This study explored determinants of perceived need for care among male inmates of general prison wards in Amsterdam (N = 208) with a normative need for care. Also, it assessed the relation between perceived need for care and criminal recidivism. Normative need for care was defined as having a mental health problem, assessed with the Brief Jail Mental Health Screen, or being substance dependent. Perceived need for care was defined as a subjective problem experience and a wish to receive care. Mental health and/or addiction problems were highly prevalent (68%). Of those inmates, only 29% had a perceived need for care. Age and borderline personality disorder were associated with perceived need for care, prior care utilization intermediated these associations. No direct relation between perceived need for care and criminal recidivism was observed. All inmates should be well screened and the benefits of mental health care should be promoted.