There has been growing concern about the quality of health services, including mental health services, within the world’s and prisons. The purpose of the current qualitative interpretive meta-synthesis (QIMS) is to examine the prison environment and how it influences the mental health services delivered to prisoners. It is the hope of these authors that with this QIMS, knowledge improvements and modifications to current policies and practices can begin to take shape. A total of five studies published between 2003 and 2013 were utilized for this QIMS. Participants in all five studies included males and females incarcerated in England, Wales, and the United States. Three overarching themes were identified after analysis: difficulties with accessing services, difficulties with primary staff, and isolation. In each overarching theme, sub-themes are reviewed in detail. These three broad categories are discussed in relation to the person-in-environment system, demonstrating its application in an incarcerated setting.