Over the past few years, mental health courts (MHC) have emerged as a new and innovative approach and tool for addressing the growing crisis of persons with mental illnesses incarcerated in local correctional systems in the United States. Since its inception in 1999, the MHC in the city of Seattle has provided services to over 1,000 individuals with serious mental illnesses and charged with misdemeanor criminal offenses. The intent of this evaluation was to set Seattle’s MHC in the national context of mentally ill offenders, document the evolution of the MHC and identify lessons learned, describe the MHC and evaluate its operations, provide preliminary findings for defendant outcomes, and examine the effectiveness and continued feasibility of the MHC. Report highlights of the findings and recommendations include: (1) MHC serves a designated target population; (2) for those MHC defendants studied, the number of bookings decreased subsequent to their MHC involvement; (3) even though the reincarceration rate for MHC defendants is approximately 62 percent in the first year, only 32 percent are reincarcerated for charges filed after MHC referral; (4) the average number of jail days served per booking increased if these individuals were re-booked into jail subsequent to their MHC involvement; (5) MHC effectively links mentally ill persons charged with misdemeanor offenses to needed mental health services; (6) participation in MHC is associated with major increases in the number of treatment episodes received after referral compared to the number received prior to MHC involvement; and (7) participation in MHC improve the likelihood of ongoing success with treatment, access to housing, and linkages with other critical supports. The findings suggest that the MHC provides a model unique from current practices with the potential to reduce the demand for jail services, yet promote positive outcomes. Tables and appendixes