The Eighth Amendment of the U.S. Constitution prohibits “cruel and unusual punishment.” Federal and State governments must provide the necessities of life to individuals in custody. Eight key legal cases have occurred between 1974 and 1995 that have determined the quality of care to inmates. To avoid litigation, correctional systems must provide three key elements: access to care, proper treatment, and qualified staff to provide for and monitor care. Common problems found placing correctional systems at risk of constitutional violations and possible litigation include lack of training of security and treatment personnel, inadequate cooperation and communication between treatment, security and administrative staff, and lack of policies and procedures on placement and followup. Both large and small correctional systems, jails, and prisons are challenged with managing bad behavior. Behavior resulting in disciplinary infractions in offenders with mental illness raises the question as to whether infractions of the rules resulted from the mental illness or mental illness is a contributing factor. Several questions must be addressed regarding the disciplinary process for mental health offenders in administrative segregation. Opportunities exist for mental health input and assessment at the misconduct issuance level, supervisory review level, and/or hearing officer level. However, policies and procedures often have unclear definitions for what constitutes mental illness and criminal responsibilities for mentally ill offenders. The question in the end is whether correctional systems will be prepared to state that they are giving the best care possible to these difficult-to-manage inmates based on lessons learned. References