Incarceration in United States correctional facilities has significantly increased in the past decade (The Pew Charitable Trust, 2009). African American adult males are more likely to be incarcerated compared to all other major ethnic groups (U.S. Department of Justice, 2010). One of the current challenges experienced within correctional facilities is the need to provide appropriate mental health treatment services (U.S. Department of Justice, 2011). Studies have noted the need for such services, however, African American adult males generally are not likely to utilize these services (Morgan et al., 2004). In the general (not incarcerated) population, research has found that cultural mistrust (Ward, Clark, and Heidrich, 2009) and mental health stigma (Deane, Skogstad, and Williams, 1999) are barriers to utilization of mental health services by African Americans. However, there is insufficient research examining reasons why African American adult male inmates underutilize mental health services while incarcerated. The purpose of this study was to explore factors that influence African American male inmates’ decisions to seek mental health treatment while incarcerated. Twelve African American males who reported depressive symptoms at intake but who had not sought mental health services were interviewed. Topics explored in the study included (a) how participants defined and described symptoms of mental health problems, (b) participants’ experience of engaging in mental health treatment, (c) participants’ awareness of mental health treatment options during current incarceration, and (d) participants’ general views of mental health treatment for inmates. Grounded theory methodology (Strauss & Corbin, 1990) was used to analyze all data. Results revealed several major themes, including: descriptions of symptoms commonly associated with mental health problems, positive benefits of mental health treatment, and barriers to seeking mental health treatment while incarcerated (e.g., participants’ preference for alternative copings styles, a lack of trust and fear about mental health treatment staff). Participants’ narratives and the overall themes that emerged helped to provide an understanding of the reasons why African American inmates may or may not choose to utilize services in prison when experiencing symptoms of depression. Limitations of the study, as well as implications and directions for future research will be discussed