The prevalence of schizophrenia in correctional settings is the product of numerous converging forces and is characterized by a vicious cycle of uncontrolled symptoms followed by joblessness, poverty, and social alienation. Effective treatment of schizophrenia in corrections environments may offer opportunities to attain long-term remission. Reasonable approaches are outlined to appropriate care. However, clinicians are required to adapt therapeutic processes based on the specific demands of their particular institution. To develop an effective approach in treating schizophrenia, clinicians must understand institutional cultures, avoid therapeutic nihilism, recognize the opportunities and limitations of patient advocacy, and devise meaningful quality improvement programs. This monograph describes key opportunities and practical strategies to interrupt the tragic cycle that often links imprisonment and schizophrenia. Figures, tables references, and appendix