Nearly half of the incarcerated population experience mental health problems. Service use, however, is rare. There may be benefits for individuals who continue treatment upon incarceration (i.e., fewer or less intense pains of imprisonment). Researchers suggest that effects of treatment may differ by gender; distinct barriers to services may exist and accessing treatment may have unique effects on experienced strains. No study to date examines whether continuation of services protects at-risk groups from in-prison strains, and whether these effects are gendered. This article examines the effects of service utilization using a nationally representative sample of inmates. Results indicate that effects of continued service use vary, protecting women against some in-prison strains. Implications for theory, research, and policy are discussed.