Mental health courts are emerging in communities across the country to address the growing number of individuals with serious mental illness in jails and the complex issues they present to the courts. Based on concepts of therapeutic jurisprudence and patterned after drug courts, mental health courts attempt to prevent criminalization and recidivism by providing critical mental health services. The authors describe mental health courts in Broward County, Florida; King County, Washington; Anchorage, Alaska; and Marion County, Indiana. Each of these courts is designed to meet the specific needs and resources of its jurisdiction. The courts' experiences suggest that involving all players from the beginning is essential. The authors discuss the issues of due process, availability of services, and control of resources, which must be addressed before mental health courts are widely implemented.