The author reports that the prevalence of mental disorders among prisoners is at least five times the rate in the general population, that a large proportion of inmates with serious mental disorders are ignored by the clinical staff, and that those who do receive treatment do not receive adequate attention. In addition, harsh prison conditions cause even more inmates to experience breakdowns or commit suicide; inadequate diagnosis and treatment of mental illness also leads to more severe and chronic cases. The discussion also focuses on the impacts of racism, rape and posttraumatic stress disorder, lack of contact with loved ones; the special problems that female inmates experience; and the prison and jail suicide rates that are twice as high and nine times as high as those in the general population. The final three chapters examine the possibilities and limits of litigation, recommendations for treatment and rehabilitation, and policy changes to reduce the use of incarceration and to change prisons into institutions that respect human life and the constitutional rights of all citizens. The author is a psychiatrist and co-chair of the Committee on the Mentally Ill Behind Bars of the American Association of Community Psychiatrists. Case examples, chapter reference notes, and index