Variations in Mental Health Courts: Challenges, Opportunities, and a Call for Caution Steven K. Erickson, J.D., L.L.M., Ph.D. Amy Campbell, J.D., M.Bioethics J. Steven Lamberti, M.D. ABSTRACT: Mental health courts have quickly proliferated in the United States and represent an attempt to expand legal leverage and enhanced treatment access to select persons with severe mental illness who are also involved in the criminal justice system. A national survey of mental health courts has begun to elucidate the procedural, clinical, and operational aspects of these courts and the defendants they adjudicate. A secondary analysis of survey data was performed to determine the similarities and differences among these courts. Results revealed large variability among existing mental health courts across multiple domains. The implications of this variability are discussed in terms benefits and limitations. KEY WORDS: mental health courts; diversion; law. INTRODUCTION Over the course of the past decade, there has been growing momentum behind use of courts to promote outpatient mental health treatment (Watson et al., 2001; Poythress et al., 2002; Kaye, 2004). Most Steven K. Erickson, Amy Campell, and J. Steven Lamberti are affiliated with the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. Address correspondence to Steven K. Erickson, J.D., L.L.M., Ph.D., Department of Psychiatry, BOX PSYCH, University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14620, USA; e-mail: steven_erickson@urmc.rochester.edu. Community Mental Health Journal (Ó 2006) DOI: 10.1007/s10597-006-9046-7 Ó 2006 Springer Science+Business Media, Inc.