As of 1994, over a quarter million people with mental illness were incarcerate in the United States (Bureau of Justice Statistics, 1999). Increasingly, mentally ill offenders, especially those who are minorities or of low socioeconomic status, receive their primary and in many cases only mental health care while incarcerated. In a related trend, a significant number of mentally ill prisoners Are being housed in a super- maximum custody conditions such as Intensive Management Units (IMUs). These units are the most restrictive form of confinement in the correctional system, where inmates are locked in solitary cells twenty- three hours daily.