Mental health courts (MHCs) are a popular type of problem-solving court, and there is ample evidence that they reduce recidivism and increase participation in community-based treatment. The authors summarize evidence for the effectiveness of MHCs and present findings from a study in which they identified and characterized 346 adult and 51 juvenile MHCs currently operating in the United States. The continued growth of MHCs will be based in large part on funding for services. The Affordable Care Act will have major consequences for services provided to this population, and its implementation may therefore affect the future of MHCs. The authors note that it is preferable that people with mental illness not become involved in the criminal justice system in the first place. Despite the success of MHCs, they are not a substitute for an adequate mental health system.