Based on 2005 to 2014 data from the National Violent Death Reporting System, this study examined mental health treatment status of suicide decedents in correctional settings, focusing on those with prior/recent suicide ideation/plans/attempts. Of all decedents (N = 1,727), 30% had prior/recent suicidal ideation/plans/attempts, and of them, 64% had not received mental health treatment while incarcerated. Multivariable analysis showed that those with past-month crime/violence (as a proxy for recent incarceration) and those with an alcohol problem had higher odds of not having received treatment. Coroner/medical examiner and law enforcement reports show that other life stressors and fear of jail environment contributed to despair. The findings underscore the importance of suicide risk screening at or shortly after incarceration and providing necessary treatment and support.