Incarcerated girls have disproportionately higher rates of physical, emotional, and sexual abuse compared with their nonincarcerated peers. Failure to address this trauma and abuse can lead to mental health disabilities such as anxiety, depression, post-traumatic stress disorder, and anti-social behaviors. Many girls who experience trauma engage in criminal behaviors as a response to these unresolved issues. The punitive nature of correctional confinement only exacerbates their mental health disabilities. This article examines the correctional confinement experiences for girls with mental health disabilities in the United States, where there is a large population of incarcerated girls, and Costa Rica, a country with fewer incarcerated girls. Policy changes are suggested to minimize the punitive nature of correctional confinement and to enhance the services and support systems available to incarcerated girls with mental health disabilities.