The immediate pressures that have led to the development of the mental health court strategy include crises in community mental health care, the drug epidemic of the 1980’s and 1990’s, the major increase in homelessness over the last 2 decades, and widespread jail overcrowding. Each of the mental health court jurisdictions has responded to both the problems experienced by persons with mental illness in overcrowded jails and the relatively common co-occurrence of mental illness among the large numbers of drug abusers in the criminal justice populations. Common features of the four mental health courts are that they are voluntary, and they accept only persons with demonstrable mental illness likely to have contributed to their involvement in the criminal justice system. They share the objective of preventing the jailing of the mentally ill and/or of securing their release from jail to appropriate services and support in the community. Each court gives a high priority to concerns for public safety in arranging for the care of mentally ill offenders in the community. The four courts differ from each other in important respects. The issues raised by the emergence of this court model include early identification of candidates for the mental health court, conflict between criminal justice and mental health treatment goals, definitions of success, and others. These courts represent important court-based community justice initiatives, are strengthening the effectiveness of community mental health treatment approaches by offering their close attention and supervision, and are returning mentally ill persons from criminal justice processing to the community to function there. Figures, footnotes, and 34 references