This report presents the results from a process evaluation examining the first three and a half years of the Manhattan Mental Health Court, a specialized docket for offenders with mental illness established in March 2011. Results from a mixed-methods research design found that the largest portion of participants (40%) were charged with property-related offenses. Seventy-three percent of participants were diagnosed as suffering from more than one serious mental illness and 63% were diagnosed with a co-occurring substance abuse disorder. Among the participants who were no longer active by the conclusion of the evaluation period, 55 had successfully graduated.