or disease expressed primarily through abnormalities of thought, feeling, or behavior producing either distress and/or impaired function. The survey represents responses from 41 correctional systems in the United States, including the Federal Bureau of Prisons and 4 correctional systems in Canada, including Newfoundland, Nova Scotia, Ontario, and Correctional Service Canada. Survey highlights include: (1) 85 percent of responding correctional systems reported screening inmates for mental health symptoms at intake; (2) 45 percent of the United States reporting systems felt the number of mental health-related therapists they had was adequate for the identified population; (3) 95 percent of the United States reporting systems provide specialized training in managing mentally ill inmates; (4) numerous assessment instruments were being used to determine the risk of violence in inmates who have mental health disorders; (5) telemedicine applications were used in 21 of the reporting systems in the United States and not used in any of the reporting Canadian systems; (6) each of the reporting United States and Canadian systems incorporated numerous options for treatment and other aftercare assistance for those inmates with mental health disorders; and (7) 95 percent of the reporting United States and all of the Canadian reporting systems supply medications to their mental health inmates upon release. Tables