The traditional response to mental illness in prison has been transfer to a State mental hospital or placement in a segregation unit along with inmates being punished and those viewed as escape risks. Mentally ill persons are less capable of managing the stressful transition to prison and more likely to become victims. This adjustment crisis produces both physical and psychological isolation which, in turn, limits access to needed services. Correctional institutions also contribute to the emergence of major psychiatric disturbances in persons who cannot manage adjustment and survival pressures. Prison mental health workers are often frustrated by their lack of control over the facility's size and population, daily living conditions, and access to jobs and training. The prison therapist faces other special problems involving confidentiality, responsibility for writing psychiatric evaluations for prerelease reports, making difficult choices between a client's short-term and long-term interests, and conflicts with correctional administrators over treatment methods. An active transfer policy for treating mentally ill inmates requires institutional diagnostic services and access to outside hospital beds. An in-house approach is used by Connecticut in its Somers prison. The mental health staff has grown to six full-time clinicians, five part-time psychiatrists, a secretary, student interns, and volunteers. The primary component is the 21-bed Transitional Treatment Unit which operates more like a halfway house to assist inmates gradually adjust to the demands of prison life. The paper includes 4 footnotes and 13 references.