Recently, the courts have recognized the right to a minimum level of mental health treatment for individuals confined in both mental and correctional institutions, utilizing a different rationale for each system. As mental health administrators in state mental hospitals accepted that they were responsible for providing an increased level of mental health services, they were disappointed that courts had subsequently ruled that individuals in state hospitals had a right to refuse treatment. The purpose of this paper is to elaborate, sociologically and legally, upon treatment refusal in the correctional system since most of the attention on treatment refusal has focused on individuals in state mental hospitals and since the legal status of inmates in correctional systems is different. An anlysis of the literature revealed that inmates in correctional institutions, similar to individuals in the state hospital system, have a limited constitutional right to refuse mental health treatment, and this right is unlimited when the treatment provided is considered by the courts to be in fact punishment.